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A Weighty Issue: Childhood Obesity

At one time, an overweight child was more the exception than the rule. Unfortunately, the number of obese children in the United States is increasing at an alarming rate.

According to a 2012 report from the National Center for Health Statistics (NCHS), the United States has the highest prevalence of obesity among developed nations. The percentage of young Americans who are overweight has more than tripled since 1980. In 2009 to 2010, 17% of children and adolescents were considered obese.

Up to 80% of children who are obese remain overweight as adults, according to the National Institutes of Health (NIH). Childhood obesity is more prevalent in the Northeast, followed by the Midwest, South, and West. It is also more prevalent in cities than in rural areas.

The determination of childhood obesity is more than the numbers on a scale. Nutritional experts rely on body mass index (BMI) to estimate body fat and the degree of overweight or obesity. BMI is a mathematical formula that uses a person's height and weight. Cutoffs to determine normal, overweight, and obese weight in children are based on BMI-for-age growth charts. Children with BMI values at or above the 95th percentile are considered overweight and therefore at risk for future weight-related diseases such as diabetes, high blood pressure, and heart disease.

Too little exercise, too much junk food

Although obesity in adults and children stem from eating more calories than are burned in physical activity, the issue involves a complex interaction between lifestyle, environment, and genes. However, the rise in childhood obesity can be primarily tied to two factors: too little exercise and too many calories. Children get less exercise at home because of more time spent with television, video games, and computers. They also get less exercise at school because many schools have cut back on physical education classes.

In addition, time-strapped families end up eating more meals at fast-food restaurants or buying take-out food — choices that often include foods high in calories and fat and large portion sizes. Many schools also include franchised fast-food menu choices for lunch, as well as soft drink and candy machines for snacks. Under public pressure, some schools have begun stocking vending machines with healthier choices, such as fresh fruit and fruit juices. 

Genetics and race also play a role in who ultimately will become overweight or obese. Children of overweight parents are at a greater risk for obesity themselves, and recent studies have found over two-thirds of American adults are either overweight or obese. More Mexican-American and non-Hispanic black girls than non-Hispanic white girls are overweight. More Mexican-American boys than non-Hispanic black or white boys are overweight, according to the NCHS.

Health concerns

Psychosocial problems. Obesity in childhood can lead to long-term psychosocial isolation. Children who are overweight are more likely to experience teasing, bullying, and social isolation that may extend into future years. This emotional abuse can have serious effects on self-esteem and social integration with peers.

Physical problems. Although excess weight can harm a child's self-esteem by virtue of teasing and/or bullying — the physical damage is just as bad. Many children who are obese already have high cholesterol, high blood pressure, abnormal glucose tolerance, or a combination of these conditions. Any one of these abnormalities increases a child's later risk for heart disease and diabetes, according to the CDC.

Sleep apnea can be a serious problem for obese children, according to the NIH. Sleep apnea is a sleep disorder in which a person's breathing is interrupted many times during the night. Sleep apnea decreases the amount of oxygen in the blood at night, disrupting normal sleep and stressing the heart. These effects can cause learning and memory problems in children.

Obese children, particularly girls, also are at risk for liver problems related to fatty liver, high blood pressure, endocrine imbalance, gallbladder disease, and stress-induced joint disease. Obese children also are more likely to have asthma.

Turn it around

Preventing obesity in children requires helping them increase their physical activity and decrease the number of calories they eat. Children should exercise every day and eat foods high in fiber and low in calories and fat. Additionally, involving children in food purchasing and preparation helps them to begin to learn about food, such as making healthy choices and balancing their own diet when parents are not there to guide them. Parents should strive to serve as an example for their kids in this regard.

Parents can help by buying fruit, vegetables, and other low-fat foods instead of stopping at fast-food restaurants. It is also important to serve children kid-size portions. Even adult portions should be smaller than many people realize and certainly should never be "super-sized." Enrolling children in team sports, such as soccer, basketball, and swimming, can keep them active — and burning calories — year-round.

