We are all aware of the obesity epidemic in the United States.
Doctors have known about it for years. It used to be, when I counseled someone about diet and nutrition, I could almost read the minds of the patient and the parents - "Yeah, right, like that's gonna work," or "Been there, tried that," or "You try keeping a hefty 13 year old boy out of the chips and pop." I gave my advice, but felt very helpless to effect much change.
Then the public became more involved - they were reading about it, seeing shows about it, noticing for themselves how many children are heavy compared to 50 years ago. I started noticing, about seven or eight years ago, that families would come for a child's check-up and the mom would say, "now Dr. Gilliland, you aren't gonna like this - we eat at McDonald's every Friday, but we did cut back from 3 or 4 times a week like you said," and I sat there, shocked, thinking "Wow! They changed how they eat." I knew it couldn't be because of me telling them to cut back, because I'd been saying those things for 15 years without much noticeable effect. I figured it was a combination of things, but I was glad to stay on my soapbox. I loved hearing moms saying, "I make 'em go outside before they watch TV," or "There isn't any pop in our house," or "Two hours - the TV goes off after two hours" or "I did what you said, Dr. Gilliland. We drink water now, not juice." Awareness is half the battle.
I have noticed a difference between Indianapolis and the U.P. It seems like kids naturally spend a lot more time outside, despite the snow and cold. I suspect that is related to the urban vs. rural differences. It also seems like people just naturally eat at home more. First impressions, only, folks - I don't want to jump to conclusions.
For those of you who don't see the big deal, I will step back on my soapbox for a minute. Obese children are much more likely to become obese adults. Children who eat out a lot, spend hours in front of the television or playing video games and never go outside, have a significantly higher risk for early heart disease, high blood pressure, high cholesterol, polycystic ovaries with infertility, depression and low self-esteem, among other things. It is much easier to prevent children from becoming overweight than it is to help them lose weight after the fact. The way to prevent it (or at least, to have the highest chance of success in preventing it) is by starting very young with healthy diet and exercise habits.
For those of you who see the big deal but have no idea how to change bad habits, especially when the whole family has them, I have a few suggestions. First and foremost, it is important to change habits as a family. It works a lot better. Secondly, for younger children, don't pay for junk food on a regular basis and don't pay for fast food on a regular basis. If you aren't providing it, the kids won't get it. With older children, especially older teens, they've got to want it, too. Do not make diet and exercise a battlefield. There is a natural tendency to resist and rebel during adolescence as teens start becoming independent and making their own choices (for good or for bad). The last thing you want is to provide such handy issues to rebel against. You can incorporate exercise into daily chores, though, by making your sedentary junk food junky responsible for walking the dog or vacuuming the house or mowing the lawn, etc. Provide them with good information; don't enable them by paying for junk food or for activities that are being overused (like TV or video games) and notice and encourage healthy choices. Otherwise, back off on control issues surrounding food and exercise.
The American Academy of Pediatrics, in their Habits for a Healthy Lifestyle, recommend the following: eat five servings of fruit and/or vegetables daily; drink zero servings of sweetened drinks, taking instead water or low-fat milk; get a minimum of one hour of physical exercise daily; and limit screen-watching (TV/video games/computer) to two hours a day. They call it the 5012 plan. And I call it the way to beat obesity and diabetes.
Editor's note: Sharon Gilliland, M.D., is a pediatrician for Baraga County Memorial Hospital Physician Group.