Fighting Childhood Obesity

[Jensen]

According to an AP article, the educational programmes designed to combat childhood obesity don't work.

The article

The federal government will spend more than $1 billion this year on nutrition education — fresh carrot and celery snacks, videos of dancing fruit, hundreds of hours of lively lessons about how great you will feel if you eat well.

But an Associated Press review of scientific studies examining 57 such programs found mostly failure. Just four showed any real success in changing the way kids eat — or any promise as weapons against the growing epidemic of childhood obesity.

I wish they had said what was working!

[Carrot Top]

There are only two children I know who have been headed towards being overweight (one would have called them "pleasingly plump" in past times rather than obese, or one would have mentioned that they were "big-boned") who were told by the doctor to lose weight and who succesfully did so.

One was a girl (then eleven) who is a friend of my daughter's one a boy (also eleven at the time) who is a friend of my son's. Both were put on diets and exercise regimens. The girl was on a low-carb diet and started both ballet and cheerleading the same year where previously she had not been active in this way. Within a year she had brought herself to where the doctor was pleased and she was too. The boy became a vegetarian after discussion of options with his mother as that choice pleased him the most, and also became more physically active than he had been before, taking karate four times a week rather than two while also participating in the soccer team at school.

In both cases, the parents were very involved in the entire process. They actively (then and now) act as coaches, support systems, aides-de-camp, and sometimes as diet cops when they feel they must.

They make sure the diets are followed, they drive the kids to activities and back each day, they set up the household to assist in the goals they set. In either case, this has not been easy at times for the parents or for the children. The lines drawn have been pretty tight.

Both children also have natural temperaments that do not buck or fight back. Both are naturally easy-going kids.

Both have lost the weight they wanted to/needed to.

I wish they had said what was working!

Well, there's an example of two cases that I know that have worked.

[prasantrin]

Someone here was concerned with her son's weight, and they started making changes in the family's diet (as in daily eating habits, not the 4-letter word) and routine. They became more active, and the children started contributing more to food choices. I wish I could remember who it was...they were quite successful, I think, with their changes, and I think the member might have started running, too.

I found the topic Overweight Kids started by pamjsa. It shows that parental support is crucial, as is the involvement of the child. The more the child feels involved in the process, the more likely the changes are to stick.

Maybe pamjsa will give us an update on her family.

Edited July 4, 2007 by prasantrin (log)

[sanrensho]

I wish they had said what was working!

←

I see all of these programs as mere band-aid solutions, so it doesn't surprise me that most fail. The article itself pinpoints the real culprit--the parents/home environment.

Quoted from the article:

Parents. Experts agree that although most funding targets schools, parents have the greatest influence, even a biological influence, over what their children will eat. Zeitler says when children slim down, it's because "their families get religion about this and figure out what needs to happen."

Also, late elementary is way too late to have an impact. You have to get at the kids earlier, such as at the preschool/kindergarten level.

Edited July 4, 2007 by sanrensho (log)

[Torrilin]

As I mentioned in Pan's thread, my mother is seriously overweight and diabetic. At some point before I was born, she formed a Clever Plan with my dad's help and active assistance. Dad's a food scientist, and they both read and study about nutrition. Their goal was to end up with children who weren't fat, and who stayed Not Fat past age 25.

Part one of the plan was no or minimal prepared baby food. I don't know how much they used for me, but I don't really recall them feeding either my sister or brother much bottled baby food. We all were breast fed, then gradually weaned onto the family's regular food that had been run through a food mill. Formula was a pretty much never thing, because we'd use bottles as squirt guns...

Part two was to feed us minimally processed foods. Frozen food with no additives was ok. Boxed cereal could have up to 5g of sugar. Generally the snack foods were sliced carrots, celery, green peppers with no dips. Cheese, yoghurt, dill pickles and other traditional processed foods were ok, if they met dad's labelling requirements. They stuck with mostly unsaturated oils or butter, probably because they're both real suspicious of anything processed.

