Tipping the Scales
Wednesday, January 01, 2003
By Mary GalliganPhoto: Frank Pinc
Parent: "Hi, honey. I bought some pants for you today. Try them on."
Child: "Size 12 husky!! Mom, do you think I'm fat?"
Parent: "Of course not! I don't think you're exactly fat. You're just. . . "
Have you had this conversation with your pre-adolescent? I have. Have you noticed there is more of him to love? And are you afraid to say or do anything?
If you're like many parents, you've heard warnings of overweight children while watching ads urging you to super-size your fast-food meals. We have schedules that allow for too few family meals, too little exercise, too much guilt and too much weight.
"We need to face the fact that we have an outbreak of obesity in children in the U.S. and we can't tolerate it anymore," says Ellen Ruppel Shell, a science journalist and author of the new book, "The Hungry Gene: The Science of Fat and the Future of Thin."
We have to face some uncomfortable facts about food and fat. Obesity among U.S. adults is at its highest level ever and costs $120 billion and 300,000 lives each year, according to Shell. And nutritionists and pediatricians are alarmed about the growing figures of our children:
~More than one in seven children, or about 9 million, are overweight, triple the rate of the 1960s.
~Children with type 2 diabetes has more than tripled in the last five years. The disease, tied to being overweight, was rarely found in children until recently.
~An overweight child is at greater risk of becoming an overweight adult and face health problems, such as heart disease, high blood pressure, stroke and cancer.
~About 13 percent of children, ages 6-11, are overweight, up from 4 percent in 1965, according to the Centers for Disease Control and Prevention's 1999-2000 National Health and Nutrition Examination Survey.
~About 14 percent of adolescents, ages 12-19, are overweight, researchers found after measuring the height and weight of 4,722 children from birth to age 19.
How and why
The numbers are dramatic. But how did it happen and can it be turned around?
Aren't we the same parents who religiously read about nutrition? We shopped for healthy foods and planned the right diet. But somewhere between school and scheduling, we lost track of time and the whole family lost the ritual of sit-down meals. So, is this your fault?
New scientific research is showing us that bad outcomes are not always a result of bad behavior. "Parents are told and told that the kids should exercise more and eat healthy meals. And that doesn't always help," says Shell.
While the advice is good, it is only part of the answer to a more complex question.
Take, for example, a family where parents push good nutrition and exercise but still end up with a child who is overweight, while the others remain fit and healthy. "This is where the biology of obesity is so important to understand," says Shell.
For three years, she has been researching the research on obesity, a new field in science. Her book is a thorough journalistic evaluation of the science of obesity, a previously dismissed but now urgent public health issue.
Scientists first discovered the obesity gene in animals in 1994 and in humans in 1997. Since then, the field has exploded and we are gaining an understanding of the biological functions that control diet and appetite.
"There is a feedback mechanism that involves our guts and our brains and peptides and proteins and when it works properly, then our brain tells us to stop eating. When it doesn't work properly, which is the case more and more, we don't stop eating," Shell explains.
In a growing number of people, that feedback is short-circuited, at least in part by processed foods with low fiber and high concentrations of sweet and fats, Shell says. In the past half decade, the presence of processed foods in our diets has increased greatly.
"How the heck are parents going to understand this if most doctors don't understand it?" says Shell. Cutting out processed and junk food is a simple solution but a tough order.
We are told weight is a problem. At the same time children are sent messages to buy and eat. TV shows and movies make children feel anxious about their weight. The stars are thin and the "fat kid" is either class clown or bully. Meanwhile, those same shows have advertisements telling children to buy, buy, buy the latest fast or processed food.
"Food advertising has a phenomenal influence on children," says Jean Kilbourne, who has studied advertising for more than 20 years. "And I can't think of anything that is advertised to kids that is nutritious. You don't see ads for broccoli."
Kilbourne originated the film series, "Killing Us Softly," about women and advertising, and her most recent book is "Can't Buy My Love: How Advertising Changes the Way We Think and Feel."
