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Childhood Obesity: A Bibliographic Analysis
Shelly Smith
Academic affiliation: Oklahoma State University
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There is a disease in society today that is becoming an epidemic. This problem affects 25-30% of America's children (Parizkova and Hills 3). That epidemic is childhood obesity. A person is considered obese if his or her body weight is more than the normal amount for a particular age, gender, or height. This determination is made through BMI (body mass index) calculations that are based upon a person's height and weight. Currently, obesity is considered the number one health risk for children in the United States today and it continues to increase. This disease will continue to threaten the younger generation if action is not taken. The purpose of this essay is to make people aware of the information available that discusses the causes of childhood obesity and ways to prevent it.

Childhood obesity is at an all time high in America today, up 50% since 1991 (Borra et al. 721). Complex social and environmental reasons for this disease include excessive viewing of television, inadequate amounts of vigorous physical exercise, excessive overeating of high calorie food, and environment. According to Maria Golan, Ph.D. and Scott Crow, M.D. considerable evidence suggests that the eating behaviors of children and adolescents are shaped by the eating behaviors of their parents (42). If parents are going to eat unhealthy foods, the children will do as they are taught. Though it is much easier in the world today to make a quick run to a fast food restaurant, most parents know a healthy nutritious meal is a better choice. In a study conducted in 2000, parents stated that a healthy child meant the absence of severe or ongoing medical problems. Weight was recognized as an issue only if it was extreme enough to prevent children from keeping up physically or socially with their peers (Borra et al. 722). An easy way for parents to control a child's eating habits is keep junk food out of the child's reach. The way to prevent this disease is to recognize the onset in the early stages and make lifestyle changes then. If it is too late, the struggle to maintain a healthy weight can become a difficult process.

The American Obesity Association website declares that when comparing their own child hood health habits to their children's 27 percent of parents said their children eat less nutritiously, and 24 percent said their children are less physically active ("Finally" 1). The critical role a parent plays in the life of the child is evident with the food choices they present and the food they, themselves, choose to eat. According to Golan and Crow, family meals appear to play an important role in promoting positive dietary intake among children. Research shows that when parents provide companionship at mealtime, establish a positive atmosphere, and model appropriate food-related behaviors, their children tend to have improved dietary quality (41). The increased frequency of family dining among teenagers showed an increase in healthful dietary patterns. This example leads to positive eating habits and is also healthy to the relationship of the parent and child. Yet, it is still more common for children to eat alone (Golan and Crow 41).

The lack of physical activity in schools today has aided in an increase of obesity. Due to budget cuts from the government, public schools are limiting the amount of classes available to students. The number of students attending daily physical education classes has decreased from 42 percent in 1991 to 29 percent in 1999 (Van Stavern and Dale 45). Physical education (PE) classes offer the most controlled way for children to channel their energy but they are the first to be done away with. Although most schools offer organized sports, not all children are able to participate and some do not involve enough energy to burn the calories they consume each day. Schools should promote more physical activity programs outside of organized sports and physical education classes.

According to a survey conducted by the American Obesity Association, the majority of parents in the United States believe that physical education classes or recess should not be replaced with academic classes ("Finally" 1). In the last decade, a number of schools curriculum programs have attempted to influence children's and adolescents' diet and activities patterns, and ultimately prevent obesity. This is a very important factor in the fight against childhood obesity. If children continue to have an insufficient amount of exercise, the health problems that can occur such as type 2 diabetes, respiratory ailments and metabolic syndrome, continue to increase. The disease of metabolic syndrome is defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and or impaired glucose tolerance (Van Staveryn and Dale 44). To supplement the information provided by Van Staveryn and Dale, Susan Landers writes, "'The Surgeon General calls for at least 60 minutes of physical activity a day most days of the week'" (26). Encouraging children to participate in activities such as skating or biking in addition to the amount of exercise received in school physical education classes could easily reach this amount.

David S. Ludwig states that since the beginning of the first children's programs in the 1950's, television has become the dominant pastime of youth throughout the industrial world (226). The typical child watches 2-5 hours of television per day. This is why TV viewing is such an enormous part of the cause of obesity. Moreover, though the media is only one of many factors that appear to be affecting childhood obesity, it is an important piece of the puzzle (Landers 29). Jana Parizkova and Andrew Hills suggest that, "combining the inactive behavior of television viewing with frequent very attractive commercials advertising food and drink" provides a direct link to obesity (10). Landers writes children should view no more than two hours of television a day. In several experiments conducted by Thomas Robinson, MD, MPH associate professor of pediatrics and medicine at Stanford University School of Medicine, children's reduced viewing of television resulted in less weight gain (Landers 26). Television consumes the afternoon of a child many days of the week. Creating fun after school activities would create a healthier lifestyle. Parizkova and Hills argue that there is a direct link between television viewing and weight gain that leads to obesity (10).