For part three, we were allowed as much milk (no skim milk, as we wouldn't drink it but we went through 2% by the gallon), water and orange juice as we wanted, but soda and most other juices weren't allowed at home. Until we were nearly full grown, we weren't allowed coffee or black tea except as emergency asthma treatment. Herbal teas like chamomile and mint were ok, and we could have chocolate milk or cocoa as treats.

The last major part was treats. No treats unless they were *treats*. Homemade cookies, yes but rarely. Homemade cake with homemade icing. Ice cream if it met dad's regs, and he's a lot stricter than the FDA is. We were allowed more of reasonably healthy treats like ice cream, nuts and fruit, and not much of less healthy treats like cookies, cakes and chocolate. If they bought a treat, it was because it was better than they could do at home.

By the time we were 8 or so, we refused to eat grocery store cakes because the icing was "too sweet". We'd grab fresh veggies for a snack over crackers or potato chips. My parents didn't think they'd "won" at that point tho. They just continued on with the Plan because it was a healthy way to eat.

We also regularly got chased outside to play, ride bikes, swim, or walk the dog.

I don't think a government program would have the same effect as Mom's Clever Plan. She (and Dad) figured that the only way to have us be stay healthy was for eating well to be an all the time thing. And they both knew that we wouldn't learn to handle treats appropriately unless they modeled the behavior they wanted.

[Kouign Aman]

Parental modeling. Amen.

Damn its hard! Good on your mom & dad, Torrilin!

My husband is fat. Has been all his life. I am not (tho I wish I would shed those extra 15 I picked up when I got the desk job!).

Life is harder for fat kids, so we want ours not to fight that battle.

Our best moments of 'thank god' so far (re diet) have been when the munchkin pushes away from a partially consumed portion of dessert, due to fullness. I think kids are born knowing satiety, but its so easy to unlearn. 3 years down, a lifetime to go!

[heidih]

I agree that early patterns are really important. My sister and I both struggle with weight and love to eat. I was really worried about not passing on my behaviors and mind set to my son. What seems to have worked (he is a lean 16 year old and has never been chubby) is not making food a treat, and allowing him to develop his own eating style. He is a "picker", could take an hour to eat a meal so I just let him eat as long or as much as he wanted to. He is not hungry when he gets up, so I relaxed the concept of breakfast. On non-school days he will just have an early lunch. This is the kind of kid who will say "I am not hungry", or will ask for pho for a late breakfast. I bought him a small ice cream cake for his birthday almost a month ago, and he just finished it yesterday with the help of friends. We shall see....

[Pontormo]

There are many reasons why the funded programs don't work and they have little to do with obesity.

We've addressed some of them before. People do not like to be told what to do when lessons are couched in negative terms and seem like personal attacks, especially when alternatives to the way they eat--in this case--are hardly appealing. It is unfortunate that so few doctors and nutritionists monitoring the diets of patients and clients are talented cooks.

Another problem is that they are leading the kids to fish and not teaching them how to fish or how to sauté and sauce the fish during consultations.*

To maintain a focus on culinary matters without dwelling at length on how much value our cultures or societies place on intellectuality or how much thought goes into periodic changes in curricula or the types of academic disciplines we offer our children, I'll just say that we need to teach the pleasures of preparing food: how to shop, plan meals and cook with raw ingredients.

The children should be brought to farms and have gardens of their own if possible, but you don't need to have Northern California's climate to learn about seasons or field trips to see how delicious tomatoes are during the first weeks of the school year in the U.S. (we start in mid-August or early September), but not worth buying in February.

Urban schools should have fully equiped kitchens and kids should have access, ideally augmented with little culinary stations in each of their classrooms as in model programs in Japan. (I'll let someone else find the links.)

Budgetary constraints, fears of e-coli and mentally unstable strangers poisoning Joanie's birthday cupcakes have transformed cafeterias into places where off-site food is reheated and expelled examples of home-cooking from the classroom.

I'm not pretending that a kid well-versed in cooking beautiful, tempting, healthful meals is not going to overeat. He needs fun, humiliation-free forms of exercise vs. the kinds of Phys Ed classes some of us endured, too. Still...

