It's not secret that we are in the midst of an obesity epidemic. We're eating more and exercising less, and it's especially evident in kids. Since 1999, childhood obesity rates have steadily climbed from 13% to 17% in 2017. With the influx of technology and the decrease of physical activity in schools, along with America's obsession with fast-food, there are a lot of factors to blame. Comorbidities associated with obesity, such as high blood pressure and type-2 diabetes, are similar in children as in adults, thus being overweight during childhood means comorbidities will worsen for an additional one to two decades. Obesity during childhood is also a key predictor for obesity in adulthood, and risk of mortality is still increased in previously overweight adults even if they lost the weight. It is vital that we take action to prevent and treat childhood obesity.
When I was a kid, I played outside all day log, and most of my friends would say the same. Now, it's almost a rare sight to see kids running around outside. Instead, they sit on the couch with a controller in their hand, and hanging out with friends means sitting in the same room while everyone is on their cell phone. In our fast-paced, on-the-go world with a McDonald's on every corner, fast-food is often a normal part of a child's diet.
A McDonald's meal tyically ranges from 600-1800 calories. In 60 minutes of continuous exercise, a 75 lb child will burn 120 calories bicycling, 180 calories walking, 240 dancing, and 700 running. Notice how the energy expenditure does not nearly cover the energy intake from the fast-food. Not to mention, in 2015, data revealed that among U.S. high school students, only 17% of girls, and 36% of boys were physically active for at least 60 minutes a day, and only half of all students attended physcal education classes once a week.
Klass Westerterp, an expert in energy metabolism, physical activity, food intake and body composition, says that the key to maintaining a healthy body is to PREVENT weight gain. It seems obvious, but people often do not think like that and assume that if they gain weight it will be okay because they can just lose the weight. Westerterp says that it is relatively easy to maintain or gain weight, but is nearly impossible to lose weight indefinitely. Yes, many people do have success at losing weight, but it is significantly harder to lose than to gain or maintain. He says the best way to keep kids at a healthy weight is to keep them physically active. This helps them build a necessary muscle base. Muscle is metabolically active, so having more muscle means you will burn more calories at rest. Muscle mass declines throughout adulthood, so it is important to establish a good muscle base during childhood/adolescence to sustain them into adulthood. This means they can maintain their weight on a higher amount of calories, thus, overeating is less of a concern.
There are three levels of prevention we must consider:
1. primordial prevention - taking action to maintain a normal BMI throughout childhood and adolesence
2. primary prevention - preventing overweight children from becoming obese
3. secondary prevention - treating obese children to reduce comorbidities and reverse the obesity, if possible
In addition to increasing physical activity, obesity prevention emphasizes increasing intake of plant-based foods and reducing high-calorie foods. To prevent children from becoming obese, mothers need to be careful not to gain too much excess weight during pregnancy, as this is a risk factor for childhood obesity. This means getting good prenatal nutrition and working to lose weight postpartum. During infancy, it is recommended that children do not get introduced to solid food until after 6 months of age and then are provided a balanced diet with limited high-calorie snacks. Preschool is a vital time to experience with different foods and flavors to expand their palate, making them more likely to enjoy the taste of healthy foods. During childhood and adolescence it is important to supply nutrition education and encourage daily physical activity.
Providing good nutrition and exercise is crucial during childhood to establish a solid foundation for life. Preventing obesity is much easier than treating it. If we can prevent it by encouraging healthy behaviors early on, we will have the greatest chance of successfully reversing the obesity epidemic we are currently facing.
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