http://www.bloomberg.com/news/2013-0...e-among-poor-children-cdc-say.html

Quote: The study is the first conducted at the state level to find evidence the obesity trend among American children may be abating. In December, the CDC announced that on a nationwide level the rate of obesity among low-income preschoolers fell 1.8 percent from 2003 to 2010.

What I don't know is whether that's 1.8 absolute percent or 1.8 relative percent.



Just as we don't have a spectacular understanding of why everyone got so fat, it seems as as if we don't have a fantastic understanding as to why the trend is reversing, although this article delves into some theories:

http://www.usatoday.com/story/news/n...7/early-childhood-obesity/2627783/

Quote: Three trends are being held up by health experts as encouraging developments: programs to get kids to exercise more, such as first lady Michelle Obama's Let's Move campaign; an increase in breast-feeding; and improvements in the nutritional content of foods provided to low-income women and children by the federal government.

One of the issues I have is with the WIC (Women Infants and Children) program. Around here, they often give out juice even though I check off the "don't give" box on all the WIC forms. They're also fond of telling parents that their normal-weight (or even overweight!) kids are underweight.

That said, WIC has been improving the nutritional content of the food that they give out, even if the local execution of the program is poor. A big thing that needs to stop is the fruit juice. He's a quick explanation of why:

Drink (8oz/240mL): Typ. Soda|Apple Juice|Orange Juice|Grape Juice
Sugar:******************27g**********26-30g**********21-26g************>36g

Shocked? Here's a hint: it takes one small apple to make one oz (30ml) of apple juice. Juice is exactly as sugary as soda. We really need to be discouraging its consumption. It turns kids into soda drinkers. Guess who wants kids to get juice with their WIC benefit? Guess which pediatrician isn't playing along?  

One thing where I would really like to see some government spending is in improving access to sporting programs for children in low and middle-income families. I think it's actually a matter of national security; if we have a nation full of fat kids, where are we going to get military personnel if we need a draft? They can't all be Gomer Pyle. It's also a sound fiscal policy, a relatively small investment in preventative medicine to prevent much higher healthcare costs. Insurance companies are starting see the fiscal benefit in rewarding members for healthy behaviors and some are planning to experiment with reward schemes (e.g. subsidizing gym memberships) to attract customers on the new state exchanges.

Breastfeeding has been a very exciting development. We could be doing better. One of the problems is that the formula companies really aggressively market their products. They even have reps come by my office with "Breastfeeding kits" including, of course, free samples of formula (they agreed to stop with the free samples in the BF kits, finally). But the "kits" are really just a bunch of marketing materials and a cheap plastic hand breast pump. I've banned them from my office. I'd like to see some better regulation on formula and its marketing; breastfeeding --you'd think the technique would just come naturally-- is really tough for the first week or two and if they can give a new mom the chance to give up, they will.

As for me, one thing I see is a lot of fat minority kids. And I do think genetics play into it. Northern European genetics seem well-suited to a modern diet. Pacific Islander genes (for example) not so much.

What have you done about this in your own lives?

This is indeed good news, very pleasing to hear.

Quoting DocLightning (Thread starter): A big thing that needs to stop is the fruit juice.

Quoting DocLightning (Thread starter): Shocked?

You're dead right of course, and no - I'm not shocked. I was also reading recently about how drinking pure juice, as opposed to eating the whole fruit with fibre and so on, results in a much higher uptake of the available sugar. Whole foods, fruit and veg are the way forward, combined with limited fat intake.

So long as pizza is a vegetable and big ag runs the FDA the US will have an obesity epidemic. This is a promising sign but I feel like this is just scratching the surface. From what I gleaned this is also only a sample of kids being fed by the government, if you're moving up the income scale of who gets this assistance like kids whose parents lost their jobs during the recession, you'll likely find that the rate of obesity will fall as more skinny, slightly richer kids come into the program. Might also be that fatter parents are having less kids.

Promising but lies, damned lies and statistics. Still a long way to go particularly if this is 'unexplained'.

Quoting DocLightning (Thread starter): where are we going to get military personnel if we need a draft?

Completely off topic but any future draft will never be successful and it won't be because of the fat kids. You can't create a liberal culture of do your own thing for 50 years and then turn around and expect people to drop everything to fight for the country when politicians get scared.

Quoting QFA380 (Reply 2): Completely off topic but any future draft will never be successful and it won't be because of the fat kids. You can't create a liberal culture of do your own thing for 50 years and then turn around and expect people to drop everything to fight for the country when politicians get scared.

There are reasons why it is increasingly unlikely, but the availability of healthy young people should a crisis occur is important to national security.

Quoting QFA380 (Reply 2): So long as pizza is a vegetable and big ag runs the FDA the US will have an obesity epidemic.

Actually, Big Food is starting to work to tackle the problem. The first thing they've done right is sort of counter-intuitive. They don't market their healthier selections as healthy. For example, McDonald's Wraps aren't exactly health food, but they're actually not that bad, nutritionally (at least as compared to other McD's fare).

Quoting QFA380 (Reply 2): Might also be that fatter parents are having less kids.

No no. Trust me. Spend a day in my office and you will be stunned at some of the people who have, somehow, managed to reproduce.

Quoting DocLightning (Reply 3): No no. Trust me. Spend a day in my office and you will be stunned at some of the people who have, somehow, managed to reproduce.

I hope your colleagues don't read this forum. Unless, of course, you've expressed your shock in person to them already, in which case it's all cool. 

Quoting RussianJet (Reply 4): I hope your colleagues don't read this forum. Unless, of course, you've expressed your shock in person to them already, in which case it's all cool.

My colleagues would (and do) agree with me. They, too, are often stunned by the...er..."wonderous variety" of the human species.

In fact, I scarcely can imagine a pediatrician who hasn't looked at a mother (or father) and wondered: "who the heck...?"

The true mysteries are the ones who are so ginormously obese that one wonders how impregnation was physically accomplished. I mean, I'm a grown man and a physician and I know how it's usually done, but when you meet a woman who is 5'2" and 388lb, it raises some basic anatomical questions.

Anyway, this is all off-topic, but the moral is that we doctors are human, too, and sometimes we judge our patients. The trick is to not let that internal monologue get in the way of our courtesy towards the patient or the quality of care that we provide.

And here I thought that childhood obesity was falling because the children were growing up ...  

Quoting DocLightning (Thread starter): Breastfeeding has been a very exciting development. We could be doing better. One of the problems is that the formula companies really aggressively market their products. They even have reps come by my office with "Breastfeeding kits" including, of course, free samples of formula (they agreed to stop with the free samples in the BF kits, finally). But the "kits" are really just a bunch of marketing materials and a cheap plastic hand breast pump. I've banned them from my office. I'd like to see some better regulation on formula and its marketing; breastfeeding --you'd think the technique would just come naturally-- is really tough for the first week or two and if they can give a new mom the chance to give up, they will.

Around here, every formula ad has to have words to effect of "This product can only be viewed as a supplement to breastfeeding. Breastfeeding is the natural and the best way to feed your newborn."