Byline: Mariko Thompson Staff Writer
Lisa Lavine makes a concerted effort to keep her 17-month-old son active. The Sherman Oaks resident limits the amount of TV that Owen watches. She also takes him to Gymboree, where he climbs on slides and moves to music.
With all the recent reports about children becoming overweight at younger ages, Lavine works to instill good health habits in her son.
``It does concern me, especially in the summer months when you can't go outside as much'' because of the hot weather, Lavine said.
At one time, baby fat was something kids outgrew. Today, it's a health hazard. According to the American Academy of Pediatrics, the number of overweight and obese children has doubled in 20 years. Nationally, an estimated 15 percent of children are considered overweight or obese.
In the San Fernando Valley, the rate is even higher, according to a recent report from the Los Angeles County Department of Health Services' Office of Health Assessment and Epidemiology. About 16 percent to 20 percent of public school children in grades five, seven and nine in the West Valley were considered overweight. In the East Valley, 21 percent to 25 percent fell into the overweight category. Overall, the report found that 21 percent of the county's schoolchildren were too heavy.
What's even of more concern to doctors and public health advocates is the early age at which children begin to tip the scales. A study from the State University of New York at Buffalo found that the average age when weight problems began was 3 1/2 years old.
``Once a child is overweight, it is so difficult to get the weight down,'' said Dr. Veena Damle, a pediatrician at Kaiser Permanente in Panorama City, which will open a new childhood obesity clinic in September.
Growing problem
Medical experts say no one factor is to blame for children's expanding waistlines. Families are bombarded with the temptations of junk food and lured into sedentary activities in front of the television and computer. Kids are less likely to walk to school or play outside if their neighborhoods aren't considered safe. Physical education and recess often get short shrift at schools.
Being overweight or obese isn't just a matter of appearance. Carrying extra weight can have a major impact on a child's health. Studies have found that 20 percent of overweight children show insulin resistance, a precursor to diabetes. Many suffer from high cholesterol and face increased risk of cardiovascular disease as they grow older. The extra weight can cause bone and joint disorders. Obese children also can suffer from sleep apnea, a potentially life-threatening condition that causes interruptions in breathing, said Melinda Sothern, co-author of ``Trim Kids'' and director of the Childhood Obesity Prevention Laboratory at Louisiana State University.
The child's mental health suffers, too. Overweight children are more likely to suffer from depression, perhaps because of the teasing and the social stigma, Sothern said. According to survey results released earlier this year by UC San Diego researchers, obese children rated their quality of life even lower than did children going through chemotherapy.
Concerned about the long-term impact on the health care system, pediatricians are pushing for preventive measures starting with preschool-age children. In early August, the American Academy of Pediatricians released a new policy. It calls for pediatricians to calculate the body mass index in children and adolescents every year and to educate families on good health habits.
``Ten years ago, the doctor would say, 'Let's wait and see,' '' Sothern said. ``Today, the emphasis is on educating the parent to get the eating under control and physical activity at a healthy level.''
The Centers for Disease Control and Prevention considers body mass index, a ratio of weight to height, one of the best methods for measuring obesity in the population. Because children's bodies change so much, there are no simple rules to determine if a child is overweight based solely on age.
Under the BMI formula, a child is considered overweight if he is heavier than 85 percent of other children of the same age and height. A child is considered obese if he is heavier than 95 percent of other children of the same age and height. Experts say parents should consult with their pediatrician to determine if their child has a weight problem.
At Kaiser Permanente in Panorama City, pediatricians will calculate BMIs on children starting at age 2. Children between the ages of 3 and 12 who are either overweight or on the cusp will be referred to the new childhood obesity clinic. The five-week program aimed at both parents and children emphasizes nutrition, exercise and behavior modification, which includes learning to read nutrition labels and choosing wisely in restaurants.
``After five weeks, they won't lose a lot of weight,'' Damle said. ``The main goal is to change the behavior.''
Dr. Teresa Quattrin, associate professor of pediatrics at SUNY Buffalo's School of Medicine and Biochemical Sciences, agreed. In the short term, if a young child maintains his current weight and continues to grow in height, the BMI will reach a healthy level, she said.
