Children's Health Children's Nutrition and Fitness

Weight Loss Strategies Kids Can Count On: The 5, 4, 3, 2, 1 Habit

Thirty years ago, there was often a chunky kid or two in a given class at school. But today, especially in low-income areas, overweight school-aged children are no longer the exception. Not only do these children face emotional pressure, they are also at high risk for developing serious medical conditions such as diabetes—and for becoming obese adults.

Below, Dr. Katherine Kaufer Christoffel, founder of the Nutrition Evaluation Clinic at Children's Memorial Hospital in Chicago and of the Consortium to Lower Obesity in Chicago Children, discusses how families can permanently change their eating and exercise habits so that their children keep fat off and stay healthy.

Why are rates of obesity rising in children?
Rates of obesity in childhood have about tripled over the last 30 years. The only way that a person becomes overweight is to eat more calories than they burn. So you have to look at factors that contribute to increased calories in and decreased calories out. And it's easy to see both in children today. The intake of fried and high-sugar foods, particularly in the form of fast foods and sugar-sweetened drinks, has gone up tremendously. One reason for that is it is less expensive to buy some of these foods than it is to buy healthier foods.

And it's been well documented that people who don't know if they'll be able to buy food for their families at the end of the month go for calories per dollar. People are also eating out much more than they were previously, and portion size is more difficult to control when you eat out. Also people are not sitting down to eat at regularly scheduled meals and instead tend to graze during the day. And, for people who are prone to gain weight easily, that kind of grazing ends up providing more calories.

On the "calories out" side, the amount of time devoted to video games, television or computers has become very prevalent during these last few decades. In inner cities, where the concentration of overweight kids appears to be the highest, there is fear of letting kids play outside because their neighborhoods are not safe. Children in all neighborhoods are also less likely to walk to school. And the rates of participation in organized sports are really remarkably low among kids.

How is obesity in children defined?
For adults, a body-mass-index (BMI)—which is measure of body weight in relation to height—over 25 is overweight and a BMI of over 30 is obese. There aren't single numbers like that for children. In fact, the Centers for Disease Control avoid the term "obesity" in childhood because the value that is abnormal continues to fluctuate as children grow and change with puberty. Instead, being between the 85th and 95th percentile BMI for gender and age is considered at risk for overweight. And being at the 95th percentile or above is considered overweight.

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