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Thursday, Aug. 10, 2017 12:34 am

Fighting the obesity epidemic

Making healthy choices a family affair

Marthe dela Cruz with a young patient.


In the past 20 to 30 years, childhood obesity has been on the rise. There are many causes, and they look very familiar to most of us. Kids have more access to video games and other different screens. Families have gotten busier, with both parents working and kids on the go with more activities. Fewer families are able to sit and have a meal together, and that means more fast food and other meals and snacks on the go. And when families do eat together? They’re eating way more. Portion sizes are bigger. And not just for food – drinks are getting larger, too.

As a result, the percentage of children with obesity in the United States has more than tripled since the 1970s, according to the Centers for Disease Control and Prevention. Nationally, the average is 17 percent, but it’s quite a bit higher closer to home, per the Illinois Department of Public Health. In Illinois, almost 20 percent of children ages 10 to 17 are considered obese. In fact, a 2011 study placed Illinois as the ninth highest state for childhood obesity.

What’s at stake for our kids? Among other issues, according to Marthe dela Cruz, M.D., assistant professor in the Department of Pediatrics at SIU School of Medicine, the biggest risk for kids is their future. Children who are obese will develop adult problems earlier – specifically, high blood pressure, diabetes and heart disease, and with that, risk of early death.

While some of these conditions aren’t common in children, others are, including high cholesterol and even sleep apnea.

“As they have more weight around their chest, neck and face, it can cause more problems with airflow while breathing at night, causing apnea issues,” Dr. dela Cruz says. “It can also complicate asthma. More weight on the chest can make it harder to breathe and move, and makes physical activity more difficult.”

Dr. dela Cruz also places emphasis on the genetic component of obesity. “There’s a vicious cycle,” she says. The CDC reports 30 to 35 percent of adults in Illinois are obese. Either by lifestyle habits or hereditary traits, that can easily be passed to their children.

To try to prevent life-threatening health issues down the road, Dr. dela Cruz stresses the importance of prevention today. But that prevention doesn’t necessarily mean losing weight. “The first thing I talk to parents about is weight maintenance, rarely weight loss,” she says. “Kids still need to grow in height and when you grow in height, you gain more weight.”

Dr. dela Cruz’s tips for prevention and maintenance include:

The 5-2-1-0 rule
The most important tips for maintaining a healthy weight can be found in the number 5-2-1-0. The popular “5-2-1-0 Let’s Go” model urges parents to give kids five servings of fruits and vegetables per day (Dr. dela Cruz clarifies that this does not include juice), limit TV or other screens to no more than two hours per day, spend one hour per day doing some form of physical activity, and allow zero sugar-sweetened drinks. “I think this system should be discussed at all well visits, even with kids who are a healthy weight,” Dr. dela Cruz says. She also likes the “Choose My Plate” style of eating, in which half the plate is made up of fruits and veggies.

Avoid the word “fat”
Of course, discussing weight issues can be a minefield, even for kids. “I try never to use the word ‘fat’ and very carefully use the words overweight and obese,” Dr. dela Cruz says. “I suggest parents talk about a healthy lifestyle, physically fit and active, so that kids feel good about themselves and don’t get tired doing the things they like to do.”

Make it a family affair
One way to ensure kids don’t develop self-esteem or body image issues is to make healthy eating a family thing. “Frame it as a whole-family activity,” Dr. dela Cruz suggests. “Get everyone onboard rather than just the family members who might need it.”

Hold off on seconds

“The body doesn’t recognize that it’s full until 20 minutes after eating,” Dr. dela Cruz explains. “Control portion sizes by eating smaller amounts, and don’t give second helpings until they’ve taken a break from eating.” One way to help the body take in fewer calories is to avoid eating while watching TV. “Try not to eat in front of any kind of screen unless it’s a special occasion, like a movie night,” she says. “Studies show we eat and snack more when we’re watching TV – and commercials are designed to make us hungry.”

Start ’em young
Most importantly, Dr. dela Cruz wants parents to promote a healthy lifestyle early – before extra weight becomes an issue.

“One study done on children with weight issues has shown that children who are obese at kindergarten have a very low likelihood of returning to a normal Body Mass Index as they get older,” she says. “It is important to start these healthy lifestyle habits at a young age.”

Courtney Hall is a writer and editor with SIU School of Medicine. She and her husband, John, have two children and two fur-children.


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