Wednesday, June 22, 2011

Who's Responsible for Childhood Obesity?

The San Francisco City Council recently banned toys in children’s fast food meals but the ban won’t fix the problem of childhood obesity because it doesn’t address its root causes. Childhood obesity, like adult obesity, is the result of numerous factors converging to create the perfect public health storm.

Children are moving less

Children spend more time engaging in sedentary activities such as playing video games or spending time online.  This is compounded by the fact that physical education programs and recess have been cut from many school programs.  Yet numerous studies have shown that physical activity has a positive impact on the academic performance of children. 

Children are eating fewer home cooked meals

Frequent family meals have been shown to increase fruit and vegetable consumption and reduce consumption of sugar sweetened beverages.  (1)  Yet away from home foods have been associated with foods that are less nutritious (higher in fat, lower in fiber) and have larger portion sizes.  (2)  Despite the unfavorable nutrition profile of away from home foods expenditures on these types of foods has been increasing.  Nearly half of families have reported consuming restaurant food at least once weekly.  (3)   Furthermore, the amount of time spent preparing food among US households has decreased for two reasons:  less time available for food preparation and lower time costs of food preparation.  The Economic Research Service report  Who has Time to Cook found that the amount of time spent preparing food decreased as the number of hours worked increased.

What are the implications?

Childhood obesity can be especially costly since it can lead to serious health conditions that have a lasting impact.  Children who are overweight and obese are at increased risk for hypercholesteremia, dyslipidemia, hypertension, insulin resistance, impaired glucose tolerance, Type 2 diabetes and depression.  The likelihood that these health conditions persist is quite high since the probability of childhood obesity continuing through adulthood increases from 20% at age 4 to 80% in adolescence.  (4)

The solution to childhood obesity will require the efforts of multiple stakeholders:  schools need to serve better food and make physical activity a part of the daily curriculum, parents need to take the time to choose foods more carefully and make family meals a priority, even employers have a vested interest since the children of employees are covered by employer sponsored health plans.  Finally the government, at state, local and federal levels, needs to continue to educate the public through programs such as Let’s Move and create incentives that encourage schools to serve healthy foods. 

Who’s responsible for addressing childhood obesity?   

The answer is easy:  everyone.  The solution is not.

(1) Fulkerson, Jayne et. al. “Family meals:  perceptions of benefits and challenges among parents of 8-10 year old children.” Journal of the American Dietetic Association (April 2008): 706-709. 
(2) Greenwood, Jessica and Stanford, Joseph.  “Preventing or Improving Obesity by Addressing Specific Eating Patterns.”  Journal of American Board of Family Medicine ( March-April 2008): 135-140.
(3) Ayala, Guadalupe et. al.  “Away from home food intake and risk for obesity:  examining the influence of  context.” Obesity (December 2008): 1002-1008. 
(4) American Academy of Pediatrics, “Prevention of Pediatric Overweight and Obesity,” Pediatrics (August 2003):  424-430.


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