Nov. 12, 1999 (Chicago) -- The bad news about childhood obesity is that more children in the United States are overweight than even 10 years ago. The good news is that health care professionals in several specialties are finding some of the causes and effective ways to treat it, according to a panel of speakers here at the 127th Annual Meeting of the American Public Health Association.
These efforts typically involve schools and families. Not surprisingly, many of the strategies involve watching less television. Watching television and obesity are intrinsically linked, says William L. Dietz, MD, PhD. He encourages parents and physicians to address obesity actively, because the rate childhood obesity has doubled to 15% since 1986. Obese children can have the same problems as adults, such as elevated cholesterol and blood pressure, as well as type 2 diabetes, formerly called adult-onset diabetes.
Dietz, the director of the division of nutrition and physical activity at the CDC in Atlanta, says that communities can inadvertently promote obesity by not providing sidewalks and bike paths. To illustrate his point, he showed a slide of a man 'walking' his dog by driving his car alongside his dog, with the leash sticking out the window.
Eating patterns can sometimes play a surprising role in the development of obesity. When parents limit sweets and high-fat food items, rather than teach children to eat them in moderation, the forbidden foods become even more attractive, says Leann L. Birch, professor and head of human development and family studies at Pennsylvania State University. In closed-camera observations of children presented snack foods, children tended to eat larger quantities of the higher-calorie foods if their parents had restricted these items in the home. Girls whose mothers dieted also ate larger quantities of these foods, she says.
Steven L. Gortmaker, PhD, an epidemiologist with the Harvard School of Public Health, encourages parents to actively limit their children's television viewing. Parents should not provide a television for a child's bedroom, and they should limit the hours their children are allowed to watch television. Simply eating meals together can reduce television watching by 30 minutes per week.
Several school programs integrate classroom lessons, school food services, physical education departments, and families, says Thomas N. Robinson, MD. One ongoing study targets third and fifth graders. "With pre-adolescents, we have an opportunity to prevent adolescent obesity," says Robinson, an assistant professor of pediatrics at Stanford University. "Also, at this age, children's diet and activity are still controlled by parents."
In earlier research, he and colleagues found that strategies to reduce television and video game viewing were more successful at encouraging physical activity. Strategies that stressed activity directly made children feel that physical activity was being forced on them, and they were unenthusiastic.
"Physicians and nutritionists are working together to develop effective ways to reduce childhood obesity," Geraldine Perry, DrPH, RD, tells WebMD. "Because television is one of the risk factors that several researchers have identified, much research is focused on strategies for reducing television viewing." Perry is an epidemiologist with the CDC's maternal and child health division.