childhood obesity

RECENT POSTS

One Doc’s Oreos-And-Batman Perspective: TV Doesn’t (Necessarily) Make Kids Fat

(Donnie Ray Jones/Flickr)

(Donnie Ray Jones/Flickr)

By Steve Schlozman, MD

Here are three recent headlines that got me thinking about kids and fat:

“Watching one hour of TV per day increases risk for obesity by 50%”

“Watching TV for Just an Hour a Day Can Make Children Obese”

“Study makes surprising link between TV time and childhood obesity”

Oversimplifications? Um, yes. Each of these headlines greatly simplifies (dare I say, incorrectly simplifies) a critical social and health issue. Personally, I don’t think TV is the sole evil culprit here. It’s far more complicated.

The medical community has long known that the amount of TV that a child watches correlates with obesity. We can even make some leaps from these data towards implicating causality. Unless your little ones happen to be doing aerobic exercises while they tune in to their cartoons, it’s easy to see how passive watching can equal active weight gain.

However, be wary of oversimplification and especially of the “one-size-fits-all” policy statements that these headlines often generate. The study authors here do, in fact, suggest further limiting TV exposure based on the existing American Academy of Pediatrics guidelines for young children as a means of controlling the rate of obesity in this country. (Currently, the AAP recommends limiting screen time to one to two hours or less for children over the age of 2, and discouraging screen time altogether for those who are younger.)

So, here’s the big question: Is the recommendation that TV time be further limited an entirely appropriate conclusion?

Beyond The Headlines

The answer, like many answers to social policy questions, is both yes and no.

What we know for certain is that we can’t really discern from the headlines what we ought to do, though there is ample reason to believe that most American rarely go beyond the headlines. Thus, we run the risk of jumping to more draconian conclusions than might be appropriate simply because we don’t have or take sufficient time to examine the flood of information.

How do we guard against this leap to oversimplification?

Here are a few key questions:

•Was there a large and diverse population studied?

There have been solid links between lower socioeconomic groups and some ethnic minorities and increased television time, as well as between lower socioeconomic groups and obesity.

The causes for both of these issues are of course multi-factorial. Fatty foods and higher calorie foods are cheaper. TV can function as a babysitter in households where parents are busy working and living paycheck to paycheck. However, the study in the headlines above, conducted by the Department of Education in conjunction with physicians at the University of Virginia, was indeed both large and diverse.

Over 12,000 children starting kindergarten were enrolled in the investigation, and a year later follow-up data was available for more than 10,000 of these children. These data included height and weight, as well as statistical analyses to account for differences in race, gender and socioeconomic effects. In other words, the numbers here are sufficiently large and diverse for us to feel comfortable drawing at least preliminary conclusions.

Causality, Really?

But beware, always beware, of flashy headlines. A Google search yielded all of the headlines above with equal weight, and yet one of the headlines clearly implicates causality. “Watching TV for just an hour a day can make a child obese.” (My italics.)

However, this study does not in any way suggest causality. There are a number of potentially unrelated factors that also happen everyday that might be associated with obesity, but not function as a cause of obesity. These could include behaviors like longer baths to cool down. We don’t know until we do the study whether longer baths would be associated with obesity. In other words, always be wary of blanket statements of causality with regard to the complexity of human behavior.

•What about the ample availability of screen-based material on demand? Perhaps the fact that children can often watch both what they want and when they want it affects their activity patterns in negative ways. We could ponder the fact that TV content, even for kids, has arguably (though not in all spheres) gotten better and of higher quality. There is even evidence that TV watching can improve behavior among kids, and this evidence also comes from the American Academy of Pediatrics. Does that mean we ought to make a policy statement advocating that TV should be less compelling?

Confessing My Bias

Things get even messier when we take the necessary step of examining our own personal biases. In my case, that examination includes a shameless confession regarding the ways my own penchants might complicate my interpretation of these data. Continue reading

Study: In ‘Healthy’ Fast Food Ads, Kids Mostly Just See French Fries

Just watch the video here and you’ll immediately get the gist of this study. To sum up: when fast food companies try to advertise to children their “healthier” dining options, (like apple slices) the kids, for the most part, don’t see beyond the fries.

The takeaway, according to researchers at Dartmouth, is that these ads from fast food giants like McDonald’s and Burger King “don’t send the right message.”

Here’s more from the Dartmouth news release:

In research published March 31, 2014 in JAMA Pediatrics, Dartmouth researchers found that one-half to one-third of children did not identify milk when shown McDonald’s and Burger King children’s advertising images depicting that product. Sliced apples in Burger King’s ads were identified as apples by only 10 percent of young viewers; instead most reported they were french fries.

Other children admitted being confused by the depiction, as with one child who pointed to the product and said, “And I see some…are those apples slices?”

The researcher replied, “I can’t tell you…you just have to say what you think they are.”

