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Weighty Issue

AIR DATE: Wednesday, November 19th 2008
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Who is ultimately responsible for curbing childhood obesity?

It's no secret that teenagers and pre-teens struggle to feel comfortable in their bodies. They worry about being too tall or too short or too fat. While height tends to even out with age, weight is often a different story.

Childhood obesity has been called an American epidemic and a new study suggests a strong link between heart disease and obesity at a young age. At the same time, another report shows kids have less time to play outside and stay active in school. While it appears that the rate of obesity among American youth is no longer on the rise, 16 percent of the nation's young people are obese and about a third are considered overweight.

Oregon's children are not immune from this national problem. An estimated one in four eighth graders in the state were obese or at-risk in 2005, according to a report released last year by the Oregon Health Policy Commission. The state legislature passed a bill (pdf) last year restricting the amounts of fat and sugar in snacks and beverages sold in school vending machines. But obesity is a complex problem, which involves not only diet and fitness but social, economic and psychological factors as well.

Have you struggled with childhood obesity? Are you the parent of an overweight or at-risk kid? Are you a teacher or school counselor? What barriers do you see for kids who are fighting the battle of the bulge? Who is ultimately responsible for preventing childhood obesity?

GUESTS:

Photo credit: Nick J Webb / Flickr / Creative Commons

Tagged as: kids · obesity · school

I am none of the things described above, but I know people who are overweight and I think that the main barrier of them is advertising. With all of the McDonald and Burger King comercials that are being circulated in the media, it's hard not to want a big mac or a bacon burger now and then. The trouble comes when it becomes more than now and then, you taste it once, and you want more and more until you feel satisfied. In this day and age when the main message that we hear is "Be happy, satisfy your hunger, you won't be happy until you eat this" it is hard not to fall. The most rediculous one I have ever herd was Taco Bell advetising its valcano taco; the man on the screen said: "Eat like a man!" The pressure to meet the criteria is overwhelming when you consider the fact that americans are obsessed with their image.
Jakeac —
While the problem with obesity in our society is caused by many factors working together, there is one major cause which is mentioned by almost no one -- the decline in the nutritional value of our food. Much of what we think is food is actually a food substitute -- a non-nutritive ingredient that mimics the characteristics of a real food so that food manufacturers do not have to pay the cost of using the real food. The major example of this is high-fructose corn syrup. It is a fact that the rise in obesity over time in the US tracks in parallel with the rise in the consumption of high-fructose corn syrup.

A book just published documents how substitute foods are sold to the public -- Swindled: The Dark History of Food Fraud (by Bee Wilson, ISBN 978-0-691-13820-6). Ms. Wilson documents how food consumers have been lulled by the existence of the FDA and the US Dept. of Agriculture into thinking that their food is safe. In fact, consumers assume that if something is sold in a supermarket or manufactured by a well-known company, it can't be bad for them. The problem is that much processed food, while not strictly speaking unsafe, is so nutritionally deficient that people can eat LOTS of it but still be undernourished.

One thing we must address is the need for better quality food, for food that contains more natural vitamins and minerals, for food that is grown in good soils under the proper conditions, for animals that are raised without artificial growth stimulants -- when food quality is low and food is nutritionally deficient, our bodies respond by craving more food. We eat a great many high-calorie foods that are nevertheless inadequate to supply our bodies' needs for micronutrients. I believe that one could argue convincingly that when people have food that is fulfilling their nutritional needs (not just for calories, but for minerals and vitamins as well) they eat less than if they are trying to compensate for nutritionally deficient foods.

There is a direct connection between the industrialization of the food supply (and high-fructose corn syrup again is the posterchild for this), the decline in the nutritional quality of food, and the overconsumption of food. The author of Supersize Me showed just how a fast food diet can cause obesity. He received a superabundance of calories, but his health actually declined because he was undernourished! Many of our children are in this exact same situation -- eating a lot, but not getting the nutrients they need. Calories are not the only nutritional aspect of food. We need to pay more attention to getting the best quality of food to feed to our children. That means turning away from industrialized and pre-processed foods, eating more raw foods, eating organic vegetables (because the use of manufactured fertilizers depletes soils in micro-nutrients), and avoiding meat of animals raised in feed lots where they are fed corn, antibiotics and growth hormones!

As a reviewer of non-fiction science books, I read and review 50-75 such books a year, but Ms. Wilson's is the first book that completely changed my behavior. The first time I went to shop for groceries after finishing Swindled, I took twice as long because I was reading so many labels, and found myself rejecting formerly habitual purchases in favor of unprocessed whole grains, fruits, vegetables, and locally-grown meats.

