ACSM Sports Medicine Basics Childhood Overweight & Obesity www.acsm.org

The global presence of overweight and obese take their children to annual well visits, it is consuming foods that are higher in calories, individuals has reached epidemic levels over up to the pediatricians, physicians assistants but low in nutrient quality for vitamins, the last few decades, notably in the U.S. (PAs) or nurses to provide the conversation minerals, fiber and protein. Kids often are not While rates of obesity in preschool age to educate caregivers about improving food, the ones purchasing or preparing the meals children have leveled off, the prevalence of beverage and physical activity choices for kids. they eat. Currently, families tend to eat more overweight and obese children ages 2 to 19, in packaged, processed and pre-prepared foods, the U.S., is still around 17 percent. Children The American Academy of Pediatrics (AAP) and dine out more; which means they have with overweight or obese parents have a and the Centers for Disease Control (CDC) less control over the ingredients compared to greater chance of being overweight and obese recommend the use of body mass index (BMI) making meals from scratch. themselves. Also, overweight children and adjusted for age to screen for overweight and adolescents are more likely to become obese obesity in children and teens ages two through Unsafe places for children to play and adults. 19 years. Children often follow their own increased time spent using technology are growth curve. If your child has been in the the other half of the energy balance equation. The comorbidities of obesity in children are 85th to 95th percentile, they are considered at This includes time spent at school. Despite the same as in adults: type 2 diabetes, high risk for overweight. Children who are > 95th research showing that children who are more cholesterol, hypertension, cardiovascular percentile are considered overweight. The physically active perform better academically, disease, breathing and orthopedic problems. term obesity is controversial as a diagnostic physical education programs are often In addition, psycho-social problems such as term in children and adolescents. sacrificed due to budget cuts and standardized low self-esteem and teasing from peers can testing performance goals for school districts. cause lifelong harm to children and their Multifactoral Dilemma Sitting has become the new smoking for emotional development. Across disciplines, Just as in adults, overweight and obesity children and adults. practitioners agree that prevention and are caused by an energy imbalance where early intervention are the keys to improved calories consumed exceeds calories expended In some communities, the environment is outcomes in overall health and longevity. throughout the day. While genetics may not conducive to recreation due to a lack of play a role, lifestyle habits and behaviors are sidewalks and/or safe parks and playgrounds. Definition of Overweight & Obese modifiable choices. When the time constraints of working parents It is now thought that the risk for obesity are factored in, the opportunities for children may begin before the age of two: maternal Sugar sweetened beverages, high calorie foods, to include additional physical activity in their habits while pregnant, lack of breastfeeding, increased portion sizes and lack of access to daily routine decreases. poor sleep habits and rapid weight gain in affordable, healthy food options, coupled infants and toddlers. Despite cultural beliefs with confusing and conflicting information about an infant’s body weight, overweight about fad and “healthy” diets, impact food children seldom outgrow it. Assuming parents choices that are not beneficial. Children are Prevention and Treatment Education Dietary Practices of Childhood Obesity Children are frequently bombarded with Children who are overweight and obese Families, health care providers and messages within the media. This includes need to reduce their daily caloric intake communities should work toward preventing television program content along with while maintaining a diet that is balanced in obesity in the first place. Family behavioral commercials that are often for fast food or nutrients to encourage proper growth and intervention must begin when a child is first low-nutrient quality foods. The behavioral development. Wholesome foods include identified as at-risk for overweight. Parents choices of children are frequently determined fruits, vegetables, low-fat or fat-free dairy, and caregivers need to be educated to lead by by parents and caregivers; many children who high fiber grains, and lean proteins. Consult example, as healthy lifestyle choices impact are overweight and obese have one or both the U.S. Dietary Guidelines at www.myplate. everyone. parents in the same situation. Weight loss can gov for more information. Consider finding a be difficult for adults, so it is understandable registered dietitian (RDN) in your community Traditionally, recommendations to maintain that families have difficulty losing weight. for individualized recommendations and body weight and waiting for their height Parents need to lead by example, engage in guidance (www.eatright.org ). to “catch up” was the norm. However, regular physical activity and make healthier in part due to multifactorial behavioral food choices. Summary & Conclusions causes, weight loss may also be necessary The prevalence of overweight and obesity to prevent the likelihood of comorbidities. Physical Activity continues to threaten the health and well- The Dietary Guidelines (health.gov/ Physical activity has a positive effect on being of children across the globe. There dietaryguidelines/2015/) recommend eating health and is an essential component in the is a need for parents, caregivers, physicians mostly plant-based foods that are high in prevention and treatment of overweight and and schools to identify children who are at fiber like whole grains, fruits, vegetables, lean obesity. Physical activity can help to lower risk and initiate lifestyle changes to prevent protein along with low and no fat I think this blood pressure and cholesterol, decrease fat further escalation of health problems. is one of the changes that they are not going deposition and help to maintain body weight. Lifestyle modifications, as described in this to focus on dairy fat?? dairy intake. Water Physical activity is important to growth and paper, can be part of prevention and treatment is the beverage of choice. The U.S. Physical development of the cardiovascular system, for overweight and obesity. This trend can and Activity Guidelines recommend at least 60 increasing bone density, and improving should be reversed! minutes of physical activity each day for muscle health. Like adults, children should children and adults. be physically active most days of the week. About the Authors Sixty minutes of intermittent, moderate-to- Written for the American College of Sports Medicine by Technology use should be restricted to no Felicia D. Stoler, DCN, MS, RD, FACSM. high physical activity daily for children is Suggested Citation: Stoler FD. Childhood Overweight & Obesity. more than two hours per day. In addition, recommended by the National Association Indianapolis, IN: American College of Sports Medicine; 2016. making sure children have at least nine for Sport and Physical Education, the US ACSM Sports Medicine Basics are official statements by the hours of sleep is vital for growing bodies to American College of Sports Medicine concerning topics of interest Department of Health and Human Services to the public at large. ACSM grants permission to reproduce this fact rest, recharge, renew and repair. Education, and the National Institutes of Health. sheet if it is reproduced in its entirety without alteration. The text participating in physical activities, healthy may be reproduced in another publication if it is used in its entirety without alteration and the following statement is added: Reprinted diets and regular health checkups can aid in Types of Physical Activity with permission of the American College of Sports Medicine. prevention and treatment of overweight and There are many ways to get children and Copyright ©2016 American College of Sports Medicine. Visit obesity. families moving: walking, biking, dancing, ACSM online at www.acsm.org. jumping rope, basketball, Frisbee and skating all count! Families can spend active time together visiting playgrounds, parks, museums and zoos. Consider taking active vacations together that include hiking, biking, walking, boating and swimming. Involve children in household activities like walking the dog, washing a car, raking leaves, lawn mowing and shoveling snow. Physical activity is an essential part of a healthy lifestyle for the entire family.