Wednesday, June 07, 2006

Childhood Obesity - Back to the Future

There is an old adage that says "for all complex problems there is a simple solution -- and it never works."

For decades must we have endured the message that eating less fat, specifically less saturated fat, is the panacea for weight management and health. Over the same period of time this message was preached, two out of every three adults have grown overweight or obese; our children are now being affected - not only are they too growing overweight and obese, they're now suffering from cardiovascular disease, type II diabetes, metabolic syndrome, high cholesterol, arthritis and a host of other obesity related illness.

Our "obesity crisis" is now a national obession with the spotlight on childhood obesity - how do we save the children?

The World Health Organization has revised its growth curves for infants and toddlers - taking acceptable weight down a notch in the hope that "the new charts give public-health officials, pediatricians and families the opportunity to redefine normal growth in infancy and rethink the social norm in which parents boast about 95th percentiles for their babies."

Robert Whitaker, a senior fellow at Mathematica Policy Research, stated "The prevalence of obesity is increasing and affecting children at younger and younger ages. If we talk about healthy weight earlier, it may be a good opportunity to start obesity prevention early."

Former President Clinton recently crusaded against childhood obesity and is partly responsible for the school soda ban, working with major vendors to voluntarily remove the sweetened beverages. He's also on an anti-fat campaign and has pledged to work with food companies and food vendors to reduce the amounts of all forms of dietary fat in the items kids love to eat, including French fries and pizza.

School districts across the country have either mandated BMI screening or are considering similar policies to weigh and measure children and include the findings in report cards sent home to parents. In addition, school boards are revising nutrition policies to ban whole milk and high-fat snacks (replaced, of course, with low-fat versions of the same junk food).

Last year the 2005 Dietary Guidelines for Americans launched with a section specifically targeting young children with interactive games to teach them that healthy eating is eating a diet low in fat that limits saturated fat. The site even includes classroom materials teachers can use to get the message across to the kids in their classes.

Don't get me wrong - I totally agree we have a problem in the United States - there is a continued trend of problematic increases in overweight and obesity amongst our children. Our children are now at significant risk of having a shorter life expectancy than we adults do. Scary!

Albert Einstein is credited with saying that insanity was doing the same thing over and over again and expecting different results.

When the government decided to modify dietary policy and recommend all Americans reduce their intake of fat, they were warned of unintended consequences. Dr. Phil Handler, in 1980 during testimony before Congress asked ''What right has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence that it will do them any good?''

Now, some thirty odd years later, we're witnessing the effects of that population-wide nutritional experiment, yet the experts remain blinded by the gospel of low-fat dogma.

It doesn't take an Einstein to go through the literature and find the diet our children eat is significantly different today than it was in 1977-79.

Did you know that parents way back then were feeding their 2-5 year-olds an average of 36.2% of their daily calories from fat, with 14.3% from saturated fat. The average preschooler ate just 4-servings of grains a day, about 3-servings of fruits and vegetables, about 2-servings of dairy and consumed about 12-teaspoons of added sugar from all sources (food and beverages) in their diet.

Good grief, how did any of us survive?

For the record, we didn't just survive - in the period of 1977-79, only 4-6% of children were overweight or obese. Today more than 15% are overweight or obese, and that number continues to climb each year.

Rather than step back and ask "what were we doing right thirty years ago?," we're intent on the idea that a low-fat diet is better for us and our children.

Within the literature we find a very comprehensive review that was published in the American Journal of Public Health in 2004 - Changes in Diet Quality of American Preschoolers Between 1977 and 1998 - in which researchers concluded that diet quality had improved over the 21-year period investigated.

The data in that study shows, as the researchers stated, that added sugars "increased strongly" in the diet of preschoolers, and that children were eating more calories. What did the researchers say was the cause of the higher calorie intake? Dietary fat! They put it this way - consumption of dietary fat also "contributed to higher energy intakes" - a wholly inaccurate statement if one simply does the math!

This is what happens when one is already convinced dietary fat is the culprit in the obesity epidemic!

I took the time to crunch the numbers from the published data and guess what? Dietary fat intake increased by 0.1g on average - put into reality, fat intake contributed just a hair less than one-calorie more per day in 1998 than in 1977. One calorie?

So where were the kids getting the additional calories from?

Added sugar accounted for 13.9% of calories in 1977 - about 198-calories; by 1998 added sugar accounted for 15.7% of calories - or about 245-calories a day.

Children also added more grains to their diet - in 1977, on average, children consumed four servings of grains - by 1998 their consumption increased to six servings. And who says parents don't listen to government recommendations?

Fruits and vegetables also increased - in 1977, on average, children consumed about 3 servings of fruits and vegetables each day - by 1998 they were consuming about 4.6-servings. Again, who says parents don't list to government recommendations?

As a proportion of their diet, fat did decrease - from 36.2% of total calories to 32.3% of calories. In absolute terms, fat intake remained flat - an additional calorie each day DID NOT contribute to their increase in calories in any significant way. It was the additional sugar, too much juice (also increased from 1.2-ounces of excess juice in 1977 to 5.4-ounces of excess juice in 1998) and additional grains that had the major caloric impacts!

The message in the last 30-years has been clear - eat more grains, added sugar is harmless and juice counts as a fruit. Guess what? Parents heeded that message, fed their kids more grains, more sugars and more juice and we're seeing the results - childhood obesity, children with type II diabetes, kids stricken by cardiovascular disease, our future generation already in poor health!

And what are we doing about it?

Preaching the same message - lower the fat, increase the grains!

The exact definition of insanity!


  1. Diet should be well balanced. We need to reach our public with a message saying that it is important to consume balanced fats, carbs and proteins.

  2. Fat kids are sick and they need help. Growing up obese is like a death sentence.

  3. As a parent I have seen the effects of too many carbohydrates in children's diets. Beautiful babies fed low- or no-fat vegetarian diets suddenly ballooning up into fat children and adolescents. Children need good healthy fats, proteins, fruits and vegetables and limits on sugars. Thankfully I figured this out while my children were still relatively young. My 14 y.o. is actually proud that we never eat fast food and claims to like every vegetable except for asparagus and brussels sprouts.