Obesity takes heavy toll on youth

Sep 16, 2004 (United Press International via COMTEX) -- UPI surveyed 84 specialists for a 15-part series weighing in on the causes, consequences and costs of a global gain in girth and measures to curtail the corpulence. Part 14 piles up facts and figures on the massive problem of underage overweight.

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SAN FRANCISCO (UPI) -- For youngsters of yore, who worked off home-cooked calories while skipping rope, climbing trees or chasing butterflies, keeping obesity at bay was, literally, child's play.

For today's tykes and teens, whose claim to physical activity may amount to no more than catching fast food on the run, severe overweight looms large as a health-crushing threat.

Increasingly, the world's oldest metabolic disorder -- recorded as early as the Stone Age -- affects ever-younger age groups, placing a heavy strain on still-growing hearts, lungs and bones and greasing the way toward cardiovascular disease, asthma, osteoporosis, diabetes, cancer and a host of other, potentially deadly ailments.

In the United States, where excess poundage weighs down 15 percent of children ages 5 to 19, the incidence of obesity among the young -- defined as girth more than 20 percent above the ideal for the gender, age and height -- has nearly tripled in the past 20 years. Now, one in 10 tots between ages 2 and 5 is too heavy -- twice the 1980 proportion. Among African-American, Hispanic and Native-American youngsters, the full-figured account for 20 percent.

To the north, the number of Canadian children who are overweight -- 33 percent -- and obese -- 12 percent to 14 percent -- has swelled by a whopping threefold in 15 years. In Egypt and Mexico, the rate has bulged to 25 percent, while, worldwide, one in five little ones has put on some big pounds.

The stark statistics bespeak dim prospects in light of studies showing extra-large adolescents stand a 70 percent to 80 percent chance of growing into oversized adults. The odds for permanent plumpness weigh in at three in four for portly preteens and one in four for king-size kindergartners.

Broadening beltlines expand the threat of hip, bone and liver disorders, sleep disturbances, premature puberty and depression and widen the scope of encroaching danger from diseases not long ago considered age-related, including hypertension, high cholesterol and type 2 diabetes, which already is belying its alias of "adult onset."

"Whereas in 1990 less than 4 percent of childhood diabetes cases were type 2, 10 years later that percentage increased to about 20 percent," observed Ruth Kava, director of nutrition for the American Council on Science and Health in New York City.

Unless the troublesome trend turns around, the next generation may be the first to have a shorter lifespan than its parents.

"It's frightening to see these 14- and 15-year-olds who, in 20 years, will be facing blindness, lost kidneys or even death," said University of California, Berkeley, nutritionist Joanne Ikeda. "In fact, the population is getting less healthy at earlier ages and facing a higher risk of chronic disease, and the way we may end up dealing with this problem is not by changing lifestyle but by replacing people's organs with artificial hearts, kidneys and transplants."

Evidence of the frightening fallout of premature paunchiness is piling up as rapidly as a plate at an all-you-can-eat buffet.

An analysis of 40 years of data on nearly 10,000 Americans has revealed as little as a mere decade can separate the buildup of bulge in 8-to-17-year-olds and the subsequent soaring in their blood pressure.

"These results suggest that in another 10 to 20 years we will be facing much higher rates of hypertension, heart disease and stroke, as these children become adults," said Paul Muntner, assistant professor of epidemiology at the Tulane University School of Public Health and Tropical Medicine in New Orleans.

Other investigations indicate inactive, obese children run a high risk of developing potentially life-threatening, non-alcoholic fatty liver disease, Dr. Jeffrey Schwimmer, assistant professor of pediatrics at the University of California, San Diego, School of Medicine, told a May 18 Digestive Disease Week meeting in New Orleans.

Researchers at the Mayo Clinic in Rochester, Minn., who first identified NAFLD in 1980, termed obesity the No. 1 cause of chronic liver disease in the United States.

"As a pediatrician, I feel we are dealing with a big epidemic -- NAFLD is certainly surpassing hepatitis C, in terms of potential damage to the liver," said principal investigator Dr. Ariel Feldstein. "NAFLD is a growing worldwide problem related to affluence and the diet and lifestyle associated with it. It's as true in the United States as it is in Europe, Japan and my native country, Argentina."

Portliness portends problems beyond the physical, according to psychologists concerned about the emotional baggage dragged by many chubby children.

"They have low self-esteem," said Ikeda, scientific adviser to the National Association to Advance Fat Acceptance, "and obese youngsters have a higher risk for being obese adults, who face discrimination everywhere, from the college admissions process to the job market."

Turning the tide hinges on hoisting habit over heredity, broadsiding bulge-building behaviors, and eschewing a culture that equates eating with entertainment.

As researchers ponder potential treatments based on their discovery of at least 250 obesity-related genes, specialists urge more immediate adjustments in attitude and action.

"Intervention on weight control needs to start early," declared Dr. Rebecca Din-Dzietham, assistant professor of social epidemiology at the Morehouse School of Medicine in Atlanta.

