Tag Archives: childhood obesity

Summer gains and losses: Maintaining good health and academic success over summer vacation.

Summer vacation is a rite of passage for children. Long summer days to play, go to camp, and relax are an important part of growing up. But many educators and health professionals are concerned about what gets lost, and what gets gained, when kids are away from school. This is something that I have written about before, but now that school is out it is worth revisiting, which I do in my Health & Fitness column in the Aiken Standard this week.

kids-jumping


Summer learning loss is a real concern. It is estimated that children lose, on average, two months of reading skills and one month of overall learning over summer break. Those losses must be made up when school starts again in the fall, so teachers spend about six weeks re-teaching material that was covered in the previous grade. That is six weeks that children are not learning at grade level, which certainly has an impact on achievement over time.

Not all kids are affected equally. Much of the disparity in summer learning losses falls along socioeconomic lines. Some children have more opportunities than others to continue learning over the summer through formal educational programs and camps and informal encouragement to read.

To address this issue, many institutions implement summer “school” through classes, on-line learning programs, and encouraging reading at home. Some target the students who need them the most while other programs are instituted for all children. In fact, all three of my kids completed online learning programs last summer.

Learning losses are not the only concern with an extended break from school. Many children gain more weight over the summer than during the rest of the year. Furthermore, fitness gains made during the school year are frequently lost over the summer.

While poor nutrition and a lack of activity in schools is a real concern, many children get more exercise and eat better at school than they do at home. Being at home over the summer can lead to poor eating habits—too much unhealthy food or not enough food in general—and lack of chances to be active.

This is important because the combination of poor nutrition, physical inactivity, and obesity has physical, psychological, and social consequences for children that frequently persist into adulthood. Overweight and obese children, especially those who are inactive, are at increased risk for type 2 diabetes, high blood pressure, heart disease, and even stroke – conditions usually associated with adulthood.

Even if an overweight child does not have these conditions now, he or she is likely on that path. In fact, many experts predict that children born today will be the first generation in history to have a shorter lifespan than their parents due to obesity-related diseases that begin in childhood.

Children who are overweight are also more likely to suffer other consequences including lower self-esteem, social functioning, and academic performance. Overweight children are also less likely to play sports or participate in other forms of physical activity, which creates a cycle leading to poorer health and, potentially, poorer academic success.

Now that school is almost out for the summer, this is a critical time of year to focus on good nutrition, physical activity, and continued reading and learning to help prevent a summertime slump in health and academics.

Schools can only do so much, so adults should model good diet, activity, and reading behaviors themselves. A good place to start is by turning off the TV and reading a book or going outside to play. It’s something all of us—adults and children—will benefit from.


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What children gain and lose over the summer

Summer vacation is a rite of passage for children. Long summer days to play, go to camp, and relax are an important part of growing up. But many educators and health professionals are concerned about what gets lost, and what gets gained, when kids are away from school.

Kids playing outdoors


Summer learning loss is a real concern. It is estimated that children lose, on average, two months of reading skills and one month of overall learning over summer break. Those losses must be made up when school starts again in the fall, so teachers spend about six weeks re-teaching material that was covered in the previous grade. That is six weeks that children are not learning at grade level, which certainly has an impact on achievement over time.

Not all kids are affected equally. Much of the disparity in summer learning losses falls along socioeconomic lines. Some children have more opportunities than others to continue learning over the summer through formal educational programs and camps and informal encouragement to read.

To address this issue, many institutions implement summer “school” through classes, on-line learning programs, and encouraging reading at home. Some target the students who need them the most while other programs are instituted for all children. In fact, all three of my kids are completing online learning programs this summer.

Learning losses are not the only concern with an extended break from school. Many children gain more weight over the summer than during the rest of the year. Furthermore, fitness gains made during the school year are frequently lost over the summer. While poor nutrition and a lack of activity in schools is a real concern, many children get more exercise and eat better at school than they do at home. Being at home over the summer can lead to poor eating habits—too much unhealthy food or not enough food in general—and lack of chances to be active.

This is important because the combination of poor nutrition, physical inactivity, and obesity has physical, psychological, and social consequences for children that frequently persist into adulthood. Overweight and obese children are at increased risk for type 2 diabetes, high blood pressure, heart disease, and even stroke – conditions usually associated with adulthood. Even if an overweight child does not have these conditions now, he or she is likely on that path. In fact, many experts predict that children born today will be the first generation in history to have a shorter lifespan than their parents due to obesity-related diseases that begin in childhood.

Children who are overweight are also more likely to suffer other consequences including lower self-esteem, social functioning, and academic performance. Overweight children are also less likely to play sports or participate in other forms of physical activity, which creates a cycle leading to poorer health and, potentially, poorer academic success.

