Childhood Obesity Risks Start Before School Age!

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A new study from Emory was published in the New England Journal of Medicine recently which showed almost half of children who are obese by eighth grade were already overweight by kindergarten! This federally funded study followed a nationwide sample of more than 7,700 children through grade school years.  When children started started kindergarten, 12 percent were obese and 15 percent were overweight. By eighth grade, 21 percent were now obese and 17 percent were overweight.  What was just as informative was that the also looked at 6,807 children who were not obese when the study started, at the time they entered kindergarten. Key findings:

Between ages 5 and 14, about 12% of children developed obesity. Boys were more likely than girls, about 14 % compared to 10% 

Nearly half of kids who started kindergarten overweight became obese teens. Overweight 5-year-olds were four times as likely as normal-weight children to become obese (32 percent versus 8 percent). Everyday I meet preschoolers who appear overweight or obese to me, and I know that for many parents they believe it's "cute" to be chubby and as a mother, I know that there is a difficult line that is hard to draw to think differently such that those rolls from the first year or two of life should be concerning to us when they are still there by age 3, 4 and older. When is a round tummy a true indicator that your child may be overweight? How do we decide if the child's chubby cheeks may indicate need to pay attention to our child's weight versus "baby fat?" There is no simple answer nor same answer for every child, but as parents I believe we need to have a courageous conversations with ourselves, then our child's primary care provider, and we need to really think about what our child's eating and drinking habits are.

The greatest increase in the prevalence of obesity was between first and third grades; it changed little from ages 11 to 14.

Race differences: From kindergarten through eighth grade, the prevalence of obesity increased by 65 percent among whites, 50 percent among Hispanics, almost 120 percent among blacks and more than 40 percent among others—Asians, Pacific Islanders and Native Americans and mixed-race children.

By eighth grade, 17 percent of black children had become obese, compared to 14 percent of Hispanics and 10 percent of whites and children of other races.

Differences based on income and socioeconomic background: Obesity was least common among children from the wealthiest families and most prevalent among kids in the next-to-lowest income category. The highest rate of children developing obesity during the study years was among middle-income families.

Birth weight may be a predictor! At all ages, obesity was more common in children who was born 9 pounds or heavier, about 36 percent of kids who became obese during grade school had been large at birth. We as mothers really need to pay attention during our pregnancy, and maybe being pregnant is not a "get out of jail card" and allow us to gain as much weight and indulge in cravings without limit! There are other factors of course, obese mothers and those with pre or actual diabetes are more likely to have bigger babies, and genetic factors play a role as well since so many mothers tell me "babies run BIG in our family."

The authors emphasized that they are not implying it's too late to intervene once children are in school age, but the findings suggest that we really need to focus on our children's weight and health during the early preschool years. I believe these findings confirm that eating behaviors start very young and most likely do not change once a child reaches school age. Each day when I have conversations with families about minimizing sugary foods and beverages, avoiding empty calories, minimizing dairy, processed foods, refined sugars, and helping our children develop better eating habits, I share with parents that a 3 year old who holds a mom "hostage" by only eating what he/she wants and train the parents to enable their "picky" eating behaviors will become the 5, 6 or 8 year old who continues to eat that way. It makes complete sense that researchers find the rates of obesity only increases with age.

Make a conscious effort now! Cut the crap out of their diet, cut it early, often, and whenever possible. Hopefully, with "A Healthier Wei" available on Kindle and Nook, I can share my insights with more families about challenges with feeding children and the philosophy behind establishing healthy eating habits and exercising early in life.

Every conversation I have with patient families start with "What does your child eat and drink all day?" "What are his/her favorites?" I try to quickly ask about sweet tea, soda, juice, milk, Capri Sun, juice boxes, etc and then we move on to foods which are high in dairy and/or  sugar such as Go-Gurts, chocolate milk, ice cream, pizza, etc. I am encouraged that almost all families are willing to make a change once they understand why it matters. It's never too early to start, no reason for babies between one and two to start loving juice and sugar and then of course, families tell me "but he/she won't drink water!". I remind families that those children have NOT had to drink water since they have the option of juice, and it's so easy to just accept that as the way their child "is."

Finally, I always share with families we have some junk in our pantry too! It's about moderation, and most importantly, DAILY conversations with your child about what are good choices and what are bad choices. I believe young children can be "brain washed" so that they grow up always aware and associate excessive sugar consumption with "bad," leading to negative health related consequences.

Share this message please. An entire generation of our children and their health depends on what we do today and everyday!


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