``You don't necessarily want the child to lose weight,'' she said. ``You want meal planning and you want to increase the caloric expenditure by having the child exercise more.''
Kids' stuff
Increasing the amount of physical activity doesn't mean putting a 3- year-old on a treadmill for an hour. Parents can do more harm than good by imposing an adult exercise routine, Sothern said.
The guidelines from the American Academy of Pediatrics emphasize ``unstructured'' activities - in other words, let them play. The National Association for Sport and Physical Education recommends that toddlers and preschoolers have at least one hour and preferably several hours of unstructured playtime daily.
At Gymboree in Sherman Oaks, teacher Stan Taffel leads mothers and toddlers in the ``Hokey Pokey'' and ``Itsy Bitsy Spider,'' songs that combine words and body movement. The children also spend the hour-long class chasing bubbles, crawling through tubes and scrambling up slides.
Between the use of walkers, strollers and playpens, it can become all too easy to restrict a young child's natural movements. But it's through movement that young children improve their balance, coordination, depth perception, strength and other skills critical to their development, said Adrian Becker, owner of the Sherman Oaks Gymboree.
``The physical is the basis for everything,'' Becker said. ``Let them explore.''
Where young children simply need opportunity, older children may require more encouragement. Physical activity drops up to 60 percent once girls turn 11 and boys turn 14, said ``Trim Kids'' co-author Sothern.
Not every child enjoys competitive sports, but everyone can participate in recreational activities. In dance, swimming or karate, children can strive for individual goals. Sothern also would like to see schools place more emphasis on intramural sports.
``If it's enjoyable, children will do it,'' Sothern said. ``We need to get these kids moving.''
Mariko Thompson, (818) 713-3620
mariko.thompson(at)dailynews.com
Keep 'em moving
All physical activity burns calories. So the trick is to make active choices throughout the day, says ``Trim Kids'' co-author Melinda Sothern, director of the Childhood Obesity Prevention Laboratory at Louisiana State University.
While sitting burns only 30 to 50 calories per hour, standing uses 60 to 110 calories and walking 120 to 200 calories in the same period of time. Here are some suggestions for encouraging movement from ``Trim Kids'' (HarperCollins; $14.95):
--Create an imagination station. Fill a plastic tub with costumes, dress-up clothes and accessories like crowns, wands, toy shields, armor, masks, vests, belts, shoes, hats, grass skirts, scarves, play jewelry and wigs. Provide a boom box with dance music on tape or CD and room to dance. Other fun items include small flags, pom-poms, Hula Hoops and jump ropes. For younger children, try small pull/push toys, plastic wagons and toy household cleaning items such as brooms, mops, vacuum cleaners and feather dusters.
--When shopping with your child, park at the far end of the lot and walk to the store. In the grocery store, ask your child to push the shopping cart. Once the groceries are loaded into the car, return the shopping cart together.
--Have a garden? Ask your child to help plant, water and weed.
--Allow your child to watch her favorite television show on one condition: She has to stand up and dance or move around during every commercial break.
--Teenagers love to talk on the phone. Invest in a cordless phone and tell her that she can talk as long as she walks. The moment she sits down, the conversation is over.
- Mariko Thompson
CAPTION(S):
5 photos, box
Photo:
(1 -- cover -- color) Weighing in on childhood obesity
Early years are the time to instill healthy habits
(2) Jake Shpiner, 2, gets airborne at the Gymboree in Sherman Oaks. The key to keeping children healthy, experts say, is providing activities they think of as fun - not as exercise.
(3) At right, mom Sharon Dash and daughter Savannah, 2, play together on the mat at Gymboree.
(4) Gymboree teacher Joy Lang, left, watches as Alexandra Nowakowski, 2, runs on the air log toward her mother, Agnieszka.
(5) Children jump for bubbles at Gymboree in Sherman Oaks. While diet remains important, activity is a key component in fighting childhood obesity.
Tina Burch/Staff Photographer
Box:
Keep 'em moving (see text)
