Lisa Lavine makes a concerted effort to keep her 17-month-old sonactive. The Sherman Oaks resident limits the amount of TV that Owenwatches. She also takes him to Gymboree, where he climbs on slidesand moves to music.
With all the recent reports about children becoming overweight atyounger ages, Lavine works to instill good health habits in her son.
'It does concern me, especially in the summer months when youcan't go outside as much' because of the hot weather, Lavine said.
At one time, baby fat was something kids outgrew. Today, it's ahealth hazard. According to the American Academy of Pediatrics, thenumber of overweight and obese children has doubled in 20 years.Nationally, an estimated 15 percent of children are consideredoverweight or obese.
In the San Fernando Valley, the rate is even higher, according toa recent report from the Los Angeles County Department of HealthServices' Office of Health Assessment and Epidemiology. About 16percent to 20 percent of public school children in grades five,seven and nine in the West Valley were considered overweight. In theEast Valley, 21 percent to 25 percent fell into the overweightcategory. Overall, the report found that 21 percent of the county'sschoolchildren were too heavy.
What's even of more concern to doctors and public healthadvocates is the early age at which children begin to tip thescales. A study from the State University of New York at Buffalofound that the average age when weight problems began was 3 1/2years old.
'Once a child is overweight, it is so difficult to get the weightdown,' said Dr. Veena Damle, a pediatrician at Kaiser Permanente inPanorama City, which will open a new childhood obesity clinic inSeptember.
Growing problem
Medical experts say no one factor is to blame for children'sexpanding waistlines. Families are bombarded with the temptations ofjunk food and lured into sedentary activities in front of thetelevision and computer. Kids are less likely to walk to school orplay outside if their neighborhoods aren't considered safe. Physicaleducation 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 showinsulin resistance, a precursor to diabetes. Many suffer from highcholesterol and face increased risk of cardiovascular disease asthey grow older. The extra weight can cause bone and jointdisorders. Obese children also can suffer from sleep apnea, apotentially life-threatening condition that causes interruptions inbreathing, said Melinda Sothern, co-author of 'Trim Kids' anddirector of the Childhood Obesity Prevention Laboratory at LouisianaState University.
The child's mental health suffers, too. Overweight children aremore likely to suffer from depression, perhaps because of theteasing and the social stigma, Sothern said. According to surveyresults released earlier this year by UC San Diego researchers,obese children rated their quality of life even lower than didchildren going through chemotherapy.
Concerned about the long-term impact on the health care system,pediatricians are pushing for preventive measures starting withpreschool-age children. In early August, the American Academy ofPediatricians released a new policy. It calls for pediatricians tocalculate the body mass index in children and adolescents every yearand 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 getthe eating under control and physical activity at a healthy level.'
The Centers for Disease Control and Prevention considers bodymass index, a ratio of weight to height, one of the best methods formeasuring obesity in the population. Because children's bodieschange so much, there are no simple rules to determine if a child isoverweight based solely on age.
Under the BMI formula, a child is considered overweight if he isheavier than 85 percent of other children of the same age andheight. A child is considered obese if he is heavier than 95 percentof other children of the same age and height. Experts say parentsshould consult with their pediatrician to determine if their childhas a weight problem.
At Kaiser Permanente in Panorama City, pediatricians willcalculate BMIs on children starting at age 2. Children between theages of 3 and 12 who are either overweight or on the cusp will bereferred to the new childhood obesity clinic. The five-week programaimed at both parents and children emphasizes nutrition, exerciseand behavior modification, which includes learning to read nutritionlabels 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 SUNYBuffalo's School of Medicine and Biochemical Sciences, agreed. Inthe short term, if a young child maintains his current weight andcontinues to grow in height, the BMI will reach a healthy level, shesaid.
'You don't necessarily want the child to lose weight,' she said.'You want meal planning and you want to increase the caloricexpenditure by having the child exercise more.'
Kids' stuff
Increasing the amount of physical activity doesn't mean putting a3- year-old on a treadmill for an hour. Parents can do more harmthan 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. TheNational Association for Sport and Physical Education recommendsthat toddlers and preschoolers have at least one hour and preferablyseveral hours of unstructured playtime daily.
At Gymboree in Sherman Oaks, teacher Stan Taffel leads mothersand toddlers in the 'Hokey Pokey' and 'Itsy Bitsy Spider,' songsthat combine words and body movement. The children also spend thehour-long class chasing bubbles, crawling through tubes andscrambling up slides.
Between the use of walkers, strollers and playpens, it can becomeall too easy to restrict a young child's natural movements. But it'sthrough movement that young children improve their balance,coordination, depth perception, strength and other skills criticalto their development, said Adrian Becker, owner of the Sherman OaksGymboree.
'The physical is the basis for everything,' Becker said. 'Letthem explore.'
Where young children simply need opportunity, older children mayrequire more encouragement. Physical activity drops up to 60 percentonce girls turn 11 and boys turn 14, said 'Trim Kids' co-authorSothern.
Not every child enjoys competitive sports, but everyone canparticipate in recreational activities. In dance, swimming orkarate, children can strive for individual goals. Sothern also wouldlike to see schools place more emphasis on intramural sports.
'If it's enjoyable, children will do it,' Sothern said. 'We needto 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 makeactive choices throughout the day, says 'Trim Kids' co-authorMelinda Sothern, director of the Childhood Obesity PreventionLaboratory at Louisiana State University.
While sitting burns only 30 to 50 calories per hour, standinguses 60 to 110 calories and walking 120 to 200 calories in the sameperiod of time. Here are some suggestions for encouraging movementfrom 'Trim Kids' (HarperCollins; $14.95):
--Create an imagination station. Fill a plastic tub withcostumes, dress-up clothes and accessories like crowns, wands, toyshields, armor, masks, vests, belts, shoes, hats, grass skirts,scarves, play jewelry and wigs. Provide a boom box with dance musicon tape or CD and room to dance. Other fun items include smallflags, pom-poms, Hula Hoops and jump ropes. For younger children,try small pull/push toys, plastic wagons and toy household cleaningitems such as brooms, mops, vacuum cleaners and feather dusters.
--When shopping with your child, park at the far end of the lotand walk to the store. In the grocery store, ask your child to pushthe 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 onecondition: She has to stand up and dance or move around during everycommercial break.
--Teenagers love to talk on the phone. Invest in a cordless phoneand tell her that she can talk as long as she walks. The moment shesits down, the conversation is over.
- Mariko Thompson
