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Overweight children risk coronary heart disease and diabetes as obese adults

Family- and school-based programs can help reverse deadly trend

For immediate release
July 12, 2001

Media advisory: To contact Robert I. Berkowitz, M.D., call Ellen O’Brien at (215) 349-5659. On the day of the briefing, call the AMA’s Science News Department at (312) 464-5374.

NEW YORK — Overweight children who mature into obese adults are at greater risk for the early development of conditions such as cardiovascular disease and diabetes mellitus. There is also alarming evidence that young adults who were obese as adolescents face job discrimination, have less education, earn less money and marry less frequently than their average-weight peers, according to Robert I. Berkowitz, M.D., a leading expert in child psychiatry and weight disorders.

“Something has to be done to help our children. Half of Americans are overweight and, based on the number of overweight children, the number of obese and overweight adults is going to drastically increase. The Centers for Disease Control and Prevention reported their preliminary results for 1999, finding that 13 percent of American children ages 6-11 years are overweight, up from the previous 11 percent from the survey conducted from 1988 to 1994. That translates into more than five million children and teenagers,” declares Dr. Berkowitz, an associate professor at The Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine in Philadelphia.

“Implementing an intervention to stem the epidemic of childhood and adolescent obesity will require significant efforts from public health, education, media and industry as well as from health-care providers,” warns Dr. Berkowitz who spoke today at an American Medical Association media briefing on obesity.

“Type 2 diabetes (non-insulin dependent diabetes) is primarily related to people being overweight. I never saw type 2 diabetes in children 20 years ago, and now the National Institutes of Health is awarding grants to study the phenomena,” laments Dr. Berkowitz.

Weight-loss efforts require family commitment

Long-term studies show that comprehensive family-based behavioral programs for children are effective in reducing obesity. Successful programs involve the child and the parents addressing lifestyle modification, nutrition and physical activity.

“These programs typically teach parents not to overload a child’s plate. A three- to four-ounce portion of lean meat, a small baked potato and salad or vegetables is appropriate,” explains Dr. Berkowitz. “Try not to use food as a reward and limit serving food family style on platters. Remember, super-sized meals make super-sized children.” Other lifestyle aspects typically include shifting the child’s focus from sedentary activities such as television and computer games to outside activities including basketball and bike riding. Some families walk together or take weekend hiking trips, according to Dr. Berkowitz.

An example of a successful method of teaching children how to make appropriate food choices is the “traffic light” diet, developed by Dr. Leonard Epstein of the State University of New York at Buffalo. Dr. Berkowitz says the program helps children understand the caloric worth of foods and is effective and easy to master even for children as young as eight years of age. Foods are described by the amounts of caution children should take when filling their plates:

“Red-light” foods suggest eating less of these high calorie, high fat foods such as ice cream, cheeseburgers, and fried foods

“Yellow-light” foods suggest going “with caution” but these are healthier foods with less fat, more nutrients, but fewer calories such as skinless chicken or a baked potato

“Green-light” foods may be eaten with ease, and are low calorie, low fat, high fiber, with high water content such as lettuce, carrots and cucumbers

Schools can help children learn about healthy eating

“Granted, schools are under great stress because everybody wants them to do everything. Regrettably, physical education is often the victim of budget cuts. The combination of physical education classes and recess during which the student may be involved in sports greatly increases a child’s daily activity level. These are not extravagances to concede during budget planning. School lunch is another area where we can try to improve both our nutrition education and meal content. School served food should be a model for healthy eating. Unfortunately, many school vending machines offer junk foods such as candy, chips and soda, while the cafeterias are serving high-fat hot dogs and hamburgers,” Dr. Berkowitz notes.

Public health messages may also benefit children

“When is the last time we saw a pitch for vegetables and fruits aimed at children?” questions Dr. Berkowitz. “The government could hire some brilliant marketing minds and put together a superb public information campaign encouraging people to eat more fruits and vegetables. The benefits would extend beyond weight control to general health enhancements.”

Editor’s note: Dr. Berkowitz’s research is supported by grants from Abbott Laboratories, Knoll Pharmaceutical, GlaxoSmithKline, Hoffmann-La Roche, National Institutes of Health, National Institute for Mental Health and Schering-Plough. He has received honoraria from and/or serves on speakers bureaus for AstraZeneca, Hoffmann-La Roche and Novartis Nutrition. Dr. Berkowitz is a consultant for AstraZeneca, Aventis, Bristol-Myers Squibb, Knoll Pharmaceutical, Hoffmann-La Roche, Ortho-McNeil Pharmaceutical and Takeda Pharmaceuticals.

For more information, contact the Science News Department at (312) 464-5374

Copyright 1995-2003 American Medical Association. All rights reserved.

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