The American Academy of Pediatrics has dedicated September as National Childhood Obesity Awareness Month. Childhood obesity is, indeed, a national health concern as nearly one of every five children is obese and at risk for what once were considered adult health problems, such as type 2 diabetes, high blood pressure, and heart disease. Fortunately, childhood obesity can be prevented and reversed.
Measuring Obesity in Children
Body mass index (BMI) is one indication of obesity. It measures a person’s weight divided by that person’s height to indicate the percentage of body fat. Pediatricians begin plotting children’s BMIs on growth charts at the age of 2. These charts track children’s growth patterns and compare them to average heights and weights. For children and teens, BMI is specific to age and sex. Although not a precise science (a large-framed child could have a lot of muscle and, therefore, a high BMI, for instance), BMI calculation is a way to monitor personal trends.
A child with a BMI below 5 percent for his or her age, gender, and height is considered underweight, while a child with a BMI of 95 percent is considered obese. Overweight kids fall in the 85th percentile, and healthy-weight kids are in the 5 to 85 percent range. (See the Centers for Disease Control and Prevention’s Child & Teen BMI Calculator to determine your child’s body mass index.) To put the numbers into perspective, an average-height 10-year-old boy should weigh around 70 pounds, while an average-height obese boy will weigh 100 pounds.
Prevalence of Childhood Obesity
Obesity can be harmful to children in a number of ways, and, unfortunately, current trends and statistics are not promising: According to Harvard University’s T.H. Chan School of Public Health, 5 percent of U.S. children ages 2 to 19 were obese in the 1970s. By 2008, that number had more than tripled, to 17 percent. The CDC estimates that currently 39.8 percent of adults and 18.5 percent of children are obese. Of those in the 12 to 19 age range, 20.6 percent are obese.
Children do not fare much better globally, where an estimated 43 million children under the age of 5 were overweight in 2010, a 60 percent increase from 1990. The greatest proportion of those children, around 35 million, live in developing nations.
Lifestyle issues are mainly to blame for the childhood obesity epidemic. Most experts point to the overconsumption of food and drinks high in calories as the leading lifestyle issue causing obesity. Too little activity is another, and genetics and hormones also contribute to being overweight and obese.
Risk Factors of Obesity
There are many factors at play in childhood obesity, including the following: 
- Diet: With the advent of prepackaged food, inexpensive fast food, subsidies given to corn and dairy producers to make more products high in carbohydrates and sugar, and advertising dollars promoting sugar- and fat-laden products aimed at children, children’s diets have become higher in unhealthy calories over the past few decades.
- Lack of exercise: Spending time in sedentary activities, like playing video games, sitting in front of computer screens, and watching TV, contributes to fewer calories burned by children.
- Family factors: Kids who come from a family of overweight individuals have a higher chance of being overweight too, especially if high-calorie foods are always on hand and physical activity is not a priority.
- Psychological factors: Stress can increase a child’s risk of being obese since children may overeat to deal with their emotions.
- Socioeconomic factors: Children who live in communities with limited access to supermarkets and a variety of healthful foods (called “food deserts”) have a higher chance of obesity, especially if their neighborhoods are unsafe and access to exercise spaces is limited.
The Problems Associated with Obesity
Childhood obesity can affect children on many levels, including physically, socially, and emotionally. The following conditions can arise from being obese:
- Type 2 diabetes: Once known as “adult-onset diabetes” because it was practically unheard-of in children, this chronic condition affects the way the body makes and uses the pancreas-producing hormone insulin, which can lead to insulin resistance and high blood sugar levels. Many adverse health conditions can occur from type 2 diabetes, including heart disease and stroke, nerve damage, kidney damage, blindness, depression, and amputation.
- Metabolic syndrome: This combination of conditions increases blood pressure, blood sugar, and body fat around the waist, and contributes to high triglycerides and low HDL (good) cholesterol. It puts kids at risk for heart disease, stroke, and type 2 diabetes as adults.
- High cholesterol and high blood pressure: These conditions cause a buildup of plaques that can narrow and harden the arteries, leading to a heart attack or stroke in years to come.
- Asthma: Obesity can produce more abdominal fat on the lungs, making it difficult to breathe.
- Sleep disorders: Excess fat deposits in a person’s neck can cause sleep apnea, the blocking of the upper airway during sleep.
- Nonalcoholic fatty liver disease (NAFLD): With NAFLD, fatty deposits build up in the liver, leading to scarring and liver damage.
- Bone fractures: Although bones in the obese tend to be denser than in nonobese people, they are not as strong as they need to be to support the extra weight.
- Low self-esteem and being bullied: Overweight children are often bullied, causing them to suffer a loss of self-esteem and an increased risk of depression.
- Behavior and learning problems: Obese children tend to have more anxiety and poorer social skills than the nonobese or overweight.
- Depression: Low self-esteem and bullying can lead to feelings of depression.