Yes, exercise is important, getting kids away from televisions and computers is important, engaging kids in outdoor activities is important -- but equally important is ensuring that what we feed our children actually nourishes them -- that they are actually satisfied by eating real food, prepared at home without fake ingredients.
SciObserver —
A report from a recent study about the counterintuitive combination of malnutrition and obesity:

http://www.star-telegram.com/news/story/1045715.html
David Miller —
I know that America has a weight problem, and as a whole, we are not healthy. But I wonder if I am giving my daughter a complex about her weight. There is so much attention put on weight. My daughter is not obese, but she is very tall and not skinny. She ? we eat very healthy, well balanced food ? don?t eat store bought junk get plenty of exercise and don?t watch a lot of TV - and all that ? but I am constantly talking about nutrition and weight gain - I feel like I might do the opposite to my daughter ? drive her to anorexia
MaryLL —
Has anyone ever considered a "fat tax"? Historically, if you want to deter a certain behavior, tax it. Studies show that alcohol consumption (and specifically binge drinking) was reduced when alcohol carried a tax. It seems to me that one reason why it is easy to gain weight is because fatty foods and high carb foods are cheap. In fact, in some supermarkets, veggies cost MORE than potato chips. Why not tax certain foods that contain more than a certain number of fat grams (some fat is indeed necessary). Furthermore, why not SUPPLEMENT the healthy foods, such as produce, with the money earned from the tax?! In a low socioeconomic family with a fixed income, what might they be motivated (and able) to buy then? How the world would change if a Big Mac cost $10.00 and an apple cost 15 cents!
JBullock —
We can all point to 1000 different causes of obesity that aren't the fault of the obese individual, but somewhere in there we have make it clear that the decisions of the obese individual or family play a major part. It was the decision of the family in the first story to get rid of their television and shop for real food that made the difference in their overall health.

Should we change policies to support healthier foods over processed foods? yes. Should we ban soft drinks in schools? Yes. But we still must hold people to a degree of responsibility for their part otherwise we allow them to abdicate any responsibility for their health. It is only through taking some control that one will be able to make long term changes necessary to improving one's health.

hazeladd —
While 'diet & exercise' indeed is an oversimplification, the phrase 'lifestyle' seems to be a better term.

I work with a non-profit dedicated towards the building of skateparks. One thing we have found is that skateboarding is a great way for the youth of today to burn calories.

Sure, some traditional thinkers look at skateboarding with some suspicion - but in this day and age anything that gets kids off of the couch and reduces screen time is a good thing.

In short, I rarely see overweight kids (or adults) at the skatepark - but they are always crowed.

-Chad

skatepark.org

skateportland.org
Chad Balcom —
The reason people are overweight in the USA is nothing to do with all these complex theories. It is actually quite simple and somewhat boring. It is called circumstance. America is prosperous, and Americans like value for money. Restaurants began to give people value, with bigger portions, free refills and slowly overtime---all these things kept getting bigger to satisfy economic success.

The problem isn't that Americans are really greedy and glutinous, they just slowly became accustomed to better value, and better value meant larger portions. Now everyone is used to these bigger portions and it is hard to go back. Europeans aren't skinnier because they are great, kind, responsible people, they are skinny because economics dictated that they had to be. They are skinny because of economic and functional circumstance. The solution to this is not about blame, but rather how do we create a different economic culture and how do you satisfy a market whose growth has for so long depended on an ever escalating "better value."
scottmil —
I've always wondered if the widespread use of canola oil in foods in the US could have anything to do with the increase in obesity. Long term use of canola oil, which is made from genetically modified rapeseed (normally poisonous), was never tested for its long term effects before its widespread adoption. I wonder what your endocrinologist guest knows about this -- have there been any studies of its relationship to obesity?
Leni Ortenburger —
Unfortunately my 14 year old female cousin is extremely overweight at probably close to 200 pounds. She is a wonderful, sweet girl. When I spend time with her family, I see her drinking soda and eating chips for breakfast. When I see her reach for a second soda of the morning, I tell her no and feel like a monster. Her family has been through a lot with the recent death of her father (my uncle)after a long illness. Could you please comment on the relationship between depression and emotional hardship and obesity and also the role that I and other family members can play to influence positive change in that family. Thanks.
adexter —
What do your guests think about the new menu labeling policy introduced by Multnomah County Commissioner Jeff Cogen introduced a few months ago? The policy would add calories to the menus of chain restaurants.
cook97203 —
The flip side of the childhood "obesity epidemic" is the corresponding rise in eating disorders among younger and younger children - particularly girls, but also boys - who are inculturated at an early age to believe that thin=good and fat=bad.

