As we make our way through the holidays facing mounds of mashed potatoes and gravy, bottles of beverages – alcoholic and non-alcoholic – and plates of pies and birds and dinner rolls, we must stop to think about the picture we present to children and teenagers. Though our children may listen to what we say, they are more likely to watch what we do. When they see us in the gluttony mode during the holiday season, they are learning that it is OK to practice overindulgence for an extended period of time. Even worse, they probably will teach their own children to do the same.

This month’s column highlights the problem of childhood obesity and explores some ways that parents and others can reverse this troubling trend.

What Is Childhood Obesity?
There are many causes of obesity. Some aspects of obesity are genetic. Health conditions and medications can also contribute to obesity. However, the major causes of obesity are eating too much of the wrong kinds of food and not getting enough physical activity.

Obesity for children and adolescents is defined differently from the way we define obesity in adults. For adults, overweight in terms of body mass index (BMI) is defined as a BMI between 25 and 29.9. Obesity is defined as greater than 30.0. Children up to age 18 are not described as obese. They are either at risk of being overweight or are overweight. Their cutoff points for overweight depend on their age and gender. Visit the US Department of Health and Human Services at www.hsca.com/membersonly/USDHHSlink.htm to learn more about BMI in children and teens.

A Cultural Issue
Let’s face it: All cultures do not view obesity in the same way. Though individual preferences within cultures do exist, it is generally understood that some cultures more readily embrace overweight and obesity than other cultures. For some, a slim child may make a parent feel guilty and embarrassed that others might judge them for not feeding their child enough. They may feel that fat children are healthier children. They may think that fat children have a better chance of surviving illnesses. They may believe that fat children are more attractive than “normal” weight children. They may feel pride in being able to buy pizzas, fried chicken, and hamburger for their children from takeout joints or buffets on a regular basis.

Problems with Obesity
There is some truth to the fact that heavier children may have a higher chance for survival than thinner children, but that depends on the context. In this country before the mid-1900s, infectious diseases such as pneumonia, influenza (flu), and measles were high on the list for reasons why American children died. In those days, heavier child might have had a greater chance of surviving than lighter weight children. Likewise, today in areas of the world where war and famine are widespread or where the distribution of wealth is more uneven than many of us could imagine, thinner children may die sooner than heavier children. However, many children in the above scenarios were or are undernourished. Today in the United States, we have antibiotics and immunizations to combat infectious diseases. Now, a different problem affects our children. That problem is over-nutrition and obesity.

It is now understood that obesity contributes to chronic diseases such as type-2 diabetes, high blood pressure, heart disease, some cancers and arthritis. It has been estimated that because of obesity, our children may be the first generation in the history of this nation to have a shorter life expectancy than their parents. Though the obesity epidemic affects all races and ethnicities, it is especially prevalent in African Americans and Latin Americans. It is also affects those who live in poverty more than those who are not poor. Obesity may well be a major factor in health disparities now and in years to come.

Tools to Tackle the Childhood Obesity Epidemic
Last month the American Public Health Association held its annual conference in Washington, DC. A big focus of the conference was the obesity epidemic, including obesity among children and teens. According to statistics that the APHA gathered from the National Center for Health Statistics, one in five children in the United States is overweight. This is double the rate of the 1980s. The website of the APHA provides links to information and tools that can help families, teens, schools and others address this troubling epidemic. One such tool is titled, “Tools for Parents, Teachers, Students and Community Leaders to Eliminate Childhood Obesity.” Visit the APHA website at www.apha.org/programs/resources/obesity/ to access these links.

Physical Activity in Childhood: Contrasting the Past and Present
It should be noted that though good nutrition is an important part of addressing the obesity problem, increased physical activity is equally important. If you are over the age of 30, flash back to the time when you were in grade school. Do you remember how you could run free around your neighborhood all day during the summer? Do you remember bypassing the bus stop to walk five or six blocks to visit your school friends to play or to study together? For those who were raised in Washington, DC, do you recall how in elementary school, most students attended neighborhood schools where they walked a few blocks, with parents or with schoolmates, to attend school?

Fast forward to the present: Crime in the city (or the perception of crime) makes so many parents keep their kids inside the house. Kids cannot be kids the same way older folks could when they were young. Schools now focus on teaching to the test. Our children may learn to be excellent test takers. However, talented test takers do not necessarily evolve into critical thinkers. What about recess and physical education or gym? How many times have schools sacrificed the arts and physical education for more time to cover facts that may or may not contribute to the scholarly growth of our children?

Stress and boredom have been shown to contribute to overeating and to obesity. Physical activity addresses both these issues. Organized sports for children and teenagers have health benefits and also psychological benefits. A relaxed child can learn better. Family activities such as strolling through the neighborhood or around a mall can benefit children.

For those who want to establish a family tradition, why not have one or two nights per week where there is a family dance affair? Family members, young and old, can put on their shoes and/or socks and do a family shuffle. The music can vary – oldies-but-goodies, hip hop, children’s songs, praise songs and hymns. Getting everyone moving is the key. Switch off the television for 20-30 minutes and turn on the music. You will be planting happy and fun memories for your children. Your children’s health and behavior may benefit from the stress-reducing advantages of physical activity. Check out the United States Department of Agriculture’s website at www.mypyramid.gov (click on “For Kids”) to see how MyPyramid for children not only focuses on good nutrition, but it also spells out what types of physical activity children should engage in during a typical week. There are interactive games as well as posters and other resources. Parents and other adults can gather information for themselves and for their children.

Dr. Harris (PhD, MPH, RD) is assistant professor at the University of the District of Columbia. Her focus is public and community health through education, information, and research. Contact her at bharris@udc.edu.