Obesity Prevention
Libraries are filled with books on diet and exercise plans to thwart obesity. The following recommendations are for children at risk of becoming obese and for those currently at an unhealthy weight: 
- Eat whole grains
- Eat vegetables other than potatoes
- Consume whole fruits, not fruit juices
- Eat nuts, seeds, and beans
- Eat fish and poultry
- Eat foods cooked in olive oil and other vegetable oils
- Drink water or beverages that lack calories naturally (unsweetened hot or iced tea, sparkling water, seltzer water)
- Limit or eliminate the consumption of sugar-sweetened foods, like candy, ice cream, and other treats
- Limit or eliminate the consumption of refined grains, such as white bread, white rice, and white pasta
- Limit or eliminate highly processed foods, such as fast food, chips, and breakfast cereal
- Limit or eliminate processed meats (salami, ham, bacon, sausage) and red meat
- Reduce portion sizes
Other ways parents can contribute to healthy weight in their children, include:
- Avoid eating out, especially at fast-food restaurants, to control portion sizes and limit calories
- When eating out, recommend healthy meals to your children
- Limit TV and other screen time to less than two hours a day for kids over age 2, with no TV or screen time for children under 2
- Encourage eating breakfast to avoid feeling ravenous and resorting to junk food later in the day
- Model good behavior by eating well and exercising in front of and with your children
- Teach mindful eating by encouraging healthy choices and enjoying the flavor of food
- Establish an adequate amount of sleep for your children, following American Academy of Pediatrics guidelines:
- Infants 4–12 months old: 12–16 hours in a 24-hour period
- Children 1–2 years old: 11–14 hours
- Children 3–5 years old: 10–13 hours
- Children 6–12 years old: 9–12 hours
- Teens 13–18 years old: 8–10 hours
Herrick Library Resources
The following books and DVDs can be requested and checked out from Herrick Library via curbside pickup or online as ebooks via OverDrive, where indicated:
- A Big Fat Crisis: The Hidden Forces Behind the Obesity Epidemic and How We Can End It, by Deborah Cohen, M.D.: Dr. Cohen argues that the obesity crisis is rooted in humans’ being hardwired to eat and lacking self-control, as well as the modern food environment.
- Don’t Eat This Book: Fast Food and Supersizing of America, by Morgan Spurlock: The Super Size Me documentarian points to school lunch programs, the lack of physical education, and the marketing of fast food as contributors to America’s obesity problem.
- Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, by Robert H. Lustig, M.D.: This New York Times best seller reveals how the increase of sugar in our diets has created the obesity epidemic.
- Fed Up (review on the blog to come later in the week): Narrated by Katie Couric, this eye-opening documentary explores the hidden truths behind the childhood obesity epidemic in America, namely the misdeeds of the food industry and the role of the U.S. government.
- Food and You: An Alien’s Guide, by Alex Francis: This children’s nonfiction ebook teaches kids the basics about food literacy, including healthy eating, portion size, and what vitamins and minerals do for the body.
- How Not to Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss, by Michael Greger, M.D.: This book explains the cutting-edge science behind long-term weight loss.
- Never Goin’ Back, by Al Roker: The TV personality reveals his lifetime battle with weight loss in this memoir.
- Sesame Street: Let’s Cook, by Susan McQuillan: Fifty healthful, fun recipes for kids are presented by Sesame Street’s Elmo in this ebook.
- Weight Management: Childhood and Adolescence FAQs, by William J. Cochran, M.D.: Dr. Cochran explains the factors that contribute to childhood obesity and answers common questions parents may have on helping children live healthier lives.
These periodicals on healthy eating and lifestyle can be checked out from Herrick Library or read online via Flipster:
- Alternative Medicine
- Bicycling
- Clean Eating
- Diabetes Health
- Diabetes Self-Management
- Diabetic Living
- Eat Well
- Eating Well
- Health
- Outside
- Parents
- Prevention
- WW (Weight Watchers)
- Yoga Journal
- Your Teen for Parents
Sources: American Academy of Pediatrics, AAP Supports Childhood Sleep Guidelines, https://www.healthychildren.org/English/news/Pages/AAP-Supports-Childhood-Sleep-Guidelines.aspx; Atrium Health, https://m.kidshealth.org/Levine/en/parents/bmi-charts.html; Centers for Disease Control and Prevention, Body Mass Index, Child & Teen Calculator, https://www.cdc.gov/healthyweight/bmi/calculator.html; Harvard School of Public Health, Obesity Prevention Source: Child Obesity, https://www.hsph.harvard.edu/obesity-prevention-source/obesity-trends/global-obesity-trends-in-children/; Harvard School of Public Health, Obesity Prevention Source: Healthy Weight Checklist, https://www.hsph.harvard.edu/obesity-prevention-source/diet-lifestyle-to-prevent-obesity/; Mayo Clinic, Childhood Obesity, https://www.mayoclinic.org/diseases-conditions/childhood-obesity/symptoms-causes/syc-20354827; Obesity Action Coalition, Understanding Obesity and Type 2 Diabetes, https://www.obesityaction.org/get-educated/public-resources/brochures-guides/understanding-obesity-and-type-2-diabetes-brochure/
Graphics: CDC, https://www.cdc.gov/obesity/childhood/index.html; CDC, https://www.cdc.gov/nccdphp/dnpao/features/childhood-obesity/index.html; Southeast District Health Department, http://www.sedhd.org/;
