Complications of obesity include: type 2 diabetes (formerly called adult diabetes), high blood pressure, elevated cholesterol, kidney disease, liver disease, and low self esteem and depression. Before 1992 type 2 diabetes made up approximately 5% of new cases of diabetes in children 10-19 years of age and now makes up 30% of new cases. This increase in the prevalence of diabetes is directly related to the increase in childhood obesity.
So why is this increase in childhood obesity occurring? Weight maintenance depends on a balance between our energy intake (the calories we eat and drink each day) and energy expenditure (the calories we burn up with physical activity). When we take in more calories in our diet or decrease our physical activity we get out of balance. The major factors related to increased energy intake include sugar sweetened drinks, high calorie snacks, dining out at fast food and other restaurants, and large portion sizes for our food and drinks.
Sugar Sweetened Drinks
Sugar sweetened drinks include soda, juice drinks, juice, Kool-Aid, sports drinks, and sweet tea. A child consuming one 12 oz. can of a sugar sweetened drink daily increases his/her risk for becoming overweight by 60%. An adult consuming one can of a sugar sweetened drink daily over 4 years increases their risk of developing type 2 diabetes by 80%. Â
Dining Out
Children eat at a fast food restaurant an average of twice a week and when dining out they consume about 200 calories more than on days when they eat at home. The foods at fast food restaurants are high in calories, sugar, and fat and low in nutrients and fiber. In addition, the portion size is large. For example, a double cheeseburger has 1200 calories, a large order of French fries 600 calories, and a 40 oz. soda 410 calories. A person would have to run 5-6 hours to burn up the calories in this combo meal.
Physical Activity
Physical activity has decreased in our youth. Only 50% of young people 12-21 years of age participate regularly in vigorous physical activity. Attendance in school physical education classes has decreased. Physical activity also decreases as children get older and become teenagers. Over 95% of 9 year old children, but only 30% of 15 year olds have the recommended 60 minutes of moderate to vigorous physical activity daily.
Screen time
As physical activity has decreased our sedentary activity (TV, video games, computer) has increased. The average child/adolescent watches at least 3 hours of TV daily. 32% of 2-7 year old children and 65% of 8-18 year olds have a TV set in their bedroom. What children see on television is advertisements, and 80% of the food commercials are for sugary cereals, candy, soft drinks, and fast food. Children watching TV for 4 or more hours a day have an increase in the prevalence of obesity compared to children watching less than 2 hours a day.
What can we do?
We are facing a serious problem. One of three children born today will develop diabetes during their lifetime, and this is the first generation of children who will not outlive their parents. So what should we do? All families should be involved in healthy lifestyle change. We can do this by remembering 5-3-2-1-almost none. The recommendations are:
      5 or more servings of fruits and vegetables daily
      3 meals a day, which includes a healthy breakfast
      2 hours or less of screen time (TV, video games, computer)
      1 hour of moderate to vigorous physical activity daily
      Almost none sugar sweetened drinks (soda, juice drinks, juice, Kool-Aid, sweet tea).
We need to get off the couch, eat a healthier diet, dine out less frequently, watch our portion size, and cut off the TV. If we want our children to eat a healthy diet we must also eat a healthy diet and make sure that our homes contain mostly healthy choices. If we want our children to be physically active we must become physically active. If we want to prevent our children from becoming overweight we must make changes ourselves and be good role models for our children, our families, and our communities.
Source: Robert P. Schwartz, MD
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