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Childhood Obesity
Our modern sedentary lifestyles are taking tolls on everyone.
More and more of us are no longer physically active at home or
at work. We eat too much and we eat the wrong foods. And to our
horror, our children are following in our footsteps, at a very
early age. Childhood Obesity has been recognized as an epidemic
in many places around the world. The research studies are eye
opening. We have not come to terms with this disease, although
me must. We are just learning how immense its scope is. We are
just learning how to address it individually and as a society.
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Helping Your Overweight Child
Healthy eating and physical activity habits are key to your child’s
well-being. Eating too much and exercising too little can lead to overweight
and related health problems that can follow children into their adult
years. You can take an active role in helping your child - and your whole
family - learn healthy eating and physical activity habits that can last
for a lifetime.
Is my child overweight?
Because children grow at different rates at different times,
it is not always easy to tell if a child is overweight. If you think
that your child is overweight, talk to your health care provider. He
or she can measure your child’s height and weight and tell you if your
child is in a healthy range.
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How can I help my overweight child?
Involve the whole family in building healthy eating and physical activity
habits. It benefits everyone and does not single out the child who
is overweight.
Do not put your child on a weight-loss diet unless your health
care provider tells you to. If children do not eat enough, they may
not grow and learn as well as they should.
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- Tell your child that he or she is loved, is special, and is important.
Children’s feelings about themselves often are based on their parents'
feelings about them.
- Accept your child at any weight. Children will be more likely to
accept and feel good about themselves when their parents accept them.
- Listen to your child’s concerns about his or her weight. Overweight
children probably know better than anyone else that they have a weight
problem. They need support, understanding, and encouragement from parents.
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Encourage healthy eating habits
- Buy and serve more fruits and vegetables (fresh, frozen, or canned).
Let your child choose them at the store.
- Buy fewer soft drinks and high fat/high calorie snack foods like
chips, cookies, and candy. These snacks are OK once in a while, but
keep healthy snack foods on hand too and offer them to your child
more often.
Eat breakfast every day. Skipping breakfast can leave your child
hungry, tired, and looking for less healthy foods later in the day.
- Plan healthy meals and eat together as a family. Eating together
at meal times helps children learn to enjoy a variety of foods.
- Eat fast food less often. When you visit a fast food restaurant,
try the healthful options offered.
- Offer your child water or low-fat milk more often than fruit juice.
Fruit juice is a healthy choice but is high in calories.
- Do not get discouraged if your child will not eat a new food the
first time it is served. Some kids will need to have a new food served
to them 10 times or more before they will eat it.
- Try not to use food as a reward when encouraging kids to eat. Promising
dessert to a child for eating vegetables, for example, sends the
message that vegetables are less valuable than dessert. Kids learn
to dislike foods they think are less valuable.
- Start with small servings and let your child ask for more if he
or she is still hungry. It is up to you to provide your child with
healthy meals and snacks, but your child should be allowed to choose
how much food he or she will eat.
Healthy snack foods for your child to try:
Fresh fruit
- Fruit canned in juice or light syrup
- Small amounts of dried fruits such as raisins, apple rings, or
apricots
- Fresh vegetables such as baby carrots, cucumber, zucchini, or tomatoes
- Reduced fat cheese or a small amount of peanut butter on whole-wheat
crackers
- Low-fat yogurt with fruit
- Graham crackers, animal crackers, or low-fat vanilla wafers
Foods that are small, round, sticky, or hard to chew, such as
raisins, whole grapes, hard vegetables, hard chunks of cheese, nuts,
seeds, and popcorn can cause choking in children under age 4. You
can still prepare some of these foods for young children, for example,
by cutting grapes into small pieces and cooking and cutting up vegetables.
Always watch your toddler during meals and snacks.
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Encourage daily physical activity
Like adults, kids need daily physical activity. Here are some ways
to help your child move every day:
Set a good example. If your children see that you are physically
active and have fun, they are more likely to be active and stay active
throughout their lives.
- Encourage your child to join a sports team or class, such as soccer,
dance, basketball, or gymnastics at school or at your local community
or recreation center.
- Be sensitive to your child’s needs. If your child feels uncomfortable
participating in activities like sports, help him or her find physical
activities that are fun and not embarrassing.
- Be active together as a family. Assign active chores such as making
the beds, washing the car, or vacuuming. Plan active outings such
as a trip to the zoo or a walk through a local park.
