This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
Overcoming, Preventing Childhood Obesity Is a Family Affair
By Sheri Porter
The sobering facts are that an 8-year-old who is obese and hypertensive has a vascular age of a 38-year old, a full three decades older than the child's chronological age, according to Larimore. And the same-age child with metabolic syndrome has a 100 percent chance of developing type 2 diabetes or measurable heart disease by the age of 18.
These children have a terrible quality of life and will die 10 to 20 years sooner than children of normal weight, says Larimore. "Kids are not born this way; they're raised this way. It's a family problem."
Tools for Family Physicians
"Be sure that your (practice) is recording a body mass index, or BMI, percentile on every child 2 years and older," at every visit, says Larimore. Ditto for recording a blood pressure percentile.
Larimore notes that three out of four cases of childhood hypertension go undiagnosed by a physician. Calculating the necessary percentiles used to be a painful process, says Larimore, but now he takes advantage of an online BMI percentile calculator, as well as a blood pressure calculator, which simplifies the work.
When Larimore speaks to groups of physicians around the country about treating childhood obesity, he urges them to follow these steps:
- train and empower your office staff to collect vital signs, including BMI and blood pressure percentiles;
- check the BMI and/or blood pressure percentiles, and if either are borderline or abnormal, make a diagnosis, inform the parents and consider intervention;
- recommend that the family try the Eight-Week Family Fitness Plan (9-page PDF; About PDFs), which was adapted by Larimore and SuperSized Kids co-author and dietitian Sherri Flynt, M.P.H., R.D., for use by physicians;
- follow up in eight weeks, and, if the child's vital signs have improved, schedule another visit in 12 weeks and urge the family to embark on the Level Two Eight-Week Family Fitness Plan (10-page PDF; About PDFs); and, finally,
- refer any child who has vital signs that have not improved or are worsening to a registered dietitian, school nurse, pediatric endocrine clinic or another reliable source.
He tells parents that getting obesity under control is just as important to a child's future success as anything else. Enrolling in advanced high-school classes and joining the elite sports team won't mean much when a child develops diabetes and metabolic syndrome at a young age and dies prematurely.
"That's not setting your child up for success," says Beutler, who is a lieutenant colonel in the U.S. Air Force. "I'm pretty harsh and brutal, but I can back (my message) up with data and feel comfortable with it."
Beutler encourages parents to make better decisions about house rules, too. And he offers parental tips in what he calls "quick brush strokes." For example, he urges parents to
- allow one hour of screen time daily for children, which includes any activity where the child is gazing into a screen of any type;
- buy children active outdoor toys, such as bikes, skateboards and red flyer wagons instead of battery-powered riding toys and video games;
- place computers and TVs in common family areas and keep such items out of a child's bedroom;
- offer children milk and water as beverage choices, and don't buy soda pop, fruit juice and sports drinks; and
- shop predominantly in the supermarket produce aisle because doing so helps shoppers take home fewer processed foods.
Beutler tells moms and dads that a good helmet will protect their child's head and that a wrist fracture sustained by playing outside could be viewed as a rite of passage.
"I'd sure rather treat fractures and little bumps and bruises then have to treat hypertension and metabolic syndrome," says Beutler.
From the Dietitian
What Flynt sees from her vantage point is that "if parents exercise and eat right, kids probably do, too."
Moms and dads decide "what food comes into the house and goes on the table," says Flynt. Parents understand the concept, but they tend to backslide. "They'll say 'I got tired of hearing my child complain that there were no potato chips or cookies,'" says Flynt. It's very easy for parents to revert back to what the child wants.
Flynt also works directly with children on how to make better food choices. She uses plastic picnic plates that are divided into three sections -- two small and one large -- to learn firsthand about a child's eating habits. She asks children what foods they would put in each section.
Usually foods such as macaroni and cheese, fried chicken, and mashed potatoes and gravy fill the plate's biggest section. "Most of the time, vegetables don't even make it on the plate," says Flynt. She helps kids think about eating a variety of foods, gently stressing that fruits and vegetables should fill the largest space on the plate, with starches and proteins placed in the two smaller sections. Flynt then sends a sectional plate home with each child as a reminder of how their food plate at home should look.
In addition, like many family physicians, Flynt encourages parents and children to focus less on body weight and more on the behaviors over which they have control.
"As you develop healthy habits, the weight takes care of itself," she says.
First Lady Launches Campaign to Fight Childhood Obesity
Family Physicians Have Major Role to Play, Says Surgeon General
USPSTF Updates Screening Recs for Childhood, Adolescent Obesity
AAFP Agrees With New Recommendations
AAFP Garners Second MetLife Grant for Children's Books on Health, Well-being
Demand for Academy's 'F is for Fitness' Leading to New Materials
More From AAFP
Ready, Set, FIT!
F is for Fitness book
AIM-HI Tips for Healthy Children and Families
SuperSized Kids program
SuperSized Kids Health assessment quiz
An Eight-Week Family Fitness Plan
(9-page PDF; About PDFs)
Level Two Eight-Week Family Fitness Plan (10-page PDF; About PDFs)