“I think they’re french fries,” the child responded. Continue reading

Make Lemonade: Study Finds Kids’ Active Video Games Boost Exercise, Weight Loss

Every time my kids hunker down for a long stretch of screen time, I get a tiny pang of guilt. The little good-parent-voice in my head says: They should be outside running around (or inside running around if you’re in New England, still praying for an end to this relentless winter). In any case, they should be active, not immobilized in front of a screen.

But maybe it’s OK for them to be active, and in front of a screen. A study published earlier this month in JAMA Pediatrics suggests that yes, those active video games do help overweight and obese kids boost their physical activity levels and lose weight too.

Chiew Pang/flickr

Chiew Pang/flickr

The study, with 75 kids between 8 and 12 years old, concluded that: “Incorporating active video gaming into an evidence-based pediatric weight management program had positive effects on physical activity and relative weight.”

Here’s more on the study from Reuters:

Both groups took part in the weight management program at local YMCAs and schools, but one group also received an Xbox game console and two active games.

The Xbox Kinect device captures the child’s body movements to operate the game. The games given to the kids in the active gaming group were Kinect Adventures! and Kinect Sports. (Children in the weight-loss program-only group received the same equipment and games at the end of the study).

All the children’s activity were recorded using an accelerometer, which measures movement, during the day.

At the start of the study, the children were between the ages of 8 and 12 years old and weighed between 123 and 132 pounds (lbs). About 67 percent of the kids had a body mass index (BMI), a measure of weight relative to height, that put them in the overweight category for their age groups. The rest of the children were in the obese category.

The researchers found that children in the group that received the active games added about seven minutes of moderate to vigorous activity and about three minutes of vigorous activity to their daily routines over the 16 weeks. Continue reading

Michelle Obama, Tufts Make New Push For More Active School Kids

Those enviable upper arms are at it again.

Hoping to extend the reach of her three-year-old Let’s Move! campaign, Michelle Obama today made a pitch for kids to be more active at school. The First Lady’s new initiative, Let’s Move Active Schools, is partnering with 9 organizations — including one based at Tufts — to help combat childhood obesity by instituting a range of creative, accessible programs for kids to get more exercise through fun, school-based activities.

The Huffington Post covered Ms. Obama’s announcement this morning: “With each passing year, schools feel like it’s just getting harder to find the time, the money and the will to help our kids be active. But just because it’s hard doesn’t mean we should stop trying,” the first lady said in her prepared remarks. “It means we should try harder. It means that all of us – not just educators, but businesses and nonprofits and ordinary citizens – we all need to dig deeper and start getting even more creative.”

Christina D. Economos, PhD, is Associate Professor at the Friedman School of Nutrition Science and Policy at Tufts University, and a leading researcher in the field of childhood obesity prevention. She’s also Vice-Chair and Director of ChildObesity180, a nonprofit based at Tufts that is working with the First Lady and supports a variety of strategies to help kids become healthier through improved nutrition and physical activity.

Piggy-backing on Ms. Obama’s news, ChildObesity180’s program, the Active Schools Acceleration Project (ASAP), made its own announcement today: the group will award grants totaling $1 million to 1,000 schools to launch one of three award-winning physical activity programs. Each of the three plans — one started by a bunch of moms in Natick, another called the 100-Mile Club and a third that supports short bursts of activity in urban classrooms — are fun for kids, accessible and have shown both physical and behavioral benefits, like better concentration in class, Economos said. Continue reading

Unexpected Post-Fukushima Health Woes: Depression, Obesity

By Judy Foreman
Guest Contributor

Nearly two years ago, a giant earthquake off the coast of Japan sent a 13-meter high tsunami crashing into the Fukushima Daiichi nuclear power plant, causing meltdowns in three of the six reactors and ultimately, triggering an explosion. Thousands were killed by the tsunami and earthquake.

No one has died from radiation and in fact no radiation health effects have yet been observed among the public or workers, according to a December, 2012 statement from a United Nations expert committee.

But even as the actual health effects from radiation – at least so far – are turning out to be much less dramatic than many people feared, a host of other, less-feared but very real, outcomes are causing lasting trouble. These include mental health problems such as alcoholism, depression, anxiety and, in the case of children whose parents and teachers are too afraid to let them play outdoors, a rise in obesity.

VOA Photo S. Herman/wikimedia commons

VOA Photo S. Herman/wikimedia commons

It is a striking illustration of what often happens in public health. What we think we should be most afraid of is often, in reality, less dangerous than we think, while other things that we are blasé about, carry higher risks. We fully believe, for instance, that we are being killed by toxic stuff in our air, water and food and ignore the huge health risks from sedentary lifestyles.

What we think we should be most afraid of is often, in reality, less dangerous than we think, while other things that we are blasé about, carry higher risks.

A fascinating article last month in the journal Nature illustrates the point beautifully.

