May 21, 2018
Over the past 40 years or so, we have seen such a dramatic rise in obesity in young children and teenagers that society is now normalizing the problem into its fabric. We are no longer sure as a populace what size our body should be to be healthy or optimal based on the significant misinformation published by medical and lay press alike.
We are currently trying to fit everyone into nice little boxes based on body mass indexes, appearance and family history.
While this was a reasonable start, it is woefully weak as a predictor of true disease as perse, smoking is to premature adult death rate. After reading hundreds of articles over the years, most readers are very aware of where I think the pathway to health lies. We need lots of daily physical movement, a heart healthy predominantly vegetarian diet, avoidance of chemicals, a village mentality coupled with spiritual belief and plenty or restorative sleep.
Let us now look at two articles published in the same edition of Pediatrics this past March. The authors of the first study by Berge et. al. looked at the trans-generational effects of parent directed encouragement to diet. They commented as follows: "Exposure to parent encouragement to diet as an adolescent had long-term harmful associations with weight-related and emotional health outcomes in parenthood and was transmitted to the next generation. It may be important for health care providers to educate parents about the potential harmful and long-lasting consequences of engaging in encouragement to diet with their children."
Article number two was produced by Bauer et. al. and had these findings: "In the results of this 15-year cohort study, it is suggested not only that adolescents whose parents encouraged them to diet continue to be at increased risk for obesity and disordered eating as adults but also that now as parents, these adults are more likely to create home environments for their children that emphasize weight and promote dieting."
Read the articles below.
Suffice it to say that we have a serious issue with a burgeoning disease profile that is associated with poor weight control and pro inflammatory lifestyle habits. We find psychological studies that reinforce the misguided need to keep the problem buried in the closet for fear of offense. The dispensing of information to children and adults alike when performed poorly will and is worsening outcomes.
What then should we do when faced with a problem that seems daunting?
Switch gears here! How fair is it to ask a child that has evolved to love sugar and flour over thousands of years to hold off when parents send thirty cupcakes to school for the countless parties that are school and parent promoted. We have a federal government more concerned with sending money overseas than feeding our children healthy food in the school setting. Many of my patients receive 66% of their main calories through school meals. Most commercials that children are inundated with during cartoons or sporting events are calorically dense nutrition bombs set to destroy the body.
Every time I walk into an exam room, I have to weigh and measure the patient's and parent's capacity to hear what is going to be uncomfortable information. How do we present this in an acceptable way?
Making someone feel guilty is counterproductive. What children do not need is judgement! I actually say those words. "I am not judging you". "But, I need to talk about some things that are worrisome." "I care about you and it appears to me that there may be things that we can do to be healthier." Then we talk about daily
exercise, which foods promote a healthy body and mind, drinking lots of water, and so on.
Body appearance is not truly relevant to the conversation with a child. It is only a marker of health. It is what you put in your body and how you use your body that will truly determine your outcome. Unfortunately, for all of us, we cannot hide from the fact that what you put in your body drives obesity which is a prime marker of disease risk for diabetes, heart disease, liver disease and much more. To deny this reality is akin to living in Neverland and frankly unproductive.
The keys to a healthy weight for a child is to have parents lead by example by not consuming nor buying foods that are sugar and fat laden processed types. Limiting access to calorically dense and nutrient poor foods is a great place to start. Then encourage family exercise daily that can be as simple as family walks. Give your children ideas of which foods on the school menu are good choices and which ones should be thrown to the wolves. In my personal opinion, frito pie and many of the offerings are suboptimal for a healthy growing mind. School menus are not far from kids menus at fancy restaurants that offer daily tenders, pizza, burgers, and frito pie.
Once again we expect a young child to choose the healthy option when they are staring at a sugar, fat and salty bomb that touches all of their evolutionary buttons for survival. It is poor parenting at the governmental level. One day a week could have a cheat day meal. Not 10 meals out of 10 possible.
If you are a teacher, administrator at a school, school nurse or just a frustrated parent, start writing letters to state and federal officials demanding they take some money back from overseas and pork belly projects and feed our children nutritious whole unprocessed food in school. It is not a child's fault that they do not have the resources to eat healthy food at home, but for Pete's sake, let us at least provide it at school.
Anytime you talk about weight and obesity, discuss it within the framework of healthy eating and movement. Try to be non judgmental and caring as that tone is less likely to promote self esteem problems.
Just my 2 cents,