If the USA is starting to get a handle on childhood obesity, as
federal health officials said Tuesday, what might we finally be doing
right?
Three trends are being held up by health experts as encouraging developments: programs to get kids to exercise more, such as first lady Michelle Obama's Let's Move campaign; an increase in breast-feeding; and improvements in the nutritional content of foods provided to low-income women and children by the federal government.
Thomas Frieden, director of the federal Centers for Disease Control and Prevention, cited all three examples in a news briefing announcing small but significant declines in obesity among low-income preschoolers in 18 states from 2008 to 2011.
BREAST-FEEDING
Statistics out last week from the CDC's 2013 Breastfeeding Report Card show that more than three out of four U.S. mothers (77%) tried to breast-feed their newborns in 2010, up from 71% a decade earlier. Rates were highest in Idaho (91.8%) and lowest in Mississippi (50.5%).
Experts cite regional differences in culture and workplace policies that support breast-feeding as the reason for the gap.
According to the report, based on a national telephone survey of more than 8,000 parents and caretakers of small children, the percentage of infants still breast-feeding at 6 months increased to 49% in 2010 from 35% in 2000. The percent still breast-feeding at 12 months rose to 27% from 16% in 2000.
A number of studies have found that breast-feeding has health benefits, including that breast-fed babies are less likely to become overweight.
"One of the things that breast-feeding does, besides the possible chemistry that may affect obesity, is that it teaches babies how to eat right and how to stop eating when they're full, instead of when their mother thinks they're full. So I'm not surprised at all that the report mentioned breast-feeding," says Gail Herrine, an obstetrician/gynecologist at Temple University Health System in Philadelphia.
"With formula, because it's so expensive, the mother makes a bottle, doesn't want to waste any, and tries to get the baby to take it all in." That sets the stage for teaching children to "stop eating when they're stuffed," Herrine says, "not when they're full."
In spite of the increase in breast-feeding rates, there is still concern that infants are not breast-fed as long as recommended.
The American Academy of Pediatrics advises exclusive breast-feeding for about the first six months of a baby's life, followed by breast-feeding in combination with the introduction of complementary foods until at least 12 months of age. Then, breast-feeding can be continued for as long as mutually desired by mother and baby.
NUTRITION
The government's Supplemental Nutrition Program for Women, Infants and Children (WIC) is now more in line with the updated dietary guidelines than in the past. The program promotes whole fruits and vegetables instead of juice, which has more sugar, lower-fat milk and breast-feeding.
Even with the improvements in programs such as WIC, it's still a challenge to follow good dietary advice when you're on a limited budget, says Lawrence Cheskin, associate director of the Johns Hopkins Global Center for Childhood Obesity in Baltimore.
"We can talk all we want about eating more fresh fruits and vegetables, but fresh fruits and vegetables are relatively expensive for the amount of calories that they provide, particularly out of season," he says. "And unfortunately, the cheapest foods are often the ones most likely to provide too many calories and too much fat."
Thomas Robinson, director of the Center for Healthy Weight at Lucile Packard Children's Hospital in Palo Alto, Calif., says several other factors may also be contributing to a decline in child obesity.
Schools are serving healthier lunches and taking junk food out of vending machines, he says. Some children's hospitals also are not serving fast foods or sugary and sweet beverages.
And restaurants' menu labels, which include caloric information, may help parents make decisions about what to order and how often to eat there, he adds.
"All those changes add up," says Robinson, a professor of pediatrics at the Stanford University School of Medicine. "They are changing the environment, which makes it easier for parents to help feed their kids in a healthy way."
MORE EXERCISE
The CDC touted Let's Move, dedicated to solving the challenge of child obesity within a generation, as a good example of an effective program. The first lady launched the program in 2010.
Sam Kass, the executive director of Let's Move, says the program now has more than 10,000 child care centers working to improve the nutrition and physical activity of kids. "We know just how vital it is to get children off to a healthy start in life."
Some experts say solving childhood obesity is complicated because the causes are not fully known.
Tom Baranowski, a professor of pediatrics at Baylor College of Medicine in Houston, says one hypothesis is that obesity levels have reached a limit.
"It's very reasonable to believe that obesity levels are the result of environmental and genetic factors," he says. That hypothesis is that those of us who are genetically predisposed to being obese in this environment have hit that limit. "It's not that the interventions are suddenly having a dramatic effect," he adds.
"We really need to understand the causes of obesity if we are to make further reductions," says Baranowski, a psychologist.
Cheskin, who is also the director of the Johns Hopkins Weight Management Center at the Bloomberg School of Public Health, says he doesn't want to get "too encouraged too early" by the improvements noted in the new report, "because there's a long way to go, and I wouldn't want to declare a victory too early, but this is a small sign that we are addressing things, that at least we're moving in the right direction.
It shows that we should be dedicating more resources to fixing this problem, because it seems possible to fix it, and it's not beyond our science and our will."
