Obesity Leveled Off in U.S., Except Among Boys
New America Media, Q&A, Viji Sundaram Posted: Jan 21, 2010
A recent CDC report may give Americans cause for cheer. It suggests that we have finally turned a corner in our fight against obesity, which has leveled off across most of the population -- except one group: 6- to 19-year-old boys.
Dr. Gautham Rao, clinical director of the Weight Management and Wellness Center at the Children’s Hospital of Pittsburgh at the University of Pittsburgh Medical Center, where he is also an associate professor at the School of Medicine, explained why obesity is still increasing among boys. He spoke with NAM health editor Viji Sundaram.
The CDC study suggests that obesity remains a significant problem in some 68 percent of the adult U.S. population. Yet, the study also suggests, there is an increase in obesity among 6- to 19-year-old boys. Why do you think this is?
The data need to be interpreted very carefully. Consider the following passage from the article:
“Among 6- through 19-year-old boys, there was a significant linear trend at the highest BMI (body-mass index) cut-off point, but not at the lower cut-off points, nor was there a significant trend in the younger age groups. The categorical analysis of survey period suggests that among 6- through 19-year-old boys, the difference is only significant between the two time periods 1999-2000 and 2007-2008, so it is not possible to tell if the 2007-2008 estimate is the continuation of a trend or not.”
Essentially, according to this data, boys in the heaviest category, that is, above the 97th percentile of body-mass index, did get heavier.
This estimate, however, is significant only when comparing 1999 -2000 and 2007-2008. We cannot be sure, therefore, that this is a trend. Consider this analogy: If the winter of 1999-2000 was cold, and the winter of 2007-2008 was colder, we cannot say for sure that winters in general are getting colder, since we are unsure of the (data) in between.
Earlier generation video games targeted at kids, like Super Mario Brothers and Halo, encouraged a sedentary lifestyle. Kids would sit for hours before their computers and use nothing more than their thumbs. But the more recent Wii video game consoles are designed to be interactive. They have players moving and exercising. Could playing these games have any impact on kids’ weight?
No, I don’t believe so. Many parents ask me about this. I always respond in the same way, with two questions:
1. Fifty years ago, how many obese children were around? Most parents know the answer is very few.
2. Fifty years ago, how many interactive video games were around? This opens up a discussion about how habitual physical activity -- which I wrote about extensively in my book titled, Child Obesity: A Parent's Guide to a Fit, Trim, and Happy Child —such as walking, cycling and free-time play—is best able to help children achieve or maintain a healthy weight.
Why is it that it’s mostly the white kids who are experiencing an increase in obesity, according to the study?
That isn’t supported by the study, which found that the heaviest 6- to 19-year-old boys overall experienced an increasing trend in obesity.
When the investigators parsed this data by race, they also found that the subpopulation of white boys had a statistically significant trend.
Bear in mind that obesity remains a much more serious problem among Latino and African-American children. More than half of children who come to our Weight Management Center in Pittsburgh belong to one of these two groups.
Many studies indicate that kids living in poorer neighborhoods are more likely to be from the African- American and Hispanic communities and are also more likely to be obese. They don’t have easy access to fresh produce. What role does right nutrition play in obesity?
Certainly obesity is much more common among blacks and Hispanics. Much is made of the availability of fresh produce, but that is only one, and perhaps an insignificant, factor. Many of our patients won’t eat fresh produce, even if it’s given away.
Obesity is a complex condition related to culture, poverty, taste preferences, health consciousness and different notions of what is a desirable weight. I sincerely believe that the leveling off is the result of better attention being paid to what I call “The Big Five” obesity culprits:
1. Sweet beverages (soda, etc.) There is more awareness of these as a cause of obesity, and better controls on their sales.
2. Fast food: More awareness of its role in obesity.
3. Screen time.
4. Habitual physical activity: More schools are incorporating physical activity into daily routines.
5. Eating together as a family. This remains uncommon, especially among minority families.
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