Ironically, some new studies suggest that among some urban children, at least, obesity is not a matter of over-eating, but of eating the wrong things.

Quoting an article published today in the Fort Worth, TX Times-Leader:

"A 9-year-old should consume 1,400 to 2,200 calories daily to sustain growth, said Dr. Roberto Trevino, director of the nonprofit Social and Health Research Center. But in the study of 1,400 inner-city children, 44 percent were consuming less than 1,400 calories, and 33 percent were obese."

It turns out that those children are deficient in key elements - calcium, magnesium, potassium and phosphorus - necessary for normal growth and metabolic activity.

(http://www.timesleader.com/news/Obesity_among_poor_children_tied_to_diet_11-19-2008.html)

No child should be on a weight-loss diet. Rather, children should be encouraged to enjoyable physical activity - not "exercise," but play - that will keep them active and strong all their lives. And in encouraging their children to live more health lives, parents should be very careful about the messages they send. Even pudgy children need to know that they are beautiful, and loved.

There are studies suggesting that among older people, the risk of being too thin outweighs the risk of being too fat, in terms of premature death. Very thin women, for instance, are at higher risk for bone loss and breakage than their more padded sisters.

However, our culture is so obsessed with fat that these studies are regularly ignored by the media, and weight-obsessed Americans wind up in a spiral of diet-regain-diet-regain which is actually more dangerous than being fat.

I recommend the excellent blog, Junkfood Science (http://junkfoodscience.blogspot.com/) for a more careful analysis of the science behind weight and other health issues.
kightp —
A number of folks have made comments suggesting a fear of letting their kids play outside. Isn't it tragic that the grossly exaggerated risk of the boogie man sneaking up and steeling children has left parents in a position where they push their kids into activities that will reduce their life expectancy by a third. If one in 3 or 4 children were being kidnapped, the exchange might be worth it, but that's not the reality. Send your kids to the park!
hazeladd —
I agree. There is also pressure from OTHER parents if you let your children walk up the street to a friends house alone. The media has scared us into our homes. My son is 8 yrs old. How is it possible that he isn't old enough to cross the street by himself in his own neighborhood?
bwcathompson —
I wanted to share a possible solution: I work at OHSU for a National Institutes of Health funded study called HEALTHY. The study is testing a type 2 diabetes intervention for middle schoolers and is a collaboration among 8 research universities around the country. The intervention includes modified, more efficient PE classes, elimination of soda and unhealthy snacks from vending machines, healthier options in the cafeteria and a 30 minute, weekly class that teaches about a healthy lifestyle. If the research finds that the intervention is successful, the program might be implemented in middle schools around the country. This could be part of a larger solution to childhood obesity.
firedancer —
I was an overweight child and as an adult it is still a daily struggle to keep my weight in a healthy range, but I know it's something I will have to be conscious of all my life. I was raised in a family where eating heartily was seen as a sign of virtue and pride, so while it's easy for me to eliminate fast food and other processed foods from my life I still find it difficult not to over eat on foods that are considered healthy. Now that I have two young children I want to be very careful to raise them to listen to their bodies and stop eating when they are no longer hungry. They're both currently at an age where they haven't learned to over eat yet, but when this comes up in a few years I will be actively watching for over eating behaviors and stop them before they become habits. Then I will work on convincing my parents to do the same thing.
Katypdx75 —
I gained 20-30 pounds in high school. I hadn't noticed the weight, because it was so gradual. However, when I spent the summer abroad, in Finland, I came home with all my clothes practically falling off and about 25 lbs lighter. I didn't try, or even notice until I got home, that I was losing weight. I attribute the change to how I ate in Finland. I had 3 meals every day, a huge lunch and a small breakfast and dinner. I still had sugary chocolates and ice cream 4 or more times a week. I walked more, and I was more active, boating and swimming, but not to an extreme extent. I also feel that my lack of concern about what I was eating really helped. As soon as I got back I started to obsess about "eating healthy" and being thin. I gained 5 pounds right back and I was miserable. Also worrying and not feeling good enough. Even though I was now trying to be thin and healthy. As soon as I got busy with school and forgot to worry about my weight again it went down to the healthy, post-Finland level. Has anyone else experienced this weird weight gain while eating well but worrying about gaining weight?
mheart —
I believe that families are larger over all than when I grew up (I'm 43).I think that some parents do not see their kids are overweight.

