Reginald Washington, M.D.: Childhood obesity a perfect storm

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Childhood obesity is a growing health threat. During the past two decades, the large increase of overweight children has been well-documented by the Centers for Disease Control and Prevention. Fifteen percent of children 6 to 19 years of age are overweight. This is three times the number recorded in 1980.

Colorado leads the nation as the state with the lowest incidence of obesity, but the percentage continues to increase at an alarming rate.

Childhood obesity has been identified in all socio-economic groups and in all industrially-developed countries. This increase in obesity, in children as well as adults, has occurred in a very short period of time, suggesting that it is not the result of a massive change in our genes.

Obesity is due mainly to poor lifestyle behaviors such as the consumption of fats and sugared products, which commonly are combined with an environment that has a marked reduction in physical activity. In short, there is an increase in energy intake (food) and a decrease in energy expenditure (exercise) in our youth.

Multiple risk factors have been implicated in this obesity epidemic, which may be categorized into three groups. First, factors for increased energy intake would include the consumption of fast foods, sweetened drinks, large portion sizes and calorie-dense foods with a decreased consumption of fruits and vegetables.

Second, factors that lead to decreased energy expenditure include:

- excessive screen time (TV, computer use and video games)

- decreased physical education in school

- fewer sports activities for the nonathlete

- excessive homework

Finally, there also are factors involving a child's family history that cannot be changed.

Obesity is the result of many factors that are increasing and coming together in a "perfect storm." For example, a child who watches an excessive amount of television also likely will snack on high-calorie foods such as chips and soda.

In addition, if children are sedentary - watching TV or playing computer games most of their leisure time - they are not physically active while doing so and will not be as likely to enjoy sports as they mature.

Families often watch television together, are sedentary together and share unhealthy eating habits.

It is imperative that these factors be explored and understood. It is especially important to understand how these factors interact with one another. This knowledge will help in the development of sound measures to be used in dissipating the perfect storm that has given rise to increased obesity throughout the world.

Parents, kids, schools and communities must act together in fighting this storm.

Reginald Washington, M.D., is a pediatric cardiologist in Denver, where he also serves as clinical professor of pediatric cardiology at the University of Colorado School of Medicine.

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