"Since parents are most often responsible for the purchase and preparation of food in the home, they can have a tremendous impact on what and how much their children eat."

Over the past 30 years, the number of overweight and obese American children has increased to three times what it was in the 1970s. More than a third of America’s youth are currently either overweight or obese, with approximately 12.5 million children and adolescents age 2-19 in the obese category. 
Some researchers have theorized that the overweight and obese youth of today may actually have shorter life expectancies than their parents. These children are at increased risk for developing chronic illnesses normally not seen in individuals until they reach middle age, such as insulin resistance and type 2 diabetes, cardiovascular disease, stroke, high cholesterol, asthma, hypertension, joint disorders and sleep apnea. 

What is the difference between being overweight and obese?
Overweight is defined as having a Body Mass Index – the measurement of weight in relation to height – between the 85th and 95th percentiles on the Centers for Disease Control growth chart.  Obese is considered as having a BMI at or above the 95th percentile. If you search on the Internet for “body mass index,” you will find sites with BMI calculators.

To address the obesity epidemic, many local and national organizations have developed programs to prevent and treat weight problems in youth.  In 2010, First Lady Michelle Obama launched “Let’s Move,” a national campaign to reduce childhood obesity that involves parents, government officials, healthcare professionals and community organizations.

What are the causes of overweight or obesity in children?
The obesity epidemic is the result of several factors, including behavior, environment and genetics.

Behaviors such as unhealthy eating and lack of exercise can lead to weight gain.  Many children frequently eat fast-food meals that are high in fat and sugar from French fries, hotdogs, milkshakes and sugar-sweetened sodas or “juice drinks.”  It is well known that portion sizes have also increased over the past 30 years (by up to 20%). Excess snacking during the day on items such as cookies, chips, fruit juice and candy can also lead to overconsumption of calories.  If children do not burn these extra calories through physical activity, their bodies store the energy as fat.

Environment can also play a role in a child’s becoming overweight or obese.  Many children spend more time on sedentary activities, such as watching TV, playing video games or surfing the Internet than they spend engaged in physical activity. If children do not have access to green spaces where they can play, such as yards, parks or playgrounds, they are less likely to get adequate physical activity during the day. Additionally, due to budget cuts, some schools have reduced or eliminated recess time, physical education classes, sports programs and extracurricular activities.  The net result is a nation of children who are eating more and moving less.

Genetics is the third factor contributing to the development of overweight or obese children.   Studies have shown that children of obese parents have a greater risk of becoming obese than children of non-obese parents. This can be the result of inherited genes or learned behaviors.  In cases of twins separated at birth, researchers found a genetic predisposition toward the accumulation of body fat in 40-70% of the subjects.  Interestingly, adopted children had BMIs consistent with those of their biological parents, not their adoptive parents.

But being born to overweight or obese parents does not necessarily mean that children will become overweight.  In fact, parents with BMIs in the normal range can have some children who become overweight or obese and other children who maintain weights in the normal range.

Do the eating habits of parents affect the quality and quantity of the food their children eat?
Although genetics plays an important role in the risk for obesity in children, familial eating habits must also be taken into consideration.  Family lifestyle can play a significant role in a child’s attitudes and behaviors towards both eating and physical activity. Cultural norms, socioeconomic status and geographic location have all been shown to influence eating habits of individuals and families.  Since parents are most often responsible for the purchase and preparation of food in the home, they can have a tremendous impact on what and how much their children eat.  If parents model healthy eating habits, their children will be more likely to follow.

How does an unhealthy diet affect children’s performance in school?
When a child’s diet includes a lot of fat or sugar-laden foods or drinks, the associated calories contribute to weight gain, but there is no nutritional benefit.  If children are filling up on these “empty calories,”it can affect their academic performance by limiting their intake of the vitamins, minerals, fiber and protein that they need. Getting the proper nutrients is especially important for young brains that are still developing. Children who eat breakfast receive higher test scores than those who skip breakfast. Research shows that healthy eating can improve children’s concentration and help them do better in school.  Iron deficiency in children can lead to tiredness and poor concentration.  The best food sources of iron are lean beef, poultry, eggs and dried beans and lentils.  Vitamins are also important for good concentration.  Vitamin B12, found in meat, dairy products and eggs, aids in concentration and brain health. Vitamin C, which is important to proper brain function, is found in mangoes, strawberries, green and red peppers and citrus fruits such as oranges, tangerines and grapefruit. Fruit juice can be a healthy beverage, but because it contains no fiber and is easy to drink in large quantities, it can be a source of excess calories.  Children should be given only 100% fruit juice, limited to 4-6 oz. per day for those 1 to 6 years old, and 8-12 oz. per day for children 7 to 18.

High amounts of sugar and fat can affect children’s concentration by causing swings in energy levels. A high-fat, fast-food cheeseburger and French fries can make kids feel sluggish because it slows digestion. Sugary foods and sweetened beverages can affect concentration by causing blood sugar to spike, which is followed by a rapid drop in energy. Too much sugar also contributes to excess weight gain, which can impair physical and emotional well-being.

What can be done to help families prevent or treat overweight and obesity?
• Exercise regularly as a family.  Find activities that the whole family enjoys  (walking, biking) and schedule a time to do it.
• Involve the entire family in doing household chores (raking leaves,  washing and folding the laundry, cleaning the house).
• Monitor the time your child spends  watching TV, playing video games  and using the computer.
• Prepare healthy meals with the entire family. Include fruits, vegetables, and whole grains.  If children are old enough, let them do the peeling, slicing and mixing.
• Eat dinner as a family and remember, there’s no need to rush – eat slowly while you share each other’s experiences of the day.
• Stock the pantry with healthy snacks – unsalted nuts, raisins, low-fat crackers, low-sugar cookies such as  graham crackers, and popcorn  kernels (for homemade popcorn).
• Keep lots of fresh fruits and vegetables in the home.
• Do not use food as a reward or punishment.
• Limit fast food to no more than once per week.
• Encourage kids to drink water if  they are thirsty. Give them water with snacks and throughout the day, saving 100% juices and fat-free or 1% milk for meals.

This Q&A was with Kilwanna Jordan, MS, RD, CDE, CD. Jordan an outpatient nutrition coordinator, is a Registered Dietitian with a specialty as a Certified Diabetes Educator. She has additional specialty certifications in adult, child and adolescent weight management. For an appointment, call 914-366-2264.