*Concerned about sustainability? Insert culinary matters into classes on science and geography. Wish to develop adventuresome palates? Teach French dishes along with the language, Native American along with local history of the Pacific Northwest, etc.

Edited July 5, 2007 by Pontormo (log)

[Busboy]

A billion dollars is spit in the ocean compared to the money that is spent marketing junk to children.

School cafeterias are increasingly given over to fast- and junk food because that's what the kids say they want. Soft-drink manufacturers buy exclusive access to school systems desperate for cash. Physical education programs are cut back because of the new emphasis on hitting test scores. Video games. It is apparently now illegal to release a kids movie without tying the

to hundreds of lloathsome products. Parents are too stressed or too ignorant to cook right. We pay vast subsidies for a monoculture farming that fights to find new ways to inject sugars, fat and starch into the our meals (guess what book I've been reading). We fear of unstructured play. We set bad examples ourselves.

We spend a billion dollars a year on ineffective programs because its easier than actually doing something.

[pennylane]

I guess it is hard to identify the fine line between raising kids to be obese and giving kids a food/weight complex. I was brought up in a similar home to Torrelin, where things like pop and chips just weren't allowed - forget about candy. We didn't even get fruit juice or breakfast cereal other than oatmeal or cornflakes. All this was more because of my mother's love for natural, healthy foods than any desire to keep us from getting fat. Well, we have all remained relatively thin to this day, but we have also all got eating disorders, as do the other kids I know who were raised this way. It's like ten years down the line we're still trying to make up for lost time...

[Kouign Aman]

pennylane, what would you differently from how you were raised?

[sanrensho]

It's like ten years down the line we're still trying to make up for lost time...

Anecdotally, I've also seen this with other people I know. That is to say, deprivation can have the opposite effect, making it seem more desirable.

With my own kids, I try not to be a food fascist. Having junk food on rare occasions is OK. (My older daughter has only had one slurpee in her life). It's out there, and they will eventually have the choice to buy it on their own and eat it once they get older.

However, when they do get to have junk food, we try to talk about choices and ingredients, as well as the importance of moderation. At the very least, I think my kids will be less inclined to eat the bad stuff when they get older. At least I hope...

[Malkavian]

A couple thoughts come to mind.

First of all, the old saying "Like father, like son" (Dads, no offense)--It doesn't matter what you teach a child at school or anywhere, if the parent(s) have horrible eating habits, the child will too, until it reaches an age where preparing his/her own food becomes an option (and then you still have to convince the parents to buy it, etc etc) A friend of mine right now is going through that ordeal, attempting to convince her mom to buy groceries differently so they can all eat a little better,

Second, it seems like cooking may be a lost art among parents, for whatever reason. My mom was not a food fascist by any means; we had sugary breakfast cereals and snack foods and whatnot, but we came out okay (alright, a bit overweight, perhaps, but we were geeks, not sporty types)

The difference, I think, is that my mom is a fantastic cook, and knew how to temper treats and eat-out nights with healthful food that made us *want* to eat her cooking rather than big macs. Lots of my own friends (and i see the pattern forming in people my age becoming parents /sigh) ate out quite often because it was that or the horror of dry meatloaf and stouffers mac and cheese or similar.

[pennylane]

pennylane, what would you differently from how you were raised?

I don't know - it's hard to say, isn't it? I suppose moderation is a good thing, but then I look at parents who ration out treats on special occasions and wonder if that doesn't encourage kids to view sweets and junk food as a "reward" or a guilty pleasure, and if that doesn't help promote eating disorders too.

My husband credits his balanced habits to his upbringing, which included some but not unlimited pop, treats, etc. along with plenty of physical activity. It does sound perfect, but what about those people, like me and Malkavian, who just happen to be geeks instead of natural born athletes?

I also agree that kids tend to follow the example their parents set. Even today, when I binge or overeat, it's generally on relatively healthy food!

[nonblonde007]

As a mother of 3 teen sons, I Must chime in here. Two of my boys are naturally slim as is often the case with boys and the third and youngest takes after his mom, tending to hold onto weight.