One way to get your children moving is to get the entire family involved in regular physical outings. You can walk or bike together, and plan family vacations that focus on staying active rather than sitting on a beach. When looking for activities, choose those that won't be difficult or embarrassing for your children.

More suggestions for parents

Here are additional tips from the NIH on preventing childhood obesity:

  • If your child has a weight problem, be supportive rather than critical. Encourage good health habits.

  • Limit the amount of time your child can watch television, play video games, or use a computer. Enforce that limit.

  • Mealtime should be spent around the table, not in front of the television. Make it an enjoyable, unhurried time.

  • Food should not be used as a reward or punishment. If you believe that your child should be on a diet, discuss it with your child's health care provider and nutritionist. Offer healthy snacks, including fruits and vegetables, low-fat cheese or plain yogurt, and cookies such as fig bars, graham crackers, gingersnaps, or vanilla wafers. Limit the amounts because even healthier foods in large quantities can cause obesity.

  • Parents may have to completely revamp what and how they cook and plan meals so that meals are higher in nutrition, lower in calories, and still satisfying. This may mean switching to foods that require more frequent shopping that may be more expensive, such as fresh fruits and vegetables. Although with planning and practice, healthy eating can be as easy and fast as unhealthy choices.

  • Limit sedentary activities for the entire family. This includes TV watching and computer time. Everyone should make exercise part of every day. An active lifestyle for everyone will make it more acceptable to children.

About Our Stroke Center

The Primary Stroke Center, certified by the Joint Commission, is focused on the emergent needs of a stroke patient with our multi-disciplinary team of physicians, nurses, physical and speech therapists, dieticians and case managers who work together to develop a customized treatment plan for each patient. Our Emergency Department is fully prepared to help you and your loved one through this delicate time, staffed with competent emergency medicine physicians, neurologists, neurosurgeons and nursing staff.

For more information about our services or a free physician referral, call the Broward Health Line at 954-759-7400.

What Is a Stroke or Brain Attack?

Every 45 seconds, someone in America has a stroke. Every three minutes, someone dies of one.

Stroke is a cerebro-vascular disease that affects the arteries leading to and within the brain. It is the third leading cause of death in the United States and the leading cause of adult disability.

A stroke is similar to a heart attack. In a heart attack the blood flow is interrupted in the heart and it doesn't get enough oxygen. A brain attack is similar but blood flow to the brain is interrupted, the brain does not get enough oxygen and brain cells quickly begin to die.

Act F.A.S.T.

Act F.A.S.T.

If you think someone may be having a stroke, act F.A.S.T. and do this simple test:

FACE Ask the person to smile. Does one side of the face droop?

ARMS Ask the person to raise both arms. Does one arm drift downward?

SPEECH Ask the person to repeat a simple sentence. Are the words slurred? Can he/she repeat the sentence correctly?

TIME If the person shows any of these symptoms, time is important.

Call 911 and get to the hospital fast. Brain cells are dying.

Remember, 80 percent of strokes are preventable. Which means every year, up to 600,000 Americans could have prevented their strokes.

Stroke Warning Signs

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking, swallowing or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause
  • If you experience these symptoms, dial 911!

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Health Tip: Help Prevent Stroke

Whether you've ever had a stroke or not, there are things you can do to minimize your risk. The U.S. Centers for Disease Control and Prevention offers these suggestions:

  • Keep blood pressure under control with lifestyle changes, and, if necessary, medication.
  • Help prevent diabetes by eating a healthy diet, losing extra weight and getting regular exercise.
  • Avoid use of any tobacco products, and limit alcohol consumption.
  • Get treatment for atrial fibrillation (irregular heartbeat). Left untreated, the condition can cause clots that can lead to stroke.
  • Help keep your "bad" cholesterol down by eating a diet that's low in saturated fat and high in fiber.

Having one or more of these risk factors does not mean you will automatically have a stroke. But because your stroke risk is higher, ask your doctor about changes you can make to prevent a stroke. Need a doctor? Call the Broward Health Line at 954-759-7400.

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