Sue Scheff: Teen and Childhood Obesity

While the CDC reports that obesity among American kids has leveled off, fully a third of our children are overweight or obese. Among the reasons for this epidemic is this: both children and adults have forgotten something they knew when they were born.

Five-year-old Emma McCurdy sits at the kitchen table counting her goldfish crackers.

“22, 23, 24, 25,” she says aloud.

“Can you eat 25 goldfish?” asks her mother, Maura McCurdy.

It’s difficult for most parents to know just how much their kids can, or should, eat.

McCurdy agrees: “You don’t. And that’s really hard.”

It’s even more difficult when everywhere we go, portion sizes are getting bigger and bigger. Fast-food restaurants offer to “super-size” everything from French fries to sodas. In fact, studies show that restaurant portions exceed recommended portion sizes by as much as 800%. And the more our kids are served, the more they eat and the bigger they get, which sets them up for lifelong health problems.

“If you are overweight as a child, or obese as a child, you have a 90% likelihood that you will be overweight or obese as an adult,” warns Rachel Brandeis, a registered dietician.

Babies are born with an innate ability to stop eating when they’re full, but that instinct gradually fades, especially in the face of huge portions and their parents’ demands.

Brandeis says that we need to help kids maintain that instinct.

“A lot of times, what we want to do is have our children clean their plate. We think that’s the way to proper nutrition, when in reality, what we really want to be able to teach our children is to self-regulate their food intake,” she says.

One way to help is to serve reasonable portions at home. But what is a reasonable serving?

“Usually, a good rule of thumb for portion sizes for a toddler is 1 year of age equals a tablespoon,” Brandeis says.

So, for a 2-year-old, that means two tablespoons of vegetables, two of meat and two of fruit. If parents serve those portions and allow their kids to decide when to stop eating, when they get to be Emma’s age, they eat because they’re hungry, not just because it’s there.

Maura agrees: “I think they’re kind of smart. They eat when they’re hungry. We should probably pay more attention to them rather than say, ‘Clean your plate, clean your plate, clean your plate.’”

Researchers suggest that ever-larger food portion sizes, both inside and outside the home, correlate to a sharp rise in American waistlines and may be partially to blame for the rising numbers of overweight and obesity cases in the United States over the past 30 years. Researchers from the University of North Carolina at Chapel Hill, who analyzed survey data of 63,000 people aged 2 and older, found that portion sizes increased for nearly all home-cooked and restaurant-prepared meals between 1977 and 1998. In fact, the size of an average soft drink is now 20 fluid ounces and 193 calories, compared to 13 fluid ounces and 144 calories nearly three decades ago. Consider these additional findings from the study:

• The average cheeseburger grew from 5.8 ounces to 7.3 ounces, swelling from 397 to 533 calories.
• Salty snacks grew from 1 ounce to 1.6 ounces, climbing from 132 calories to 225 calories.
• Pizza was the only food that did not increase in size or calories between the late 1970s and the mid-1990s, and portions actually decreased in size.
• The largest portion sizes were found in fast-food restaurants between 1994 and 1998, but for desserts, hamburgers and cheeseburgers, the largest portion sizes were actually dished out at home.

Tips for Parents

Children who are overweight are at an increased risk of developing type 2 diabetes as well as these additional health complications:

• Cardiovascular problems
• Orthopaedic abnormalities
• Gout
• Arthritis
• Skin conditions
• Obstructive sleep apnea and respiratory problems

Being overweight also is likely to negatively affect a child’s social and psychological development, and it has been linked to the premature onset of puberty. Moreover, the health threats posed by being obese in early childhood can be long lasting, with overweight adolescents at greatest risk of becoming overweight adults. Given the seriousness of the health consequences associated with being overweight, and the rate of increase in the past few decades, the U.S. Surgeon General has declared overweight prevalence in children and adolescents “a major public health concern.”

Variety in food choices is a key ingredient in helping children to establish healthy eating habits. Consider trying these additional tips, published in the Journal of the American Dietetic Association, for helping you and your child maintain healthy, balanced diets:

• Go family style. Adults and children do better at controlling portion sizes when they serve themselves. Children as young as 3 can serve themselves. The dinner table should not be a battleground. As a parent, you are responsible for bringing in healthy food and putting it on the table.
• Talk to your child so he or she can learn from his or her own body how much to eat and to stop eating when he or she is full.
• Instead of forbidding your child to eat sweets, provide him or her with nutritious foods first. Stopping your child from snacking just before dinner is wrong if he or she is munching on healthy foods.
• Be aware of portion sizes. At home, start with reasonable serving sizes and keep food for second helpings in the kitchen, not at the dinner table. When your family is eating out, ensure that your child doesn’t feel like he or she has to finish everything on his or her plate.
• Get out of the habit of having a lot of food for not a lot of money. It is something that fast-food providers get you to think about. This practice is really not good value in the long run. It is better to make a decision to go for smaller portions.

References

• Centers for Disease Control and Prevention
• Child Trends DataBank
• Journal of the American Dietetic Association
• Journal of the American Medical Association
• U.S. Department of Agriculture
• U.S. Surgeon General

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