Boeing Center for Children's Wellness (Lean Team)
Obesity is a new problem for children and adolescents that has rapidly become the most important cause of current and future morbidity and mortality. Recent US Surgeon General Richard Carmona, MD called obesity the greatest threat to public health today, and one that also affects our national and global security. The American Academy of Pediatrics believes that the epidemic of childhood obesity has become the greatest threat to our children’s future health. In addition to an increased risk of premature death, adverse health effects attributable to overweight and obesity during childhood and adolescence are described below:
- Asthma: The prevalence of overweight is reported to be significantly higher in children and adolescents with moderate to severe asthma compared to a peer group.
- Diabetes (Type 2): Type 2 diabetes in children and adolescents has increased dramatically in a short period. Type 2 diabetes accounted for 2 to 4 percent of all childhood diabetes before 1992, but skyrocketed to 16 percent by 1994. Obese children and teens are reported to be 12.6 times more likely to have high fasting blood insulin levels, a risk factor for type 2 diabetes.
- Hypertension: Persistently elevated blood pressure levels have been found to occur about 9 times more frequently among obese children and adolescents (ages 5 to 18) than in non-obese.
- Orthopedic Complications: Among growing youth, bone and cartilage in the process of development are not strong enough to bear excess weight. As a result, a variety of orthopedic complications occur in children and adolescents with obesity. In young children, excess weight can lead to bowing and overgrowth of leg bones.
- Psychosocial Effects and Stigma: Overweight girls and boys are at risk of developing a negative body image, particularly during adolescence/early adulthood. This can lead to subsequent development of eating disorders, such as anorexia nervosa and bulimia nervosa. This phenomenon is not limited to females; 5-10% of all adolescents with eating disorders are males (APA 2000).
- Sleep Apnea: Significant disturbance in breathing during sleep occurs in about 7 percent of children with obesity. The deficit of oxygen results in school performance problems and deficits in logical thinking as well as cardiac strain.
- Metabolic Syndrome: Metabolic syndrome is a cluster of risk factors including obesity, high blood pressure, high blood lipid levels and diabetes that increases the risk four-fold for stroke, heart disease and kidney disease.
From 1980 to 2004, the percentage of youth who were obese tripled from 7% to 19% in children (6-11 years) and 5% to 17% in adolescents (12-19 years).1 In 2009, the South Carolina Youth Risk Behavior Survey confirmed that 17% of South Carolina’s high school students were obese (>=95th percentile BMI) and that unhealthy dietary behaviors and physical inactivity were prevalent.2 A recent MUSC study conducted by The Lean Team, focused specifically on Charleston County public schools, found that 43% of school-aged children, 67% of adults, and 70% of teachers were either overweight or obese.
Obesity results from an imbalance in caloric intake versus expenditure. The extreme rise in obesity over the years is fueled by the greater prevalence of poor food choices in our society, reduction in amounts of physical activity and a de-emphasis on health and physical education in the schools. Recommendations for reducing childhood obesity are often focused on the school environment, given that >95% of school-aged children are enrolled in schools. Schools have also spent the last few decades responding to increased pressure from the government to improve standardized test scores, leading often to reduced emphasis (and opportunity) for children to participate in physical and health education in the school setting. In addition, most schools offer a plethora of unhealthy eating choices to students throughout the day, through vending machines, schools stores, fundraising campaigns, class parties, after-school programs and a la carte items for sale in the cafeteria. Many of these food sales fund additional teachers and programs (academic and cultural) that the school would otherwise not be able to afford.
Reversing the obesity epidemic will take great effort from all parts of society, but a strong contribution from the schools is a key component. The CDC recommends that schools emphasize better health education, more PE and physical activity programs and in general, healthier school environments. The Institute of Medicine (IOM) recommends adoption of nutrition standards for food and beverages offered outside of the federally-funded school lunch program and that all foods and beverages offered on the school campus contribute to an overall healthful eating environment.3