7 minute read
Childhood Obesity A Growing Epidemic
BY JASON HUDDLE
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School children can be cruel. Even in a society where we teach students to respect all people, no matter their race or sex, somehow the children who are overweight still get excluded from that directive. The unfortunate truth is that 1 in 12 children are overweight or obese; and those numbers are in developed countries. When a child reaches the 85th percentile of having a body mass index (BMI) greater than 85% of their peers, he or she is designated as overweight. When it gets to 95%, they are considered obese, and 97% are severely obese. Not only can childhood obesity lead to serious physical complications, such as diabetes, heart disease or joint problems, it can also lead to social isolation, depression, and decreased self-esteem.
Some who read the previous statement might claim the solution is simple. “Stop feeding them junk food,” they might say. However, in realty, the answer is not that simple, and the epidemic of childhood obesity is only getting worse.
“The problem is complicated and multifactorial,” stated Dr. Shelly Houston, a pediatric childhood overweight treatment specialist with Atrium Health. Jessica Castrodale, Community outreach coordinator for Atrium Health Cabarrus concurs. “If we could map the causes of obesity, child or adult, the causative factors would look like a computer circuit board, and many are interrelated.”
Of course, many would blame the rise in obesity on fast food, and they would not be wrong, to a certain extent. “Due to the creation of low cost, high palatability and high energy, dense (high calorie) food, the three of those together led to a pretty abnormal regulation of what our diet should really be,” explained Houston.
However, the finger cannot be pointed solely at one industry. Lisa Watson, a nurse practitioner with Atrium Health, explained, “Socioeconomic factors play a big role in it. Unhealthy food is cheap, healthy food is expensive. How we feed our kids at school is a factor. The fact that physical education needs to be daily. We’re lucky if it’s once a week. I think so many societal changes have occurred. My dad used to be the only working parent (in my household). However, with others, both parents may be working two or three jobs, so there’s no time for these kids to be outside and playing and joining sports. There are genetic factors. There is new research around adverse (traumatic) childhood events, (and how) they can also change your metabolism in response to growth…I think that really speaks to how hard it is to treat because there’s no single cause. And, even if they have the same cause, the same treatment won’t work on different kids.”
—JESSICA CASTRODALE, COMMUNITY OUTREACH COORDINATOR FOR ATRIUM HEALTH
In other words, the problem is both cultural and metabolic. Knowing that, what can be done to treat children now and keep future numbers from increasing? Dr. Houston says the answers may be in the past. “My favorite thing to do is to look at their growth curve. And so I just go back to their birth. And I follow it. And I ask, ‘Where did we start to get off track?’ Everybody has a different life story, and everybody has different life events and that curve looks different for everyone. But it’s really important for me to go back to the beginning. For some kids, their body was regulating their intake and energy use until they were two and for others it was age four, and for others it was age 13. And so, the genetic predisposition is very important and I talk with families about that on a daily basis. They cannot go back and rewire their DNA and change that programming. But if that makes up 30 to 40% of the problem, we can still change 60% of it.”
Houston and Watson, who serve as two of the four healthcare providers at the Levine Children’s Healthy Futures Clinic, both say it’s important for parents to be aware of physical
changes, especially in the wake of a change in the child’s life, such as a move, divorce or death of a loved one, to cite a few examples. Particularly, in these cases, it is important for parents to be aware of changes in behavior with their children. “Are they always food seeking? Are they finding wrappers in the rooms? Do they get the sense of the child never full and always hungry, or they’re using food for comfort? What are the behaviors that are going on that feel like change?” said Watson.
The difficult part comes when change is implemented as it rarely effects only the child. Because children normally acquire their dietary habits from their parents, familial intervention is usually required. “It’s hard because in pediatrics, if you’re dealing with a problem with that child, typically, you’re going to have to impact the entire family,” explained Dr. Houston. “And the family intervention is really what works. It’s not going to work just for that one child.”
Then, there are children who look healthy from a physical appearance standpoint, however, because of poor dietary choices, have the organs of a child who is obese. “Even at young ages, you can have changes in your arteries in your heart, and where plaque builds up and (that) puts (children) at high risk for heart disease,” said Watson. Unfortunately, when there is no outward sign of poor health, and the child feels fine, it is difficult for parents or doctors to know the severity of their condition until much later into adulthood. This is another reason Houston said
—DR. SHELLY HOUSTON, PEDIATRIC CHILDHOOD OVERWEIGHT TREATMENT SPECIALIST WITH ATRIUM HEALTH
it is imperative parents bring their children to annual well-checks and get their cholesterol screened.
Other factors parents need to be aware of include family histories of conditions such as heart disease, high blood pressure and if there are smokers in the household. Any one of these could lead to obesity in a child or foreshadow future complications.
So, what can parents do? When do they know it’s time to seek help?
Watson said when children hit that 95th percentile number, professional intervention is needed, but they are prepared to help. “We have a medical team. We have a dietician. We have an exercise physiologist (and the patient) will eventually have a counselor. It just takes (that) team approach…kind of ‘walking the walk’ with the patient, helping them make small steady changes.” Castrodale said the first step to getting help is to visit your general pediatrician and have them evaluate the situation and make recommendations. “They may recommend changes that your family can make to promote a better balance of nutrition, physical activity, sleep, etc. They may determine the factors affecting that child and their situation are more difficult than they can manage in that primary care setting; and they may make a recommendation to go see our Levine Children’s Healthy Futures clinic. From the community level, we realized that we cannot affect the child without affecting the family. So, we’ve tried to put in some widespread cultural changes to promote healthy behaviors, not necessarily focusing on overweight, but general healthy behaviors. So, we have adopted the ‘5210’ messaging and strategy that’s been recommended by the American Academy of Pediatrics.”
“5210” refers to a daily regimen of five servings of fruits and veggies per day, two hours or less of screen time, one hour or more of physical activity and zero sugary drinks. Adhering to a simple plan such as this can make dramatic changes in a child’s health.
Ultimately, a healthy child will result in them becoming a healthy adult. “A healthy child learns better. A healthy child is more fit for military service. A healthy child is a better employee as an adult and will carry those healthy behaviors into adulthood, most likely,” Castrodale summarized. If we’re going to change this pattern, the future is now.
To learn more about childhood obesity and its treatment, visit: www.healthycabarrus.org/priorities/ childhood-obesity.
