Fighting Childhood Obesity At Home

Let me preface this post with a quick warning.  My encouragement for the improvement in the dietary and lifestyle decision making of our children may be redundant, but I whole heartedly believe that we are responsible for our future and we all need to participate in creating happy, healthy and active kids.  Also, as someone who was lovingly referred to as “little fat Matt” as a kid, this issue and creating widespread change is particularly relevant to what I wish to accomplish on a large scale.  So, consider yourself warned.  This is another post on childhood obesity and what we can do to reverse the trend that is overwhelming our youth.

The stark reality of the situation is that the health of our nation’s youth has been in steady decline for a great while now and, although the government has set some pretty specific goals aimed at reducing childhood obesity, the majority of the influence needed to create widespread change should be generated closer to home.  Parents are the primary source of influence in encouraging healthy lifestyle habits and reducing sedentary behavior, which is of particular importance in helping to reach the recommended caloric “energy gap” (calories consumed > calories expended) reductions necessary to halt and reverse the onset of childhood obesity.  Although I am generally a proponent of “bottom-up” change initiatives and I am heartened by  the proposed federal dietary recommendations, children are generally at an intellectual disadvantage in their understanding of nutrition and the federal approach in nutritional intervention may neglect cultural and familial interactions where parental influence and knowledge is paramount.  While that last sentence may have been too wordy, lets just say that adults are the most capable “change agents” and need to encourage lifestyle modifications by participating in the health and wellness of our youth.

Since the early 1970’s, average BMI (body mass index) and weight have increased .5 and 1.5 kg (3.3 lbs), respectively, per decade in U.S. youth and it is projected that the prevalence of childhood obesity will reach approximately 21% by 2020 if this trend continues.  In order to halt this alarming growth rate, Healthy People 2020 (a U.S. Health and Human Services initiative.  Press release here. Website here) established the need to eliminate 41 calories per day to halt the rise in body weight and reduce the “energy gap” by an additional 23 calories daily if we wish to reverse the trend.  Suggested public policy strategies that can help accomplish this total caloric reduction of 64 calories a day include: removing all sugar-sweetened beverages from schools to reduce caloric intake, increased energy expenditure through physical education programs and domestic reductions in “screen time” (time spend watching TV and playing video games) 1.  Again, I applaud the federal effort in encouraging change, but I believe that parental and peer influence can generate the most change in the “energy gap” dilemma based on familial intimacy and a thorough understanding of established cultural norms that determine a great deal of what is practiced within the home.

In fact, a recent study published in the American Journal of Health Prevention reinforces the importance of parental intervention in encouraging and supporting healthy lifestyles.  According to the study, involvement in nutrition education, encouragement of exercise and family participation resulted in a reduction in sedentary behavior, which is a significant factor in childhood obesity 2.  Beyond parental encouragement, the Institute of Medicine is asking every single American (those with and those without children) to become involved in changing the way Americans approach exercise and nutrition.  By integrating physical activity every day, promoting healthy lifestyle choices, increasing availability of healthy foods and encouraging schools and health care professionals to facilitate change, we can collectively “reinforce, amplify, and maximize” change 3.  I agree with this “all hands” approach and can attest to the idea that informal relationships can play a great part in encouraging change.  Chief of the IOM committee that issued the plan, Daniel Glickman said it pretty poignantly with, “When you have a national epidemic of this size, it is in the hands of every individual to make this [change] happen.”

In addition to improving the dietary outlook of our nation, there are economic gains to be had in the betterment of our national health crises.  Direct and indirect costs associated with obesity are estimated to be roughly $190 billion a year in the United States with the CDC reporting direct medical costs totaling approximately $147 billion 4 5.  Direct medical costs include “prevention, diagnosis and treatment services,” and indirect costs are related to morbidity and mortality.  Just imagine where that money could be better spent.  Luxury cars and jewelry, yes?

As I step down from my soapbox, we are all responsible for our nations health and wellness.  Much appreciation to the government for establishing guidelines and attempting to inform the masses on the particulars of the current crises, but change must occur at home and within the familial and peer relationships that encourage many of the decisions made by our youth.  That being said, Matthew is…….done.

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