Now that school is almost out for the summer, this is a critical time of year to focus on good nutrition, physical activity, and continued reading and learning to help prevent a summertime slump in health and academics. Schools can only do so much, so adults should model good diet, activity, and reading behaviors themselves. A good place to start is by turning off the TV and reading a book or going outside to play. It’s something all of us—adults and children—will benefit from.


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School gets out, weight goes up. Why now is the time to focus on preventing childhood obesity.

Obesity is a major concern for adults, linked to several leading causes of death and numerous other health problems. What you may not know is that obesity is also a serious health issue for children. It is troubling to note that nearly one-third of school-aged children and teenagers are over a healthy body weight and nearly 20% are considered obese. Remarkably, 10% of infants, toddlers, and preschoolers, are also considered obese.

This is important because the common combination of poor nutrition, physical inactivity, and obesity has physical, psychological, and social consequences for children that frequently persist into adulthood. There are many reasons why childhood obesity occurs and much that can be done to prevent it. Now that school is almost out for the summer, this is a critical time of year to focus on good nutrition and activity to help prevent unhealthy weight gain in kids. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Childhood obesity cartoon


Overweight and obese children are at increased risk for type 2 diabetes, high blood pressure, heart disease and even stroke – conditions usually associated with adulthood. Even if an overweight child does not have these conditions now, he or she is likely on that path. Many experts predict that children born today will be the first generation in history to have a shorter lifespan than their parents due to obesity-related diseases that begin in childhood.

Children who are overweight are also more likely to suffer other consequences including lower self-esteem, social functioning, and academic performance. Overweight children are also less likely to play sports or participate in other forms of physical activity. Considering that the consequences of obesity are made worse by low levels of activity, this creates a cycle leading to poorer and poorer health.

There are numerous potential causes of obesity in children, but the most likely suspects are too little activity and excessive calorie intake, largely because of added sugars. Fewer than half of all kids meet the minimum recommendation of 60 minutes of activity each day and many children spend as much time watching television or playing video games as they do in school. We shouldn’t be surprised that we have a childhood obesity problem!

While poor nutrition and a lack of activity in schools is thought to contribute to the problem, many children get more activity and eat better at school than they do at home. A recent report suggests that children gain more weight over the summer than during the rest of the year. Furthermore, for many kids, fitness gains made during the school year are frequently lost over the summer. Since summer vacation is rapidly approaching, this is a critical time to help our children stay fit and healthy.

The good new is there is much we can do. Ensuring that children get plenty of healthy foods such as fruits and vegetables, reducing the consumption of added sugars, and eating appropriate portion sizes will go a long way to addressing the diet aspect of obesity. Making sure that kids of all ages have opportunities to be active while limiting time spent sitting, especially in front of a screen, are equally important.

Since children don’t make most of the decisions about their activity and diet, it is important to recognize the role that parents, grandparents, and other caregivers play. More often than not, obesity is a family issue. This means that  solving the problem is a family issue, too. Adults should model healthy behaviors by making diet and activity changes themselves. A good place to start is by turning off the TV and going outside to play or for a walk. It’s something all of us—adults and children—will benefit from.

Exercise, like all prescriptions, only works if you use it as directed.

Earlier this week  I wrote about the Exercise is Medicine initiative and why physicians should prescribe exercise to all of their patients.

Despite the widely-known benefits of exercise, many physicians—and people in general—believe that chronic health conditions should be managed using medications, not  proper nutrition and physical activity. This is a misguided approach considering that weight gain and health conditions related to weight gain  accumulate over a period of years, resulting from eating too much combined with low levels of activity.

One reason that physicians are hesitant to prescribe exercise (and, similarly, good nutrition) is that in their experience, it doesn’t work. What they mean is that the results they see after recommending lifestyle modifications are typically not sufficient. So the assumption made by doctors and patients is that lifestyle modifications don’t work. But this is not necessarily the case

This debate comparing lifestyle modification with medical management of chronic diseases is familiar. Consider statins, the popular lipid-lowering medications that are currently among the most-prescribed drugs (examples include Lipitor, Zocor, Crestor and Vytorin). The effect of statin drugs on lowering blood lipids is significant in most patients. This, together with clever marketing to both patients and physicians, explains why they are so widely used.

It is possible to lower blood lipids as much as statins by carefully controlling diet and regular exercise, but it is difficult. How difficult depends on the individual, but everyone would agree that successful lifestyle modification takes more effort and dedication than taking a pill. In order for any treatment to work, it has to be followed. A patient who doesn’t follow their diet or exercise program is no different from a patient who doesn’t take their medication as directed. In both cases, the response to the treatment will fall short of expectations.

If someone didn’t take their statin medication and their blood cholesterol didn’t go down, no one would label the drug a failure. The medication may well have worked if the patient took it. But people routinely claim that diet and exercise don’t work, when the real problem is that these treatments aren’t followed. This could be because the patients weren’t provided with appropriate and actionable information or because they didn’t faithfully follow the instructions they were given.