"It is unfair to target children," says Kilbourne. "They are much too vulnerable: They can't tell the difference between ads and programs and are influenced by celebrities. We should totally ban advertising to children," she says. "Other countries have done it and the European Union is considering it."
The ads have crept past the television screens and are in toys, clothes and other products. Most fast food chains reward children with a toy for buying packaged meals.
"The best figure I've seen is $12 billion a year spent on marketing to kids—double what it was in 1992," says Susan Linn, associate director of the Media Center at Judge Baker Children's Clinic in Boston, Mass., and founder of the national coalition, Stop Commercial Exploitation of Children.
The number includes everything because it's almost impossible to see where food stops and products begin. "Everything is merging, food companies and toy companies are putting out food that are toys and toys that are food," says Linn. Wrap that all with movies, video games and television shows. "The Rugrats are macaroni and cheese, Barbie is in McDonalds meals," says Linn. "And you are advertising a movie which has licensed a candy."
Kids now see 40,000 commercials on television alone—doubled in recent years, Linn says. The ads are also in cash-strapped schools where they have signed contracts with soft drink and fast food companies, says Kilbourne. Coca-Cola, Pepsi-Cola and other firms have "partnerships" with schools around the country, buying exclusive rights to school vending machines—and access to a vulnerable student body.
Kilbourne wrote: "Twenty years ago, teens drank almost twice as much milk as soda. Today, they drink twice as much soda as milk. Some data suggest this contributes to broken bones while they are still teens and to osteoporosis in later life." Bottom line is, Kilbourne says, "We should be funding our public schools in a better way so they don't have to look for this money. But even so, we have to do whatever we can to get advertising out of schools."
Advertising and biology aside, parents have a role to play in ensuring children are getting the nutrition they need. "It's overwhelming and it's exhausting but it's important for parents to recognize that there is a problem," says Linn.
Robin Orr, a nutrition specialist for the Cooperative Extension Service of the University of Illinois in Urbana, recommends a two-way approach. "You change what foods are available and you practice what you preach."
The food industry thinks of these on-the-go foods and no-think as foods kids can eat walking out the door. "Children should not be eating on the go," says Shell. "None of us should be eating on the go."
In addition to rethinking food choices, we need to rethink physical activity. Don't just tell kids to go out and play. "Go out on family walks and do other fun activities together," says Orr. Make exercise a family activity, not something punitive.
Experts caution against strict diets and weight-loss medications. "Overweight kids are still growing kids," says Orr. They need nutrients for growth and development.
"I never once put a child on a diet," says Dr. Rebecca Unger, an attending pediatrician at Northwestern Memorial Hospital who also counsels overweight children at the nutrition clinic where the approach is positive and stresses fitness. "With older kids it's way too dangerous to talk about diets," she says, because of problems such as anorexia, bulimia and other eating disorders.
"We stress the importance of lifestyle exercise," she says. "We get them to integrate it into their day." She encourages families to make small changes, such as parking at the far end of the parking lot and walking to the store, raking leaves and using the stairs instead of elevators. "With many kids, sometimes it is tough to get them moving," Unger says. "We know, though, that any exercise in a sedentary lifestyle is beneficial. Even 10 minutes of activity, three times a day, is good."
The CDC guidelines recommend children get at least 60 minutes of physical activity daily. Illinois requires all schools to offer physical education but many offer far less than that. In Chicago, many elementary public school students get physical education only once a week.
Parents can make up for that deficit with fun physical activities. It can range from after-school programs that offer sports and physical exercise to getting children to walk or bike to school.
One of the CDC's initiatives is called the Walk to School Program. Eighty-five percent of children's trips to school are made by car or school bus. Only 13 percent of all trips to school are made by walking or bicycling. The CDC hopes to raise the physical activity of kids by encouraging them to walk and bike to school in groups accompanied by adults.
"We have to get rid of the idea that movement is punishment and you are a bad parent if you make your kids walk," says Shell, "The Hungry Gene" author. "You are a good parent if you get your child moving."
Mary Galligan is a freelance writer living in Chicago with her husband and son.