First and foremost, the moment that the government begins to take responsibility for the upbringing of your children, is the moment your license to breed needs to be revoked! Society can not be blamed, advertising, t.v., peer pressure, etc. etc. are not responsible for our childrens shortcommings. We are. Children learn what they live, including discipline in eating habits. The key word being "discipline". The best gift we can give them is to teach them self-discipline in all areas of life and responsibility for our actions and consequences.

That said, our family will indulge in snacks, within reason, untill we are satisfied. The boys have discovered that a craving for chocolate can most of the time be relieved with just a single bite. Leaving them satisfied and yet not over-indulged. Because we have educated and never restricted sweets, or unhealthy snacks, simply limitied them, there seems to be no need to gorge. My youngest, who battles with a bit of a weight issue, regulates himself and chooses healthy foods, with bits of intermittent goodies whenever he feels like he has put on a little too much weight. He understands that allowing himself the chips or candy comes with a price, and chooses whether or not to pay it.

I have my own feelings and beliefs on how my children should be fed and raised. I realise that it may not mesh with the norm or be politically correct, but still it is my choice. I resent and oppose the government stepping in and deciding for me what is right for my family. I also have little respect for a parent who will give over the health and training of their children to faceless lawmakers. We are responsible for ourselves, our choices, our children and our consequences.

O.K., I am off my pedestal now!

[pennylane]

Yes, but I guess many parents don't know how to instill healthy habits in their kids, especially since many of them may struggle with bad eating habits themselves. I suppose the idea behind government regulation is that these kids shouldn't suffer because of their parents' short-comings. I mean, I don't know if I'm really in favour of it, but I guess I can see where they're coming from.

[nonblonde007]

Yes, but I guess many parents don't know how to instill healthy habits in their kids, especially since many of them may struggle with bad eating habits themselves.  I suppose the idea behind government regulation is that these kids shouldn't suffer because of their parents' short-comings.  I mean, I don't know if I'm really in favour of it, but I guess I can see where they're coming from.

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I, also feel for these kids, their only crime being having unschooled parents. However, I grew up with entirely ignorant parents, horrible habits and skills, dirt poor. I was one of those kids. If I can educate myself, and feel responsible for my choices and my childrens, why can not they? There is no excuse for laziness when children are involved. There are always resourses and even caring neighbors and friends to turn to. Not to mention books, endless television programs, free courses and the internet at the library. If it's depression, there are free meds and counseling. If it's health, the same.

I don't mean to sound harsh, but I grew up very harsh, and managed to pull myself up by my bootstraps and say "not for me". I have been through the worst, and the best, and learned the hard way that it comes down to personal choices and accepting responsibility for onesself and loved ones. It is up to us, all of the people to take the time to teach all of the children, not just our own, to take the 5 minutes to talk and listen. Wow, reading that back to myself, I didn't realise that I felt so strongly about this issue. Forgive me for my rantings. Feel free to slam me if you need, i asked for it airing my beliefs in such a way.

[prasantrin]

I, also feel for these kids, their only crime being having unschooled parents.  However, I grew up with entirely ignorant parents, horrible habits and skills, dirt poor.  I was one of those kids.  If I can educate myself, and feel responsible for my choices and my childrens, why can not they?  There is no excuse for laziness when children are involved.

Having worked with young adults who grew up in similar (or worse) environments, and many of whom had their own children, it's not about laziness. It's more about fear, lack of confidence, and low self-esteem. It's not so easy to instill those things into people.

There are always resourses and even caring neighbors and friends to turn to.  Not to mention books, endless television programs, free courses and the internet at the library. 

Most of the students I worked with didn't have caring neighbours or friends or family. Or at least they had very few caring people in those lives, and those people generally knew little to nothing about nutrition. As part of the program, a dietician would come in and give a talk about proper nutrition, yet few if any of the students could understand the things she said. Sure there are TV programs, but if you can't afford a TV, you can't watch them. And if your reading skills are poor (like the skills of many who grew up in poverty), books aren't going to help much either.

If it's depression, there are free meds and counseling.  If it's health, the same.

Depending on where you live, access to such things is not always as easy as you make it sound.