Schools also play an important part of the obesity crisis because of the unhealthy food served in cafeterias. One in five schools now offer brand-name fast food such as McDonalds, Taco Bell, and Pizza Hut at lunch and for snacks. Also, schools are starting to negotiate contracts with soda companies to sell soda and allow young people easy access to vending machines during recess breaks. Because of the availability the consumption has nearly tripled in the last 3 decades (Van Stavern and Dale 44). These two components alone can cause a major problem; consuming only 12 ounces of a carbonated soda can be the same as eating 10 teaspoons of sugar. The reasons schools negotiate contracts with the food and soda companies are that they "are not being provided enough funding to ensure that the total school environment supports the development of healthy eating patterns" ("Finally" 5). Golan and Crow argue that children could experience and appreciate a wide variety of nutritious food in their early years if exposed to it through parents and childcare providers (42). For example, if a child is exposed more to fruits and vegetables than high calorie, fried foods he or she is more likely to consume those foods as he or she ages.

The lifestyle of the parent sets the example for the child. Further, the lifestyle of the community is also an example for a child. A program in North Carolina titled the North Carolina Prevention Partners (NCPP) is a coalition of organizations that are involved in public health issues such as obesity, accidents and physical activities (Dietz et al. 84). The program helps the community organizations to develop ideas and programs to fight the obesity problem. One such program is the Winners Circle Healthy Eating Dining Program. It promotes healthful eating in restaurants, schools and convenience marts (Dietz et al. 84). The partnership has also aided in the development of school nutrition and physical education programs through state legislative committees. Another example of community intervention in the fight against obesity is The National Heart, Lung and Blood Institute (NHLBI) Child and Adolescent Trial for Cardiovascular Health (CATCH) which represents state of the art multiple component intervention for improving diet and increasing activity in children (Robinson and Killen 264). Robinson and Killen further suggest the CATCH intervention includes school curricula, school food service, physical education and, in half of the intervention schools family-based components. Yet despite producing significant modifications in school lunches, reductions in fat intake, increased activity during PE classes and increased total daily vigorous activity, these changes resulted in no significant decreased in BMI or triceps or sub scapular skin fold thicknesses (Robinson and Killen 264).

Further, in addition to eating habits of children being associated with eating habits of their parents, parent and child dietary habits can be related to the environmental and geographic location of the child, so be it a third world country or a more industrialized nation. Parizkova and Hills suggest, for example, preschool children living in north and central portions of Mexico have higher obesity prevalence rates than those living in the southeast. The risk of obesity in these regions was positively associated with the educational level of the head of the household and with the social and economic conditions (Parizkova and Hills 4). This can also be related to the fact that children and adolescents have easy access to their own money. According to Golan and Crow, efforts made by adults to limit children's intake of sweet snacks and drinks are being undermined by earlier and earlier influences in the child's life and by the child's access to money (41.) It is common in this country for children to have more money now than in previous decade and also the opportunity to spend it as they wish and usually without parental awareness.

Childhood obesity will continue to increase if action is not taken against it. The components to the solution, as examined by the scholarship in this essay, include parental involvement in the child's live, restricting television time, altering school lunch programs to include a healthy, low calorie diet, preventing the elimination of physical education classes as a result of adding academic classes, and community involvement with prevention. Implementing these solutions nation wide would lead to a decrease in the epidemic.

Works Cited

Borra, Susan T., Lisa Kelly, Michael B. Shirreffs, Kerry Neville, Constance J. Geige. "Developing health messages: Qualitative studies with children, parents, and teachers help identify communications opportunities for healthful lifestyles and the preventions of obesity." Journal of The American Dietetic Association 103.6 (2003): 720-28.

Dietz, William H., et al. "Policy Tools for the Childhood Obesity Epidemic." The Journal of Law, Medicine and Ethics 20.3 (2002): 83-87.

"Finally a Cure for Obesity." American Obesity Association 17 Sept. 2004. www.obesity.org/subs/childhood/causes.shtml.

Golan, Moria, Scott Crow. "Parents Are Key Players in the Prevention and Treatment of Weight-related Problems." Nutrition Reviews. 62.1 (2004): 39-50.

Landers, Susan J. "Kids, TV a Weighty Blend of Trouble." American Medical News 47.12 (2004): 26-27.

Ludwig, David S., and Steven L. Gortmaker. "Programming Obesity in Childhood." The Lancet 364.9430 (2004): 226-27.

Parizkova, Jana, and Andrew Hills. CHILHOOD OBESITY Prevention and Treatment. Ed. Ira Wolinsky and James F. Hickson, Jr. Boca Raton: CRC Press, 2001.

Robinson, Thomas N., and Joel D. Killen. "Obesity Prevention for Children and Adolescents." Body Image, Eating Disorders, and Obesity in Youth. Ed. Thompson, J. Kevin, and Linda Smolak.

Van Stavern, Tonia, and Darren Dale. "Childhood Obesity Problems and Solutions." Journal of Physical Education, Recreation and Dance 75.7 (2004): 44-54.

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