Three trends are being held up by health experts as encouraging developments: programs to get kids to exercise more, such as first lady Michelle Obama's Let's Move campaign; an increase in breast-feeding; and improvements in the nutritional content of foods provided to low-income women and children by the federal government.
Thomas Frieden, director of the federal Centers for Disease Control and Prevention, cited all three examples in a news briefing announcing small but significant declines in obesity among low-income preschoolers in 18 states from 2008 to 2011.
BREAST-FEEDING
Statistics out last week from the CDC's 2013 Breastfeeding Report Card show that more than three out of four U.S. mothers (77%) tried to breast-feed their newborns in 2010, up from 71% a decade earlier. Rates were highest in Idaho (91.8%) and lowest in Mississippi (50.5%).
Experts cite regional differences in culture and workplace policies that support breast-feeding as the reason for the gap.
According to the report, based on a national telephone survey of more than 8,000 parents and caretakers of small children, the percentage of infants still breast-feeding at 6 months increased to 49% in 2010 from 35% in 2000. The percent still breast-feeding at 12 months rose to 27% from 16% in 2000.
A number of studies have found that breast-feeding has health benefits, including that breast-fed babies are less likely to become overweight.
"One of the things that breast-feeding does, besides the possible chemistry that may affect obesity, is that it teaches babies how to eat right and how to stop eating when they're full, instead of when their mother thinks they're full. So I'm not surprised at all that the report mentioned breast-feeding," says Gail Herrine, an obstetrician/gynecologist at Temple University Health System in Philadelphia.
"With formula, because it's so expensive, the mother makes a bottle, doesn't want to waste any, and tries to get the baby to take it all in." That sets the stage for teaching children to "stop eating when they're stuffed," Herrine says, "not when they're full."
In spite of the increase in breast-feeding rates, there is still concern that infants are not breast-fed as long as recommended.
The American Academy of Pediatrics advises exclusive breast-feeding for about the first six months of a baby's life, followed by breast-feeding in combination with the introduction of complementary foods until at least 12 months of age. Then, breast-feeding can be continued for as long as mutually desired by mother and baby.
NUTRITION
The government's Supplemental Nutrition Program for Women, Infants and Children (WIC) is now more in line with the updated dietary guidelines than in the past. The program promotes whole fruits and vegetables instead of juice, which has more sugar, lower-fat milk and breast-feeding.
Even with the improvements in programs such as WIC, it's still a challenge to follow good dietary advice when you're on a limited budget, says Lawrence Cheskin, associate director of the Johns Hopkins Global Center for Childhood Obesity in Baltimore.
"We can talk all we want about eating more fresh fruits and vegetables, but fresh fruits and vegetables are relatively expensive for the amount of calories that they provide, particularly out of season," he says. "And unfortunately, the cheapest foods are often the ones most likely to provide too many calories and too much fat."
Thomas Robinson, director of the Center for Healthy Weight at Lucile Packard Children's Hospital in Palo Alto, Calif., says several other factors may also be contributing to a decline in child obesity.
Schools are serving healthier lunches and taking junk food out of vending machines, he says. Some children's hospitals also are not serving fast foods or sugary and sweet beverages.
And restaurants' menu labels, which include caloric information, may help parents make decisions about what to order and how often to eat there, he adds.
"All those changes add up," says Robinson, a professor of pediatrics at the Stanford University School of Medicine. "They are changing the environment, which makes it easier for parents to help feed their kids in a healthy way."
MORE EXERCISE
The CDC touted Let's Move, dedicated to solving the challenge of child obesity within a generation, as a good example of an effective program. The first lady launched the program in 2010.
Sam Kass, the executive director of Let's Move, says the program now has more than 10,000 child care centers working to improve the nutrition and physical activity of kids. "We know just how vital it is to get children off to a healthy start in life."
Some experts say solving childhood obesity is complicated because the causes are not fully known.
Tom Baranowski, a professor of pediatrics at Baylor College of Medicine in Houston, says one hypothesis is that obesity levels have reached a limit.
"It's very reasonable to believe that obesity levels are the result of environmental and genetic factors," he says. That hypothesis is that those of us who are genetically predisposed to being obese in this environment have hit that limit. "It's not that the interventions are suddenly having a dramatic effect," he adds.
"We really need to understand the causes of obesity if we are to make further reductions," says Baranowski, a psychologist.
Cheskin, who is also the director of the Johns Hopkins Weight Management Center at the Bloomberg School of Public Health, says he doesn't want to get "too encouraged too early" by the improvements noted in the new report, "because there's a long way to go, and I wouldn't want to declare a victory too early, but this is a small sign that we are addressing things, that at least we're moving in the right direction.
It shows that we should be dedicating more resources to fixing this problem, because it seems possible to fix it, and it's not beyond our science and our will."
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