Kids and obesity

SNOHOMISH — It was scoliosis screening day, 2001, at Valley View Middle School.

Dozens of boys and girls removed their tops so nurse Theresa Fay Hutchison could check for unusual curves along the lengths of their spines.

What she saw scared her, though it had nothing to do with the children’s’ spines.

"Without exaggerating, at least 50 percent of our seventh-graders that I screened, both boys and girls, were very obese — lots of extra fat and tissue literally hanging over their pants," Hutchison said. "If I was to reach out with my hand, I could grab a chunk.

"I walked out thinking: How did we get this way?"

Health experts across the country call childhood obesity an epidemic. Though that word is usually reserved for fast-spreading, contagious diseases, terming childhood obesity an epidemic is an attempt to get parents to pay attention.

It’s called an epidemic because of how quickly it has become a major health risk to children up to 19 years old, one that’s likely to lead to lifelong health problems unless exercise and eating habits change.

Today there are more than twice as many obese 6- to 11-year-olds as there were in the 1970s. In 2000, 15.3 percent of U.S. children in that age group were obese, compared to 6.5 percent in the late 1970s.

The problem is worse for those 12 to 19 years old — to 15.5 percent — At least one of every six children, or 15.5 percent, is obese. That compares with 5 percent in the late 1970s, according to the federal Centers for Disease Control and Prevention.

What does this mean on the scales?

A typical 11-year-old girl weighed 11 more pounds in mid-1990s than in the 1960s.

In Snohomish County, about 8 percent of eighth- and 12th-graders are obese, while 10.5 percent of 10th-graders are obese, according to a fall 2002 state Health Department survey. The findings were based on students reporting their height and weight.

Even more students in all three grades are overweight and at risk of becoming obese.

Of all students in the county, 14 percent of eighth-graders, nearly 13 percent of 10th-graders and nearly 14 percent of 12th-graders weigh at least a third more than their peers.

The statistics aren’t just for health experts to use for laying guilt trips on parents, or to fan the flames of another health scare.

"We see the devastating effects of obesity every day," said Dr. Ben Danielson, medical director of the Odessa Brown Children’s Clinic in Seattle. "It’s tragic to see the beginning of lifelong problems."

Obese children have more diabetes and more joint pain. Obesity makes childhood asthma worse. In adolescence, obese girls have more painful menstrual cycles.

Obese children often have high blood pressure. Their labored breathing leads to troubled sleep. That makes obese children tired, and can affect their school performance.

Obesity isn’t a problem children grow out of. The chances of overweight children becoming seriously overweight or obese adults increases with age, from about 20 percent at age 4 to approximately 80 percent at adolescence.

The potential health care costs associated with childhood obesity are great. In 2001, the U.S. surgeon general warned the costs could exceed those associated with cigarette smoking.

Obesity also takes a psychological toll on children at a time when they can be particularly vulnerable.

"Their self-confidence has been kicked around so much — the last to be picked for a team, the one who can’t complete the run in PE class," said Caroline Brown, health and fitness director for the Marysville YMCA. "Pretty soon, there’s no self-esteem left.

"So all they see every single day in the mirror is, ‘I’m a fat kid. ’ "

Children themselves believe there’s a problem with kids being overweight.

"If kids realize that they don’t want to die at age 40 of a heart attack, they might want to consider being more active and listening to what they say at school — that certain foods are good," said Alex Fischer, 13, a seventh-grader at Valley View Middle School.

More than half of children 9 to 13 years old believe there’s a problem with kids being more than a few pounds overweight, according to a national survey from Southern Illinois University.

Not exercising enough and not eating right were listed as some of the causes by children surveyed in nine cities.

And 44 percent of those surveyed said no one —parents, teachers or doctors — ever talks to them about their weight.

Kids often get the message that they’re supposed to look like that skinny person on TV. That makes it difficult for many seriously overweight children to bring up the topic with their doctors, "let alone stepping into a plan and dealing with it," said Danielson of the Odessa Brown Clinic, part of Seattle’s Children’s Hospital and Regional Medical Center.

Television, computers and video games have been blamed as reasons for childhood inactivity.

One telling statistic: 20 percent of U.S. children ages 8 to 16 report two or fewer instances of vigorous exercise a week, while more than 25 percent watch at least four hours of television a day, according to the American Academy of Pediatrics.

The organization suggests limiting television and video game time to two hours a day.

Almost 60 percent of Snohomish County eighth-graders who are overweight said they spent three or more hours a day watching television, playing video games or using a computer for fun, according to the state Health Department.

The ads children see while watching TV play a far bigger role in obesity, according to a report by the Kaiser Family Foundation.

The typical child is exposed to 40,000 ads a year on TV. The majority of ads targeted at kids tout candy, cereal, soft drinks and fast food, the report said.

Candy and snack companies are marketing Web sites to kids with arcade games, action sports and downloads, said Vicky Rideout, a foundation vice president.

"They’re spending an average of 12 minutes playing the game, which is like a 12- minute ad," Rideout said.

Food-industry marketing and advertising to young people "is very sophisticated, expensive and effective," she said, with products strategically placed in movies, video games, on the Internet and on TV.

In addition, flipping on the TV has a habit-forming association — reaching for snacks.

"Sometimes, there’s an automatic thing that takes over, you’re eating by rote and you don’t realize how much you’re eating," Rideout said.