Because his or her body is not ready yet, do not encourage your pre-adolescent
child to participate in adult-style physical activity such as long
jogs, using an exercise bike or treadmill, or lifting heavy weights. FUN physical
activities are best for kids.
Kids need a total of about 60 minutes of physical activity a day,
but this does not have to be all at one time. Short 10- or even 5-minute
bouts of activity throughout the day are just as good. If your children
are not used to being active, encourage them to start with what they
can do and build up to 60 minutes a day.
FUN physical activities for your child to try:
Riding a bike
Climbing on a jungle gym
Swinging on a swing set
Jumping rope
Playing hopscotch
Bouncing a ball
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Discourage inactive pastimes
- Set limits on the amount of time your family spends watching TV
and videos, and playing video games.
- Help your child find FUN things to do
besides watching TV, like acting out favorite books or stories, or
doing a family art project. Your child may find that creative play
is more interesting than television.
- Encourage your child to get up and move during commercials and
discourage snacking when the TV is on.
Be a positive role model
Children are good learners and they learn what they see. Choose healthy
foods and active pastimes for yourself. Your children will see that
they can follow healthy habits that last a lifetime.
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Find more help
Your health care provider
Ask your health care provider for brochures, booklets, or other information
about healthy eating, physical activity, and weight control. He or
she may be able to refer you to other health care professionals who
work with overweight children, such as registered dietitians, psychologists,
and exercise physiologists.
Weight-control program
You may want to think about a treatment program if:
- You have changed your family’s eating and physical activity habits
and your child has not reached a healthy weight.
- Your health care provider has told you that your child’s health
or emotional well-being is at risk because of his or her weight.
The overall goal of a treatment program should be to help your whole
family adopt healthy eating and physical activity habits that you can
keep up for the rest of your lives. Here are some other things a weight-control
program should do:
- Include a variety of health care professionals on staff: doctors,
registered dietitians, psychiatrists or psychologists, and/or exercise
physiologists.
- Evaluate your child’s weight, growth, and health before enrolling
in the program and watch these factors while enrolled.
- Adapt to the specific age and abilities of your child. Programs
for 4-year-olds should be different from those for 12-year-olds.
- Help your family keep up healthy eating and physical activity behaviors
after the program ends.
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Other resources
The Food Guide Pyramid can help
you make healthy food choices for your family. Available from the Center
for Nutrition Policy and Promotion, 703-305-7600 and at www.usda.gov/cnpp/pyrabklt.pdf
Tips for Using the Food Guide Pyramid for Young Children
2 to 6 Years Old can help you teach your young child
what to eat to grow and stay healthy. Available from the U.S. Government
Printing Office, 202-512-1800 and at www.usda.gov/cnpp/KidsPyra/PyrBook.pdf
Healthy Eating and Physical Activity Across
Your Lifespan: Helping Your Child provides in-depth
information for parents. Available from the Weight-control Information
Network (WIN), 1-877-946-4627 and at www.niddk.nih.gov/health/nutrit/pubs/parentips/tipsforparents.htm
http://www.kidnetic.com/ provides healthy
eating and physical activity tips for kids and parents.
http://www.kidshealth.org/ provides
information about nutrition and fitness for kids.
http://www.bam.gov/ answers kids' health
questions about body and mind.
http://www.verbnow.com/ encourages kids
to get physically active.
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Weight-control Information Network
1 WIN WAY
BETHESDA, MD 20892-3665
Phone: (202) 828-1025
FAX: (202) 828-1028
E-mail: win@info.niddk.nih.gov
Internet: www.niddk.nih.gov/health/nutrit/nutrit.htm
Toll-free number: 1-877-946-4627
The Weight-control Information Network (WIN) is a service of the National
Institute of Diabetes and Digestive and Kidney Diseases of the National
Institutes of Health, which is the Federal Government’s lead agency
responsible for biomedical research on nutrition and obesity. Authorized
by Congress (Public Law 103-43), WIN provides the general public, health
professionals, the media, and Congress with up-to-date, science-based
health information on weight control, obesity, physical activity, and
related nutritional issues.
WIN answers inquiries, develops and distributes publications, and
works closely with professional and patient organizations and Government
agencies to coordinate resources about weight control and related issues.
Publications produced by WIN are reviewed by both NIDDK scientists
and outside experts. This fact sheet was also reviewed by Leonard Epstein,
Ph.D., Professor of Pediatrics, Social and Preventive Medicine, and
Psychology, University of Buffalo School of Medicine and Biomedical
Sciences, and Gladys Gary Vaughn, Ph.D., National Program Leader, Cooperative
State Research, Education, and Extension Services, U.S. Department
of Agriculture (USDA).