The problem isn’t that lifestyle modification isn’t effective, it’s that people don’t implement healthy changes for the long-term. Whereas a statin drug results in rapid changes, the benefits of behavior change are realized more slowly. This can lead to the incorrect conclusion that diet and exercise aren’t working, even though they are.

In reality, medication can be part of a treatment plan, but should not be the only prescription.  Long-term health benefits come from changing eating and activity patterns. Medications should be used as a  “jump start” to treating a condition, with a goal of developing a new way of eating and regular activity as the long-term treatment.

For example, medications like statins can lower cholesterol quickly. Then, lifestyle changes can keep the cholesterol down, reducing the need for the drug. Since side effects depend on the dose and duration of treatment, this approach would reduce the risk of potentially dangerous side effects.

For many patients, lifestyle changes are effective on their own, meaning the medication isn’t necessary. And consider this: maintaining a healthy body weight, proper nutrition, and regular exercise has been proven to be the best—and at this point, only—way to prevent most of the health problems most of us will face. Good nutrition and physical activity really are the best medicine!

Not sure where to begin to improve your health? A guide to taking the first step

If you are thinking about losing weight, becoming more active, or quitting smoking you are not alone. These are three of the most common health-related New Year’s resolutions. Considering that two-thirds of American adults are overweight, about half don’t meet minimum recommendations for physical activity, and one in five smoke, there are many people who need to change more than one of these behaviors.

Quitting smoking and changing eating and exercise habits to lose weight or improve fitness are among the most difficult behavior changes to make, especially at the same time. Some people focus on one change to begin with.

Obviously, changing all three of these behaviors is ideal, but if you are only willing to change one, which should you take on first to have the biggest impact on your overall health? This is the topic of my Health & Fitness column in the Aiken Standard this week.

You might think that quitting smoking would be the most important change to make initially. Smoking is the primary cause of lung cancer and other respiratory diseases such as emphysema and chronic bronchitis. Smoking also increases the risk of most other cancers and is a major contributor to heart attacks and strokes. Quitting smoking greatly reduces these risks with beneficial changes that begin within days of quitting. Despite this, if you only want to change one behavior, smoking isn’t the place to start.

Being overweight is a leading cause of diabetes, high blood pressure, heart disease, and some cancers. If you are overweight, losing just 10% of your body weight (20 lbs. for a 200 lb. person) can significantly reduce the severity of these conditions. Maintaining a healthy body weight can prevent many of these health problems. However, losing weight is not the first change you should make.

It turns out that becoming physically active is the most important change you can make to improve your overall health. Decades of research show that regular physical activity reduces the risk of most chronic diseases including diabetes, heart disease, and some cancers and can extend the lifespan by up to five years. In fact, the health risks of inactivity are equal to or greater than that of obesity or smoking. Regular activity also improves muscular strength, aerobic fitness, bone density, cognitive function, and memory. There is no other single intervention—drugs included—that has as many health benefits.

Research also shows that the negative health effects of being overweight and obesity are, in part, caused by inactivity and poor fitness. If you are overweight but physically fit, your risk of death is lower than if you are at a “healthy” weight but unfit. Regular exercise can reduce the risk of diabetes in people who are overweight, whether they lose weight or not. Furthermore, studies of “successful losers” show that daily exercise is a requirement for long-term weight loss, so becoming active now can help you lose weight later.

You should change all three of these behaviors to achieve optimal health. But if you are looking for an initial step that will have the biggest impact, start by becoming more active. A good initial goal is to reduce the time you spend being sedentary (sitting) and to get a minimum of 30 minutes of moderate-intensity activity, such as a brisk walk, each day. You can get greater benefits by participating in more intense exercise, including strength training, three or more days per week. And once you have established a routine of regular activity you will be ready to make other health changes.

What parents and schools can do to make sure kids are ready to learn

Physical activity and good nutrition have long been recognized as essential for promoting good health in adults and children. More and more research suggests that these health behaviors can have beneficial effects beyond health, including how we perform both physically and mentally. The emphasis here is on children in school, but it applies to adults, too.

Unfortunately, taking time for activity and good nutrition is seen as a luxury or a distraction to learning in most schools. Far from being a distraction, physical activity and healthy eating are prerequisites for learning and academic achievement. In short, these often ignored factors can help make sure children are ready to learn.

Regular physical activity is essential for good health, growth, and physical development, including maintaining a healthy body weight. This last point is important given the epidemic of childhood obesity and related health problems, including “adult” diseases like high blood pressure and type 2 diabetes.

Current recommendations call for all children to get at least 60 minutes of activity per day. This can include activity at school from physical education classes, recess, other classroom activities as well as games, sports, and unstructured play. Unfortunately, most kids don’t get nearly enough activity at school and many aren’t active at home.

