Obesity: A Growing Crisis
By Lesley Stanford, MS, RD, CSP, and Dennis Clements, MD, PhD, MPH
your child is overweight or at risk of becoming overweight and you
want to take action, start with a visit to your childs pediatrician
-- he or she can give you many of the tools youll need to
visit may begin with a look at your childs growth chart. The
pediatrician can use the height and weight measurements to calculate
your childs Body Mass Index (BMI) -- a measurement used to
assess whether the child is underweight, normal, overweight, or
obese, based on guidelines for children adapted from the Centers
for Disease Control (see chart below).
--------- BMI for Age
Underweight ----------Less than 5th percentile
percentile to less than 85th percentile
Overweight------------85th percentile to less than 95th percentile
than or equal to 95th percentile
In some cases, the best goal may not be to lose weight, but to allow
your child to grow into his or her current weight. Keeping your
childs weight stable is often the right advice.
your child needs weight management, your doctor will help you develop
a program to help your child reach a healthy weight goal.
Over the last 25 years, the rate of obesity has doubled for children
ages six to 11 and has tripled for teens. Today about 10 percent
of two- to five-year-olds and 15 percent of six- to 19-year-olds
Academy of Pediatrics described the rise in childhood obesity as
an unprecedented burden on childrens health.
in childhood has been associated with hypertension, diabetes, sleep
apnea, and psychosocial and orthopedic problems. Overweight teens
have a 70 percent chance of becoming overweight or obese adults.
North Carolina, the numbers are more alarming than the national
average. Childhood obesity is an epidemic in this state. Data from
the 2004 NC Nutrition and Physical Activity Surveillance System
(NC-NPASS) show that childhood obesity affects:
than one in four (27.2 percent) youth 12 to 18 years of age
More than one in five (23.8 percent) children five to 11 years
One in eight (14.9 percent) preschool children
your child is overweight or at risk for being overweight, look closely
at what your family routines are. Do you eat out more than you did
last year? Do you buy chips and cookies and other high-fat snacks
each trip to the grocery store? Do you rely on fast food?
Parents Can Do
If you and your childs doctor determine that weight has become
an issue for your child, its not too late to start working
on healthy habits. Be a positive role model. While weight management
is hard work, it is possible.
these tips to help keep your child from becoming overweight.
intake of sweetened beverages.
Offer water between meals.
Offer water when children express thirst.
Buy low or nonfat milk for all family members above age two.
Choose sugar-sweetened beverages as an occasional treat only.
Limit 100-percent juice to four to six ounces a day for children
two to six years of age and eight to 12 ounces a day for older children.
These are new guidelines from the American Academy of Pediatrics.
TV/video time to one to two hours a day.
Help children to prioritize what they watch.
Encourage active play instead of sedentary time in front of the
computer, watching television, or playing video games.
Some children eat a larger snack while watching TV than sitting
at the table.
Discourage watching television in a childs room.
daily physical activity.
a good example. Exercise with your children. Plan times for family
Be active together as a family. Assign active chores like raking
leaves, washing the car, or vacuuming.
Buy a Frisbee, jump rope, or a kickball. Physical fitness does not
have to be expensive.
portion sizes of foods that are appropriate for the age.
food and learn what ½ cup looks like.
Serve food on your childs plate instead of family-style.
Help children learn to eat when hungry and stop when full. Do not
encourage the clean plate club.
Avoid all-you-can-eat buffets and super-sized meals. Sometimes a
meal deal or combo meal means larger portions.
Ask for a take-out container when there is extra food.
Watch the portions of beverages when eating out.
and eat more meals at home.
the amount of meals eaten away from home. Meals eaten at home usually
contain more fruits and vegetables.
Choose restaurants with healthy options.
Resist "eating from the bag." When snacking, place a few
chips, crackers, or cookies in a bowl to help prevent overeating.
a healthy eating environment.
your pantry and refrigerator with healthy foods.
Offer vanilla wafers, graham crackers, animal crackers, canned fruit
packed in its own juice, fresh fruit, saltines, baked chips, and
pretzels for snacks.
Purchase low-fat or nonfat dairy products.
Keep fruits and vegetables available.
Plan healthy meals and eat together as a family. Eating together
at meal times help children learn about portion size.
Grow a garden.
Lesley Stanford, MS, RD, CSP, is a pediatric nutritionist in the
Division of Pediatric Gastroenterology and Nutrition. She is board-certified
as an expert in pediatric nutrition by the American Dietetic Association.
Dennis Clements, MD, PhD, MPH, is the chief medical officer of Duke
Children's Hospital. For more information, visit: www.dukehealth.org
information presented on this site is intended solely as a general
educational aid, and is neither medical nor healthcare advice for
any individual problem, nor a substitute for medical or other professional
advice and services from a qualified healthcare provider familiar
with your unique circumstances. Always seek the advice of your physician
or other qualified healthcare professional regarding any medical
condition and before starting any new treatment.