This e-text is not copyrighted. WIN encourages unlimited duplication
and distribution of this fact sheet.
NIH Publication No. 04-4096
July 2004
Prepared in cooperation with the International Food Information Council
Foundation http://www.ific.org/
http://win.niddk.nih.gov/publications/over_child.htm
Prevalence of Overweight Among Children and Adolescents: United
States, 1999-2002
Note: Excludes pregnant women starting with 1971-74. Pregnancy
status available for 1963-65 and 1966-70. Data for 1963-65 are
for children 6-11 years of age; data for 1966-70 are for adolescents
12-17 years of age, not 12-19 years. SOURCE: CDC/NCHS, NHES and
NHANES
Results from the 1999-2002 National Health and Nutrition Examination
Survey (NHANES), using measured heights and weights, indicate
that an estimated 16 percent of children and adolescents ages
6-19 years are overweight. As shown in table 1, this represents
a 45 percent increase from the overweight estimates of 11 percent
obtained from NHANES III (1988-94).
Body mass index, expressed as weight/height2 (BMI;kg/m2) is
commonly used to classify overweight and obesity among adults,
and is also recommended to identify children who are overweight
or at risk of becoming overweight. Cutoff criteria are based
on the 2000 CDC BMI-for-age-growth charts for the United States.
Based on current recommendations of expert committees, children
with BMI values at or above the 95th percentile of the sex-specific
BMI growth charts are categorized as overweight.
To assess changes in overweight that have occurred, prevalence
estimates for participants in the 1999-2002 NHANES were compared
with estimates for those who participated in earlier surveys.
The NHANES 1999-2002 and earlier surveys used a stratified, multistage,
probability sample of the civilian noninstitutionalized U.S.
population. A household interview and a physical examination
were conducted for each survey participant. During the physical
examination, conducted in mobile examination centers, height
and weight were measured as part of a more comprehensive set
of body measurements. These measurements were taken by trained
health technicians, using standardized measuring procedures and
equipment. Observations for persons missing a valid height or
weight measurement were not included in the data analysis.
When the overweight definition (greater than or equal to 95th
percentile of the age- and sex-specific BMI) is applied to data
from earlier national health examination surveys, it is apparent
that overweight in children and adolescents was relatively stable
from the 1960s to 1980 (table 1). However, from NHANES II (1976-80)
to NHANES III, the prevalence of overweight nearly doubled among
children and adolescents. In the time interval between NHANES
II and III, the prevalence of overweight among children ages
6-11 years increased from an estimated 7 percent to 11 percent
(figure 1), and among adolescents ages 12-19 years, increased
from 5 percent to 11 percent. One of the national health objectives
for 2010 is to reduce the prevalence of overweight from the NHANES
III baseline of 11 percent. However, the NHANES 1999-2002 overweight
estimates suggest that since 1994, overweight in youths has not
leveled off or decreased, and is increasing to even higher levels.
The data for adolescents are of notable concern because overweight
adolescents are at increased risk to become overweight adults.
The 1999-2002 findings for children and adolescents suggest the
likelihood of another generation of overweight adults who may
be at risk for subsequent overweight and obesity related health
conditions.
Table 1. Prevalence of overweight among children and adolescents
ages 6-19 years, for selected years 1963-65 through 1999-2002
|
Age
(years)1
|
NHANES
1963-65
1966-702
|
NHANES
1971-74
|
NHANES
1976-80
|
NHANES
1988-94
|
NHANES
1999-2002
|
|
6-11
|
4
|
4
|
7
|
11
|
16
|
|
12-19
|
5
|
6
|
5
|
11
|
16
|
1Excludes
pregnant women starting with 1971-74. Pregnancy status not
available for 1963-65 and 1966-70.
2Data for 1963-65 are for children 6-11 years of age; data
for 1966-70 are for adolescents 12-17 years of age, not 12-19 years.
Fact Sheet
For more detailed estimates see:
Hedley, AA, Ogden, CL, Johnson, CL, Carroll, MD, Curtin, LR,
Flegal, KM. Overweight and obesity among US children, adolescents,
and adults, 1999-2002. JAMA 291:2847-50. 2004.
bullet Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence
and trends in overweight among US children and adolescents, 1999-2000.
JAMA 288:1728-32. 2002.
U.S.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers
for Disease Control and Prevention
National Center for Health Statistics
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overwght99.htm
