Dr. Jacqueline Gerhart: Childhood Obesity Has Many Causes
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that usually appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I work in a café and constantly see kids ordering frappuccinos and sugary smoothies. Can you please write about childhood obesity for families who may not know?
Dear Reader: First, definitions: According to a 2007 article from the journal Pediatrics, "overweight" is defined as having excess body weight for a particular height. This extra weight can be from fat, muscle, bone, water, or a combination of these. "Obesity" on the other hand is defined as specifically having excess body fat.
In the medical community, we often measure obesity by calculating the body mass index (BMI). For patients less than 20 years of age, there is an online calculator to determine a child's BMI. For patients age 20 and older, a BMI of 25 or higher is considered "overweight" and a BMI of 30 or higher is considered "obese." BMI is not perfect. It measures your weight compared to your height, but doesn't take into account body composition. So, if you are a well-trained athlete with large muscle mass, your BMI may state you are overweight – when in reality you are quite fit. But, in most situations, BMI is an inexpensive way to gather weight information on populations – and to determine if our nation is becoming "fatter." Furthermore, it helps us to discuss risks with individual patients, since studies have shown that a higher BMI can be associated with increased risk of diabetes, high cholesterol, heart disease and stroke.
The state of our nation: Regarding our children, a recent 2014 study in the Journal of the American Medical Association states that teenage obesity has quadrupled over the last 30 years, and that as of 2012, 17 percent of children are obese, and 21 percent of adolescents are obese. Plus, over one-third of our children are either overweight or obese.
The cause is multifactorial. As you mention, there is much media, pop-culture, and even socialization surrounding certain types of foods. For example, a "pizza party" is more common than a "salad party." And you are more likely to see a parent sipping a latte than you are carrot juice. Bottom line: For kids to eat less junk, they need to be exposed to less junk. Less on the media, less in your pantry, and less in the hands (and mouths) of their parents and friends. Furthermore, a balanced diet and healthy exercise are key.
For more info on how our country is approaching diet and exercise in children, check out the "MyPlate" initiative and the "Let's Move" initiative. For more information about our nation's obesity epidemic and what is being done about it, check out the HBO miniseries called "The Weight of the Nation."
One quick disclaimer — getting kids to eat healthy can be very hard. And sitting a child in front of the TV can sometimes be the "easiest" answer to keep them busy. Just remember – it's all about balance. You may catch yourself throwing your hands in the air saying, "Fine. Eat mac and cheese for the third day in a row!" Forgive yourself and your child. And then start over again thinking of small ways you can make your child's life healthier.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 03/19/2014