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Dropping Preschool Obesity Rates an Encouraging Sign

Thursday, April 3rd, 2014

The news is mixed when it comes to obesity rates in the United States. The good news is that the obesity rates in preschool-age children appears to be dropping. The latest data shows a decline in preschool obesity, from 14% to 8% since 2003. However, at the same time, obesity rates in women over 60 seems to be going in the opposite direction. The overall obesity rate hasn’t changed in the last ten years.

By analyzing data from the CDC’s National Health and Nutrition Examination Survey (NHANES), researchers determined that there has been a significant drop in obesity rates in two- to four-year-old children, particularly those from low income families who participate in federal nutrition programs. The news is encouraging because it means that there is hope for affording even more widespread and long-term changes.

One piece of information the new data does not provide is the precise reasons for the changes. However, in recent years, there has been an increasing initiative at both local and regional levels to provide enhanced opportunities for increased physical activity and improved nutrition in child care centers and schools, probably playing a role in the positive changes that are occurring. For example, consumption of sodas and other sugary drinks has declined, which is most likely one major factor.

The CDC also reported last year that only one in five adults gets enough exercise, something that could certainly contribute to the rising obesity rates in older women. Healthy adults over 65 should strive for the equivalent of 30 minutes of brisk walking five days a week plus strength exercises twice a week. Children need much more; those under 18 should be getting around an hour a day of aerobic exercise, plus muscle and bone strengthening activities.

However, it’s important to recognize that adding more exercise into your daily routine alone will most likely not be enough to achieve significant weight loss. If you have extra weight to lose, and you are ready to get started, realize that while exercise plays an important role, nutrition plays a much more important one. This is partly because many people overestimate the number of calories they burn exercising, or they are hungrier after they exercise and eat more to compensate.

Sometimes creating small changes in your diet may be all you need; others will need to make more dramatic changes. Either way, making the changes gradually will probably help you develop more lasting habits and ultimately see better results. Focus on natural, healthy foods, and try some helpful tricks such as eating more slowly, planning meals ahead of time, and getting more sleep, if you don’t tend to get enough. Lots of helpful information can be found here.

The bottom line is that the unchanging overall obesity rate means that there is an ongoing need for education and initiative. However, the decline in preschool obesity is an encouraging sign that the scales may be starting to tip in the right direction.

– Yvonne S. Thornton, M. D., M. P. H.

Childhood Obesity Speeds the Onset of Puberty in Girls

Tuesday, April 24th, 2012

When I was young, even though my Dad wanted to “plump up” me and my sisters so that we would be less attractive to boys, for the most part, sitting down at the family table meant eating a well-balanced meal and reconnecting with each other after a busy day.  This time wasn’t just important for the bonding opportunity it provided, but for the proper nutrition it allowed my sisters and I to receive.  It was there that we learned what a balanced diet was and to appreciate the food we had.  Snacking throughout the day was a privilege and eating snacks between meals was a luxury a poor person could ill afford. Unfortunately now days, it seems that many parents don’t have time for traditional dinners or are unwilling to make time for time them.  Snacks are cheap, ubiquitous and filled with carbohydrates. With so many people reaching for the quickest, easiest foods, families are moving to a culture of convenience and their kids are paying the price.

Childhood obesity is on the rise and it’s having effects in some unexpected areas.  Studies are now suggesting that girls who are overweight start menstruation at much younger ages.  The average age of onset of menstruation (menarche) in the late 20th century was between 12.6 to 12.8 years.  Recently, that age has decreased to 12.43 years.   It has been argued that girls need to reach a critical weight (47.8 Kg) to initiate pubertal changes; it is more likely that what is needed is a shift of body composition, with an increase in the percentage of body fat. The percentage of body fat in children (16%) needs to rise to 23.5% to initiate puberty.  A 2011 study found that each 1 kg/m2 increase in childhood body-mass index (BMI) can be expected to result in a 6.5% higher absolute risk of early menarche (before age 12 years).

Normally, once a young woman reaches a particular body mass index, that tells her body she is of childbearing weight.  This starts the menstruation cycle.  If a young girl, say of about eight or nine, is overweight, she will reach this body mass index much sooner, triggering her body to go into early puberty.  While early childhood obesity is itself a problem, early puberty can also lead to a shortened growth span.  Most girls stop growing a few years after starting menstruation.  If they start this too soon, they will also stop growing much earlier than normal.  If childhood obesity continues to increase, the rise in early maturation is likely to follow.  In 1965, about 5% of kids were considered obese in the US.  Obesity in children has increased three-fold over the past 30 years.  In 1980 obesity in children, ages 6-11, was a mere 6.5% but by 2008 it increased to 19.6%.

Today, about 25 million children are either overweight or obese.  Researchers are finding that increases in the number of girls hitting puberty early seems to be in keeping with these obesity statistics.  The First Lady is even promoting a change in our habits that affect childhood obesity.

Although convenient, fattening foods have flooded the markets; there are still plenty of healthy foods out there.  Parents cannot expect their kids to make smart choices about their diets, especially at such young ages.  It’s up to them to teach their children how to eat, so they can grow up to make good choices for themselves and their own families.  There’s something to be said for those traditional sit-down dinners, because they truly benefit the health of our children in more ways than one.

— Yvonne S. Thornton, M. D., M. P. H.





Obesity and early puberty

Saturday, July 31st, 2010

A new study confirms what earlier studies have found: girls who are obese begin puberty earlier.

With childhood obesity approaching an epidemic, early puberty is becoming more common. There appears to be a critical weight for girls, above which the body starts its journey to womanhood with thelarche (breast buds), pubarche (pubic and axillary hair) and finally, menarche (onset of menses).   So, in general, the heavier a young girl is, the earlier the onset of her secondary sexual characteristics.

While we don’t know all the possible consequences of early puberty, we know that puberty is a time of emotional turmoil. For a younger child, that’s going to be more difficult.

We also know that youngsters have a great need to feel like they fit in and the combination of obesity and early puberty can punch a hole in a young girl’s self-esteem.

So, watch the eating habits of your whole family, and help your children make good choices –  just as you make healthier choices for yourself. As I’ve said before, when it comes to battling the bulge, I’ve been there, so I know it’s a struggle. But maintaining a healthy weight is essential, for everyone.

– Yvonne S. Thornton, MD, MPH