I don't mean to sound harsh, but I grew up very harsh, and managed to pull myself up by my bootstraps and say "not for me".  I have been through the worst, and the best, and learned the hard way that it comes down to personal choices and accepting responsibility for onesself and loved ones.  It is up to us, all of the people to take the time to teach all of the children, not just our own, to take the 5 minutes to talk and listen.  Wow, reading that back to myself, I didn't realise that I felt so strongly about this issue.  Forgive me for my rantings.  Feel free to slam me if you need, i asked for it airing my beliefs in such a way.

←

I don't think you sounded harsh. You were speaking from your own experience, and it's wonderful that you were able to end your family's cycle of ignorance, poverty, etc. But it's important not to generalize to others. Just because others can't escape, doesn't mean they're lazy or stupid. And it doesn't mean those who tried to help them but didn't succeed are failures, or didn't try hard enough. It takes a hell of a lot more than "5 minutes to talk and listen." If only it were that easy.

[mizducky]

From the article cited by the original poster:

Doctors like Tom Robinson, who directs the Center for Healthy Weight at Lucile Packard Children's Hospital at Stanford University, said . . . "I think the money could be better spent on programs that are more behaviorally oriented, as opposed to those that are educationally oriented, or studies that just describe the problem over and over again," he said.

Yeah, that jives with my personal experience. All the nutritional info I'd learned over the years was definitely useful -- but only once I developed the personal motivation to modify my behavior. And making modifications on behaviors so deeply-seated and ingrained into my psyche so early in my childhood took (and continues to take) a major amount of effort.

Further, the behavior mods only even began to take on my head once I put all my understanding of my behavior to work. Alas and as I've harped on before, my experience is that a lot of weight loss pundits, having apparently not ever experienced having to lose weight themselves, have a hard time grasping how truly difficult this behavior modification is.

And I don't think I could have done any such work while I was still living under my parents' roof--the familial psychological terrain regarding food and overweight was just way too fraught with shame, guilt, blame, mixed messages, denial, and modeling of poor behavior.

I generally have a positive attitude towards public programs to address various social ills, but I confess to being dubious as to whether any public program can be devised to address these issues of behavior modification and family dysfunctionality around food in any kind of large-scale way. And that's not even touching the socioeconomic and media-message issues.

I'll tell you one hunch, though--if someone could figure out how to market healthy eating and sensible weight loss as really "cool"--in a way that kids accept as cool, and not just yet another embarrasing adult attempt to appear cool--things might really get somewhere. Like, if some rap or rock star that parents really disapprove of suddenly went vegetarian and did a whole trip about how rebellious and bucking-the-system it was, I bet you'd see a whole bunch of kids decide to annoy their parents by demanding tofu and wheat germ.

[nonblonde007]

prasantrin, I agree with much of what you are saying. I didn't mean 5 minutes literally, what I am trying to say is that it takes a village. If we start excusing everyones behavior and stop putting responsibility in each persons hands, then we become a lazy society. There are allways exceptions to everything. We are human and should have compasion for those who realy need it. In fact for everyone. It's the adage about giving the man a fish or teaching him to fish. The choice is still his, he has to choose to fish. I was a foster parent for 10 years, I understand feeling lost and having no self esteem or learning. A child should never be deprived in any way. But each individual as an adult, still has the choice of remaining as they are or bettering himself. I am sorry that some never understand that. I am adressing the general public and parents specific. If you are adult enough to have children, then it is your responsibility and duty to do the best you can by them, not to rely on the government nor blaim the government for the rearing of your child. If your child has weight issues, don't blaim anyone but yourself for them. Then, do something about it istead of pointing fingers. If health is truly an issue and you can't get assistance with that, step up, be a parent and ask for help with your children to keep them safe. Like I said it takes a village. Please understand, I didn't in any way intend to put responsibility on the children themselves.