Physical activity is also important for academic performance. Research shows that children who participated in an activity program had better executive control, which includes resisting distractions and maintaining focus, improved memory, and doing better switching between tasks. This is particularly relevant for children with ADHD, but the effects can be seen in all kids. These positive changes can maximize class time and lead to improvements in academic achievement, especially math and reading test scores.

Similarly, good nutrition is also essential for health, growth, development, and academic achievement. Eating a good breakfast improves cognitive function, alertness, and academic performance in students of all ages. It should be no surprise, then, that skipping breakfast impairs cognitive function and academic achievement. This is one reason that many schools offer breakfast to start the day or include a healthy mid-morning snack.

The same is true for lunch, too. A good lunch can support learning in the afternoon and gives a chance to teach kids about good nutrition by providing healthy food that, unfortunately, many children may not get at home.

Schools have a unique opportunity to use physical activity and nutrition to promote health, support academic achievement, and teach healthy habits. Since formal nutrition education is missing from most curriculums and PE programs are being reduced or cut completely, schools must be creative to incorporate these essential subjects.

A way around this problem is to make sure children get a chance to move and play, ideally multiple times during the day. This is what recess is for. Teachers can also incorporate activity and nutrition education in the classroom and get away from the idea that kids must be sitting still to learn. As research shows, quite the opposite is true!

Schools are often hesitant to teach about nutrition and activity because it is thought of as a responsibility of parents, not schools. But most parents don’t teach these good habits at home, which affects what happens at school. Despite the obvious benefits, it will probably take years of effort to change this view.

In the meantime, parents can encourage their kids to be active and make smarter food choices at home so they are ready to learn in school.

Fat still matters

Last week I wrote about some recent research suggesting that low-carbohydrate diets may be better for weight loss that low-fat diets. For many, this study reinforced the notion that traditional recommendations are wrong and that the key to good health is to eliminate carbohydrates from your diet. This couldn’t be further from the truth.

The recent study did show that people lost more weight and experienced beneficial changes in blood lipids when they followed a low-carbohydrate diet compared to those who ate a low-fat diet. However, this does not mean that low-fat diets aren’t effective for weight loss or that they are “unhealthy.”

In fact, low-fat diets have long been used effectively to promote weight loss, reduce heart disease risk, and lead to healthier eating in general. This is supported by the results of hundreds of research studies as well as the practical experience of health professionals and real people. Here are two reasons why fat still matters when it comes to health.

First, reduced-fat diets have been shown to improve blood cholesterol and lower the risk for heart disease. Eating a diet low in fat, especially saturated and trans fat, has been the foundation of nutrition recommendations for decades. The fact is that these diets are effective for weight loss, reducing cholesterol, and otherwise improving heart health.

One famous study demonstrated that following a low-fat diet contributed to a reduction in the severity of atherosclerosis, the narrowing of arteries that leads to many heart attacks. Literally hundreds of other studies have shown similar beneficial results.

This isn’t some magical effect of eating less fat, though. The health benefits are likely due to eating more vegetables, fruits, and whole grains as much as they are to reducing fat intake. The point is that adopting a low-fat diet can lead to better nutrition overall.

Second, reducing fat intake is a good way to reduce calories. This is true because fat contains nine calories per gram, more than twice that of carbohydrates and protein, so cutting fat is an effective way to cut calories. Limiting fat intake also reduces calories indirectly because many high fat foods are also high in sugar and calories (think of most desserts).

It is important to mention that simply reducing fat intake won’t always lead to weight loss; total calories must be lower, too. This is a mistake many make when they reduce fat intake, but increase the amount of calories from other sources, typically carbohydrates. Many low-fat foods are actually relatively high in calories due to added sugar or people tend to eat more of them (the SnackWell Effect).

The effectiveness of low-fat diets for weight loss has been demonstrated in research studies (like this one) and countless weight loss programs. In one notable study, a diet low in fat even led to weight loss in people who weren’t trying to lose weight. And don’t forget that in the recent study about low-carbohydrate diets, the subjects that followed the low-fat diet also lost weight.

For some people, cutting carbohydrates as a way to lose weight is reasonable; for others, reducing fat intake makes sense. For most people, though, doing both to some extent is the best option, but going to extremes is unnecessary.

Eating less added sugar and avoiding foods with added fats (such as French fries) are good recommendations for almost everyone. That said, there is little evidence for the benefit of limiting carbohydrates in the form of whole grains, legumes, vegetables, and fruits or the fat in meat and dairy.

The bottom line is that the quality of food we eat is more important than the specific amounts of the nutrients it contains. Eating low-carbohydrate or low-fat diets can help steer you toward making healthier choices, but so can avoiding processed foods in favor of wholesome, nutrient-dense “real” food.