The Fukushima Health Management Survey, described in detail in the Nature article, found that the doses of radiation experienced by people evacuated from the nuclear zone were surprisingly low. For nearly all the evacuees, the exposure level was only about 25 millisieverts (mSv). That is considerably less than the 100-mSv level, at which risks from radiation, including cancer, are believed to increase. (A Sievert is a unit of ionizing radiation.)

And this is not the only research team to have found lower levels of radioactive pollution than feared. A World Health Organization project studied exposure to radiation in the six months after Fukushima. Continue reading

Michelle Obama’s Initial Doubts About Fighting Childhood Obesity

Just in case you’re not a regular reader of the journal “Childhood Obesity,” FLOTUS — The First Lady of the United States — has written the foreword to this month’s edition. She begins with her initial doubts about whether progress fighting children’s obesity was possible:

When I first decided to focus on the issue of childhood obesity, I wondered whether it was really possible to make a difference. I knew the conventional wisdom on this issue —- particularly when it comes to changing how and what our kids eat. There’s the assumption that kids don’t like healthy food, so why try to feed it to them? There’s the belief that healthy food doesn’t sell as well, so companies will never change the products they offer. There’s the sense that this problem is so big, and so entrenched, that no matter what we do, we’ll never be able to solve it.

Now, she writes, she’s thrilled to report that “We have begun to change the conversation about childhood obesity in America.”

I know, I know, it’s political and there’s a very, very long way to go to reverse the current wave of childhood obesity. But I’m a sucker for good news, and she offers a nice roundup of some: Continue reading

Palfrey, Leading Pediatrician, To Head First Lady’s Let’s Move! Program

The just in from The White House Press Office:

WASHINGTON – First Lady Michelle Obama today announced that one of the country’s leading pediatricians, Judith S. Palfrey, M.D., will lead her Let’s Move! childhood obesity initiative as Executive Director starting on Tuesday, September 6. For decades, Dr. Palfrey has provided clinical care to thousands of children and families, conducted groundbreaking pediatric research, taught future physicians and led major medical organizations. Palfrey has been a longtime supporter of the Let’s Move! campaign and spoke at its launch in February of 2010 when she was president of the American Academy of Pediatrics (AAP).

“It was my children’s pediatrician who first told me that I needed to pay closer attention to my children’s health so I understand the significance doctors play in family health. That’s why we are eager to welcome Judy Palfrey to the White House where I know that she will take the Let’s Move! program to new heights. Judy has worked with families one-on-one and partnered with communities on health promotion initiatives. She is a leading researcher and respected voice in the field. Her tremendous experience and insight in pediatrics and community health will make her a strong leader for Let’s Move! and make a real difference in the lives of our nation’s children,” said First Lady Michelle Obama. Continue reading

Childhood Obesity Crisis: Can We Grow McNuggets In Our Garden?

The website DCentric posted an interview with journalist Kavitha Cardoza about her truly sad and shocking portrait of obese kids in DC and the profound obstacles they face.

Some of the more troubling facts presented by Cardoza and Ginger Moored, of WAMU, in their five part series on obesity include these:

1. One child couldn’t bite a carrot because her teeth have rotted from her diet.
2. One obesity clinic had a three-year waiting period.
3. A local councilmember came to support the school gardens program after a kid asked if he could grow Mcnuggets there.
4. One little girl had never seen a strawberry’ another called cauliflower “white broccoli.”

Here are a few excerpts from the DCentric interview:

So there are many factors that complicate their attempts to get healthy?

Every facet of these kids’ lives is complicated…one boy didn’t own a scale or a pedometer. He had never been on a treadmill. All of the advantages we might enjoy– we may be able to afford a gym or we may live in a neighborhood where it is safe to go for a walk. They don’t have any of that. So even if you tell them to lose weight, what does that mean in terms of class if they don’t have access to what they need?
I read that Councilmember Mary Cheh became a proponent of school gardens after she heard a student ask if they could grow McNuggets.

That’s a larger issue of how disconnected we are from the process of growing food, especially in urban areas. There is a total disconnect that these kids are not well-served by…they eat junk and don’t realize why they need to eat healthy or what that even means. A lot of people ask why the government should be involved, but on a policy level whose responsibility is it? Childhood obesity is a huge problem, but is it a family issue? A school issue? There’s no consensus even on that. Why do we even need policies like the Healthy Schools act? It’s an uphill battle. And yet gardens are wonderful, kids go outdoors, they see food grow, they learn colors.

Did anything surprise you?

One thing that shocked me is that kids may be picky eaters, but they are curious and interested. Imagine not ever being exposed to strawberries. I remember when a little girl told me that…I asked her to clarify what she meant. Had she never tasted one? She said, “No. I’ve never seen one.” To me that was so shocking. Some kids saw cauliflower and would say, “Can I have white broccoli?”