My kids are thin. We get lots of pressure to get our kids to eat more. My friends kids are heavier and the parents call them "solid". How is an 8 yr old solid? Solid muscle? Not possible. These are college educated parents. What gives?
bwcathompson —
Schools play such an important role in nutrition education. What is taught in the classroom is completely opposite of the options they are given in the cafeteria. Sodexho provides food services at my son's Oregon City school. Each day they have the option to choose from cheese, pepperoni, Hawaiian, and combo pizza, hamburger, cheeseburger, sub, nachos, soft taco plus a daily entree which typically includes popcorn chicken, wiener wraps, meatloaf, corn dogs, or cheese bread sticks to name a few. Yes there is also a salad bar and, at times, a healthy entree. However, the vast majority of food options are loaded with fat and junk carbs.

I never let my son eat the school meals and always make sure he takes a healthy lunch made at home.

WesleyR —
In the Beaverton School District our school offers PE every other day for 30 minutes. Why hasn't this become a bigger priority and scheduled every day for an hour (how I was raised)

Cynthia
bwcathompson —
I worked for a program called Let's Get Movin' in Boston that taught overweight and obese children how to lead a healthier lifestyle. Overweight youth were referred into the program by their doctor and then participated in classes four times a week. We used a combination of nutrition and exercise classes to help these children eat healthier and be more active. One of the components of our program that seemed to really work were family cooking lessons and vegetable gardening.

Are there any programs that specifically work with obese children in Portland? If so, how do they approach this problem?
IanLandus —
I am not a vegetarian; however I heard about this class being offered through PCC by David Gabbe, called Vegetarian Dessert Heaven and decided to give it a try. The food was wonderful, delicious and if I hadn?t been told it was vegetarian I would never have known.

Here is a link to his web site. He does classes all around the Portland area.
http://www.davidsvegetariankitchen.com/

So instead of unhealthy snacks, parents should try to come up with healthier choices, like the ones that David Gabbe teaches in his classes.
JMehegan —
I think it is quite disingenuous to claim that the school lunch program has nothing, or very little to do with the problem. In Title 1 schools obesity starts with breakfast: Cheese Pleasers, Pancakes (with the syrup build in), tater tots, and so on. These are the schools that service the most at risk youth, those whose poverty prevent them from seeking and serving wholesome food at home. My school's kitchen doesn't even have a proper oven, steam table or grill... warming oven and serving area heated with lights. There is no cooking going on there.

We influence our kids' taste for processed and sweet foods at the elementary school level and this taste continues when they come home.

I have twin boys in the fourth grade. One is learning disabled and the other isn't. We eat a low-fat, vegetarian diet at home. I make lunches for them every day, and have since their first day of school. Why is one boy overweight and the other isn't?

I discovered that children are, for the most part, allowed to eat as much as they want at breakfast. A boy like mine, who cannot self-regulate, is allowed to eat six or seven times. The school gets reimbursed for the meals they serve, the food is loaded with fat and sugar, the child cannot self-regulate and you have a perfect storm for obesity.

I volunteer at the school quite often, but still I am unable to watch my son everyday and everywhere. I invite you to have lunch with your child -- or better, breakfast -- and you will be absolutely dismayed by a salad bar filled with iceberg lettuce, carrots that bear a chemical taste, chili served with "scoopin' chips," and Uncrustables. It is absolutely appalling, and to say that the public schools bear no responsibility in all this is quite laughable.

Check out more at http://www.thinkgoodthoughts.com
homedad —
I think what is often missing from these conversations about childhood obesity is the examination of the very 1st food that we give our children. The impact of giving formula to our children vs. formula is huge. Not only is the 2nd ingredient in most formulas high fructose corn syrup or its equivalent but research has shown that formula feeding our babies will increase the likely hood that those children will get Diabetes (both type I and 2), heart disease, cancer, asthma, I could go on and on. When will we start really supporting women and giving families the information and resources to make that important early choice for their children that will impact them for the rest of their life.
megstalnaker —
Whoops. My comments above were meant to say - The impact of formula vs. human milk.....
megstalnaker —
I'm a civil engineer, and as alluded to by a previous caller, part of the problem is urban and suburban design - the built environment is designed to move people seated in cars, not walking or really even cycling.

Also, the biggest difference I see since I was a kid in the '70s is that when I went outside, it was wide open country - room to roam, run, explore, and live. Today that same countryside is housing - my nieces and nephews step outside in the same part of the county, and they're in their neighbor's yard. Television's just become more attractive.

I'm curious whether the panelists have any thoughts about the use of electronics - especially those with headphones that promote social isolation - on the level of physical activity in users.

Thanks - great show.

John
John Axford —

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