[shellfishfiend]

prasantrin, I agree with much of what you are saying.  I didn't mean 5 minutes literally, what I am trying to say is that it takes a village.  If we start excusing everyones behavior and stop putting responsibility in each persons hands, then we become a lazy society.  There are allways exceptions to everything.  We are human and should have compasion for those who realy need it.  In fact for everyone.  It's the adage about giving the man a fish or teaching him to fish.  The choice is still his, he has to choose to fish.  I was a foster parent for 10 years, I understand feeling lost and having no self esteem or learning.  A child should never be deprived in any way.  But each individual as an adult, still has the choice of remaining as they are or bettering himself.  I am sorry that some never understand that.  I am adressing the general public and parents specific.  If you are adult enough to have children, then it is your responsibility and duty to do the best you can by them, not to rely on the government nor blaim the government for the rearing of your child.  If your child has weight issues, don't blaim anyone but yourself for them.  Then, do something about it istead of pointing fingers.  If health is truly an issue and you can't get assistance with that, step up, be a parent and ask for help with your children to keep them safe.  Like I said it takes a village. Please understand, I didn't in any way intend to put responsibility on the children themselves. 

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I agree with you 100 percent. We need to stop passing blame for our decisions onto "society." We all have the freedom of choice and need to take responsibility for our lives and actions.

[MarkIsCooking]

Interesting thread. As parent of 3, I think a lot of the youth weight thing boils down to 3 things:

> Parental Control: It seems like so many parents are not willing to set limits for their kids (i.e. don't want to say no) and plenty of parents simply don't understand the basics of healthy eating (just look at them).

> Portion Control: The volume of food many people (including some kids) eat is just staggering. There just isn't enough exercise and activity to offset it. Anybody seen the new Shaq program where he's trying to help a bunch of fat kids turn things around? Not as easy as he thought. Parental control and portion control are at the heart of the struggle.

> Processed foods: I've gotten into the habit of simply not buying anything where the ingredient list is long. I've never seen a long ingredient list that didn't have tons of stuff which is not food, but stuff designed to change the color, shelf life, etc. I'm convinced that years of large amounts of these chemicals is changing the body chemistry in many of us.

-Mark-

[Kouign Aman]

Like, if some rap or rock star that parents really disapprove of suddenly went vegetarian and did a whole trip about how rebellious and bucking-the-system it was, I bet you'd see a whole bunch of kids decide to annoy their parents by demanding tofu and wheat germ

I know one vegetarian who lives on cheese pizza, fruit, and cigarettes. Her refusal to eat meat has not been balanced with a desire to eat vegetables or legumes.

So, what I'm trying to say is: I think it would work, and the message would have to be VERY carefully crafted to be that eating veggies is cool. Of course, that wont eliminate the ranch dressing and cheese sauces!

I was a geek (?was?). There's outdoor opportunities for geeks too. Just takes more parental effort to figure 'em out. Treehouses equipped with entry via climbing rope, etc.

I dont know that there's a "right" answer. I suspect weight control is as individual as everything else. Why does my kid stop eating cake and icecream just because she's full, but I will eat rice'nbeans til I hurt?

But it is nice to know someone is checking the efficacy of tax-funded programs so they can be changed or eliminated if not working as desired.

[Darcie B]

I was raised in an environment where sweets and goodies, whether homemade or not, were readily available at all times. We ate plenty of processed food from boxes and cans, but with some homemade and even home-grown foods thrown in the mix. Most of our beef, chicken and eggs came from my grandparents farm, for example, but we used that ground beef to make Hamburger Helper.

We were expected to play outside weather permitting, which in North Dakota meant not in a tornado or blizzard, everything else was fair game.

Personally, I think it is more about genetics and activity rather than food. There were ALWAYS cookies, bars, cakes, pies, candies and ice cream in the house and we ate a LOT of them. But we were always active in sports or just riding our bicycles or swimming. The three of us kids never had a weight problem, but now in our 30s we are not thin but still we aren't obese. For that I think we can thank our genes because we surely aren't that active anymore. I dunno, maybe we're more active than I think.

I think nutritional education is a good idea, but I don't see how it is going to help by itself. I believe that we really need to add back recess and outside play, and a lot more phys. ed. if we are to do anything about the problem. We had phys. ed. three times per week all throughout school, and I think that helped more than anything since our school lunches were abysmal in terms of nutrition AND taste.

Just my two cents' worth.