Why Are We Raising Them Fat?

The changes that have quickly advanced modern society over the past few decades have put humans in outer space and enabled scientists to protect people from once-fatal diseases. The accompanying evolution in lifestyle, however, has had a negative impact on our health: we're all getting fatter, even our children.There are lots of reasons: families are busier and depend more on high-calorie/high-fat convenience foods; people are more sedentary because of TV and computer games; and schedules have become more hectic, which affects eating habits, activity, sleep schedules and overall well being. The solutions are more simple (but not that easy): go back to basics and make good health a family affair, get adequate rest, eat a balanced diet, and get off the couch.Health professionals look at the fattening of America as a national health epidemic that is trickling down to younger and younger ages. In a report published last October in The Journal of the American Medical Association (JAMA), the national Centers for Disease Control and Prevention estimated that 22 percent of adults in this country are obese, a term that indicates body fat or a Body Mass Index (BMI) -- weight in kilograms divided by the square of height in meters -- of 30 or more. Physicians considered the topic serious enough to devote an entire issue of JAMA to studies researching the subject.Comprehensive statistics for obesity in children are not available, but health professionals believe they are comparable with trends seen in the older population. Reports printed in JAMA indicate that obesity has increased 6 percent in the United States between 1991 and 1998, and that it accounts for more than 300,000 premature deaths annually. It gets worse. The Washington, D.C.-based Worldwatch Institute research group earlier this month released a report citing statistics from the World Health Organization and other United Nations groups; it found that 55 percent of American adults are overweight, and that the obesity suffered by almost half of that number cost the United States about $118 billion last year.The prevalence of excess weight in Americans has caused a flurry of activity in the health profession, with a plethora of medical studies, renewed emphasis on exercise, development of wellness centers in hospitals, and even calls for new courses in medical schools to teach future doctors about obesity and nutrition. Former U.S. Surgeon General C. Everett Koop, who says "obesity is escalating to epidemic levels" and estimates that one in every two adults is overweight, has launched a Web site called Shape Up and Drop 10 (www.shapeup.org), an interactive weight management program that is customized for each patient.Some children are genetically inclined to have weight problems, but health professionals say about 60 percent to 70 percent of the cases can be attributed to inactivity and bad diet."Weight control, especially in kids, is a big problem today," says Melinda Sothern, who administers the 13-year-old Committed to Kids weight control program, whose findings have been published in the Journal of Obesity Research."This is a disturbing trend we've seen," she says. "We had to start a pre-school program" for overweight 3- to 5-year-olds. "At that young age, if they already are above 40 percent overweight, that's not going to go away."Cardiologist Dr. Gerald Berenson, the lead investigator of the 28-year-old Bogalusa Heart Study (conducted in Boglusa, Lousiana), says childhood weight problems can trigger other medical complications, including heart disease and diabetes. Since 1972, Berenson and his medical team have tracked health histories of people living in the doctor's hometown of Bogalusa. Children tracked in the first years of the study are now in their mid-40s, and about 1,000 of their offspring now are part of Berenson's research. The cardiologist's results, recommendations and programs for healthier living are contained in four books, 600 manuscripts and an equal number of presentations at national and international meetings."Kids are getting fatter and there is a lot less exercise," he summarizes. "I think it has to do with modern society, the availability of food, changes in diet, more inactivity." Berenson's project seeks to track indicators of heart disease in children and develop prevention programs in communities. The result is a public school program, Health Ahead, that includes instruction for food service workers, teachers, children and their families concerning low-fat food preparation, healthy eating, exercise, self-esteem and the importance of avoiding risky habits such as smoking and alcohol. He says the cost to schools is $5 to $10 per student, a small price tag considering his estimate that half of the country's 60 million school children eventually will die of heart disease."We want to try to break the natural course of heart disease," Berenson says. "What we've learned is that heart disease begins in early childhood. Children as young as 2 years old can begin to develop high cholesterol (a risk factor for coronary disease), and we've seen increases in certain diabetes in children." High blood cholesterol can lead to fatty deposits on the walls of the arteries, a condition Berenson notes was present in the bodies of children who were autopsied after they died in accidents."Very clearly, adult heart disease, hypertension, diabetes [type 2] ... and obesity begin in childhood," he says. "We know how to study risk factors in children, and we have an understanding that lifestyles begin in childhood. Most of all, we've learned the importance of prevention."The weight trends in the United States reflect a shift to a more sedentary lifestyle in which meals often comprise convenience foods, and families, especially youngsters, entertain themselves with television and computer games. Sothern says it is up to parents to minimize TV viewing times and use the computer as a learning tool instead of entertainment, and limit usage time to 30 minutes. Most of all, parents must serve as examples."The concept of 'normal' in America today is warped," Sothern says. "It's completely unnatural for the ways our bodies were designed. They were made to take in a certain amount and kind of food, get enough exercise and rest. When you deviate on both [diet and exercise], you run into trouble."

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