Former Gov. Booth Gardner is so concerned about childhood obesity that he has called for a statewide summit this year to discuss the issue.

"I’ve done a lot of work with youths all my life," Gardner said. "I was concerned that lately we see more and more kids not participating in activities that allow them to stay fit."

He’s bringing together parents, teachers politicians, doctors and others as part of the national Coalition for a Healthy and Active America. The idea is to create demonstration projects that help children slim down — and show evidence that they work.

"No one thing is going to be the answer," he said. "It has to be a way of life, a value in the family."

So why don’t families pay more attention to the problem of childhood obesity?

"Oh, please! It’s hard!" said Julia Graham Lear of the Center for Health and Health Care in Schools in Washington, D.C..

"Times have changed, the environment has changed and the family structure has changed," Lear said. "Every one of those changes has tended to mitigate against a lot of exercise and encourages consuming more calories that you probably need.

"You go out to the suburbs, and a lot of developments don’t have sidewalks. Where’s your kid going to ride the bike?"

And if parents spend several hours a day commuting, it’s unlikely they’ll come home and say to their kids: "Let’s go roller skate in the dark," she said.

"We’ve got two-worker families in most cases. They’re tired at the end of the day and they stop at McDonald’s."

Overblown fears over child safety also keep many parents from pushing their kids to play outside.

Only one-third of children in the United States who live within a mile of their school walk to classes, said Dr. William Dietz, director of nutrition and physical activity for the federal Centers for Disease Control and Prevention.

"One of the worst things that happened was the milk-carton campaign of missing or abducted children," Dietz said. "It created the illusion that it’s unsafe for children to walk to school."

While some parents may know about the problem of child obesity, they may not recognize it in their own children.

"When you do surveys of American parents, they say, ‘Yes, children are overweight, but not my kid. He looks like everybody on the Little League team.’ The problem is, they’re all wearing XXX-sized uniforms," said Joe Piscatella, author and founder of the Institute for Fitness and Health in Gig Harbor.

To notice that their child is seriously overweight might make parents feel they "haven’t done such a hot job of parenting," he said.

"In a society that has allowed schools to have candy machines and soft-drink machines in order for the school to have enough money," Piscatella said, "in a society that allowed physical education to go away and fast-food companies to handle (school) lunches, there are a lot of complicated forces at work here that may overwhelm a parent."

Snohomish parent Cati Sandoval, 31, has run one marathon and several half-marathons. Her goal this year is to participate in a half-Ironman competition: a 1.5-mile swim, a 13.1-mile run and a 56-mile bike ride.

Her daughter, Stephanie Nikolaisen, participates in mini-triathlons, runs cross country, is a member of volleyball and softball teams, and ran in the kids Seattle Marathon last fall.

Even with all that family activity, her mother said she sometimes has to urge Stephanie to turn off the TV.

"A lot of times, you have to force the children to go out," she said.

Stephanie, 12, a seventh-grader at Valley View Middle School, said students don’t think much about the consequences of inactivity until doctors tell them their health could be hurt if they don’t become more active and watch what they eat.

"It’s usually when they start to gain weight that they’re concerned," she said.

Stephanie joins her mother for workouts at the gym or bikes alongside her mom when she goes for a run.

"One of the biggest reasons for kids not being active is intimidation," Sandoval said. "Even adults don’t start something new unless it’s introduced."

The most critical thing for parents to understand about getting kids active is that "kids don’t do what you tell them to do, they do what you do," Piscatella said.

"What kind of example are you setting for your child about physical movement in your own life?

"If you’re a La-Z-Boy rocker guy who likes cheeseburgers, what in the world leads you to think your kid is going to be physically active and eat vegetables?"

Children in families where both parents exercise are about six times more likely to be active as those whose parents don’t exercise, Piscatella said.

Being active doesn’t have to mean putting kids in formal exercise classes. It can be routine daily activities such as walking the dog, raking leaves in the yard or not circling the parking lot looking for the closest space but parking farther away and walking, Piscatella said.

Children learn by copying the adults around them, said Patty Hencz of the obesity action team at Children’s Hospital in Seattle. "Your child may not listen to you, but they’ll never fail to imitate you," she said.

Childhood obesity isn’t just the child’s problem.

"This is a family lifestyle issue," Hencz said. "If you make healthy eating, activities and attitudes toward food a family value, it’s much more manageable than trying to focus on one individual."

Rather than making heavy children feel as if they’re being punished, "let’s explore some new recipes that are lower in fat, fun to cook and healthy for everyone," said Brown, the health and fitness director for the Marysville YMCA.

One weight-sensitive teen told Brown of going to a family picnic. While everyone else was eating hot dogs, hamburgers, potato salad and chips, the girl was told she had to eat salad.

"The family has to come on board," Brown said. "If we don’t focus on that, it isn’t going to work."

"Think of it as a family challenge instead of identifying that person as having this big problem," said Danielson, the medical director at Seattle’s Odessa Brown clinic.

The way you live is important.

Not just for your own health, "but for setting the foundation of the health of your children," Piscatella said.

As much as people want a quick fix, it takes concentrated effort to change.

"You’re making conscious decisions about lifestyle," Hencz said.

"It’s complex. It’s emotions, activity, behavior and the media. There’s so many things that contribute. You’ve got to pay attention."

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.

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