Experts advise parents to monitor and mentor children, working to improve dietary habits; minimize consumption of fast and processed fare drenched in salt, sugar and fat but depleted of fiber; shun food ads aimed at youngsters; fit exercise into daily life; swear off video games and television, and firm up physical-education programs in schools.

"The anthropologist of food Claude Levi-Strauss famously said, 'What is good to think is good to eat,'" said Leon Rappoport, emeritus professor of psychology at Kansas State University in Manhattan and author of "How We Eat: Appetite, Culture, and the Psychology of Food" (2003, ECW Press).

"So kids start out enjoying the food/entertainment experience at pizza parlors and 'McBurger' places, and this is reinforced by parents who use tasty items as a reward for good behavior," Rappoport said.

"The food industry is advertising heavily to young children for kids' meals and fast foods," said Nancy Amy, associate professor of nutrition at UC Berkeley, noting studies show youngsters swallow nearly twice as many calories when eating out than when filling up on what mom or dad cooks up. "Children cannot legally enter into contracts, vote or exert other forms of informed personal choice, yet they are being unduly influenced by the food industry."

Specialists would prefer to use the persuasive power of media to more productive purposes.

"From the standpoint of healthcare policy, we need to take advantage of the food industry's enormous skill delivering messages to people, and make sure the right message is being given," said Dr. Frederick Samaha, chief of the Cardiovascular Section at the Philadelphia Veterans Affairs Medical Center.

News worthy of spreading includes findings pointing to flab-foiling features of a diet rich in fiber -- which is abundant in berries, broccoli, nuts and whole grains, among other foods -- and calcium, plentiful in such fare as dairy products, sardines and tofu. Many youngsters may be shortchanged on at least one of these vital nutrients, each of which has been shown to promote leanness.

"Our research that has focused on children living in rural areas ... shows that fruit and vegetable intake averages only two servings each day, when five to eight are needed," said Sylvia Moore, principal investigator in a four-year, $4.3 million federal study of countryside health behaviors under way at the University of Washington in Seattle.

In a recent survey of adolescents, more than half had eaten no vegetables the previous day and only 15 percent met the recommended requirement for fiber-rich fresh produce.

Suggestive of another deficit, research published in the American Journal of Clinical Nutrition tracks a 36-percent plunge in calcium-rich milk consumption and a 200-percent spike in soda sipping by adolescents over the past 30 years.

"Teens think that they are 'bullet proof' and can survive on 'Coke' and fries," mused Phil Connelly, associate professor at the University of Toronto in Canada.

A notion made easier to swallow by the affordability of such fare.

"Calories come really cheap these days," noted Gail Woodward-Lopez, associate director of the Center for Weight and Health at UC Berkeley. "Food with sugar used to be an expensive rare treat; now, it's cheaper to eat candy than fruits and veggies."

Those convinced educational institutions will whip their children into shape may wind up eating crow. A new report card for California, the nation's most populous state -- where one in four youngsters carries too much weight -- fails half the school districts reviewed between 1998 and 2003 for exceeding the federal standards for fat and saturated fat in their lunch offerings.

In addition, the President's Council on Physical Fitness and Sports reports only 36 percent of American children are in a daily athletic program at school and a mere half of those ages 12 to 21 regularly participate in vigorous physical activity.

"Obesity, which used to be a middle-age and later phenomenon, now has spread to ever-younger ages, in the context of a major decrease in physical activity," said Caleb Finch, adjunct professor of psychology, physiology and neurology at the University of Southern California in Los Angeles. "Today, schools have fewer -- or no -- exercise periods, less athletics and less attention to physical fitness."

In a study of 878 students ages 11 to 15, San Diego scientists identified a lack of physical activity as the leading cause of childhood obesity.

"There's often too much emphasis on what people consume and not on how much energy they're expending during a given day," said Dr. Kevin Patrick, UCSD professor of family and preventive medicine. "Insufficient physical activity and too much time spent on sedentary behaviors like computer games and watching TV may equal -- and even exceed -- diet quality as important contributors to overweight in adolescence."

Beefing up Patrick's case, a UC Berkeley study shows Americans spend nine times as many minutes watching television or movies as participating in sports, exercise and all other leisure-time physical activities combined. Another survey, involving 872 Swiss first, second and third graders, reveals a dangerously-elevated risk of overweight in video game aficionados.

A poll of 1,047 Americans indicates most look to educational institutions to take on much of the burden. At least 75 percent of respondents support stuffing school vending machines with healthy snacks, limiting fat-fueling fare in student lunchrooms and requiring the teaching of weight-wise eating and exercise habits. Most also favor restrictions on marketing to children and expansions of community exercise opportunities. Few show an appetite for regulatory changes, such as hiking the price of fattening foods or requiring standard portions in restaurants.

"Our children did not create this world where an over-abundance of appealing, low-cost, high-fat foods is widely available, a world where machines perform most of the tasks that used to require human energy expenditure, where electronics entrance us into long hours of sedentary activity," Ikeda concluded. "As adults, we must assume the responsibility for this situation and make every effort to change it."

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Next: Dishing out advice on weight management in the young

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UPI Science News welcomes comments on this series. E-mail lwasowicz@upi.com

Copyright 2004 by United Press International.