The Big Issue of Obesity

Childhood obesity is quickly becoming an epidemic. Could your kid become one of the statistics? The risk may be greater than you think.

Introduction

No doubt you've heard the scary news reports:

The number of overweight children is three times higher today than it was 25 years ago; more than 15 percent of school-age kids are too heavy; weight-related childhood diabetes has skyrocketed; and the risk of other health problems continues to climb.

"Today's American children may be the first generation in modern history to live shorter lives than their parents did," says Kelly D. Brownell, Ph.D., a Yale University obesity expert, in his book, Food Fight: The Inside Story of the Food Industry, America's Obesity Crisis, & What We Can Do About It. With such dire warnings, it's natural for parents to worry: Could this epidemic affect my child?

That's tougher to predict than you might think. Most of us figure we can tell whether our children weigh too much. But research suggests parents are frequently off the mark. In one study, even when moms had weight problems of their own, 79 percent failed to recognize when their pre-schoolers were too heavy. At the other extreme, some parents fret over routine weight gain. "It's not always easy to tell whether children are overweight, because at certain stages, some fat is healthy and normal," notes Dennis Styne, M.D., chief of pediatric endocrinology at the University of California, Davis, Children's Hospital.

One thing is sure: It's worth keeping an eye on childhood chunkiness. Even if your child's weight is appropriate now, if his dietary habits are bad, he may be headed for trouble. The good news is that many obesity risks can be controlled -- and warning signs for future weight problems are clear if you know what to look for. Here are the questions you need to ask.

How Does Your Child Measure Up?

Weight alone won't tell you whether your child is too heavy. "You have to look at the ratio of weight to height," Dr. Styne says. Growth charts tracking normal weight and height have been around since the 1970s. Several years ago, however, the Centers for Disease Control and Prevention established new screening standards for kids that calculate weight-for-height as a single number -- what's called the body-mass index, or BMI. This number is plotted on new charts that track normal BMI patterns by age and gender. Kids who fall at or above the 95th percentile for their age are considered too heavy, and those at or above the 85th percentile are at risk of becoming overweight.

Ask your pediatrician to plot your child's BMI at every checkup: Your doctor can accurately calculate the numbers and track patterns over time.

How Old Is He?

Gaining girth isn't always cause for concern: Kids naturally get fatter at certain points during their development. "There's an accordion effect," says Robert Murray, M.D., director of the Center for Nutrition and Wellness at Children's Hospital, in Columbus, Ohio. Expect a baby to be charmingly chubby at least during the first year. After that, his BMI will gradually fall until it reaches a lifetime low at around age 5 or 6 -- a point known as "adiposity rebound." Then he'll gradually put on more padding until adolescence, thinning out again when the growth spurts of the teen years add height and muscle. "At least, that's the way it's supposed to happen," Dr. Murray says. But researchers say that glitches in this pattern may warn of trouble ahead: Several studies have found that, for unknown reasons, the earlier a child hits adiposity rebound, the more likely he is to become obese later in life. Other research suggests that kids who are overweight at age 5 have a higher risk of being too hefty at 10.

Are You or Your Partner Overweight?

Children -- like adults -- usually become obese due to a combination of lifestyle factors and genetics. That means standing in front of the mirror may give you a glimpse of your child's future when it comes to weight. Having even one overweight parent doubles the risk that a child under age 10 will become an obese adult herself, even if she starts out thin. (However, the older a child gets, the more her own weight matters as a forecast of future fatness, especially after age 6.) Bottom line: You may not be able to change your family's gene pool, but knowing how it affects your child's risks can help you jump-start lifestyle changes that may make a difference.

How Much Time Does He Spend Watching TV?

Lolling in front of the tube obviously keeps your child from more active pursuits that would burn off calories. But that's not the only reason TV time puts your child at risk of weight gain. Consider a 2001 study that found children who watched TV during meals ate 5 percent more junk food while getting nearly 5 percent fewer fruits and vegetables than other kids. It's clear from this and other research that children who watch a lot of television eat more when parked for their programs -- plus, they're fed repeated bad nutritional messages through advertising.

According to Dr. Brownell, the average American child sees 10,000 advertisements for food each year on TV. And, while watching Saturday-morning cartoons, kids see an average of one food ad-vertisement every five minutes. Most of those ads are for fast foods, sugared cereals, soft drinks, and candy. Some nutrition experts, including Dr. Brownell, are advocating a com-plete ban on food advertising during children's programming -- or at least required public-service announce-ments promoting good nutrition. But such proposals are far from be-coming reality. For now, experts say the best way to limit your child's exposure to junk-food ads is by restricting his time in front of the television.

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