Tackling Childhood Obesity: the Fine Line Between Pointing Fingers and Sticking Your Head in the Sand
Twenty years ago parents, educators and government rallied to respond to the unfortunate truth that “Johnny couldn’t read.” Today, those same forces, despite a plethora of eat less/move more initiatives, are faced with an even larger reality: the fact that Johnny, Suzy and their parents can’t seem to reach and maintain a healthy weight.
As a nutritionist and former social worker, I have often pondered the physical and emotional pros and cons of the approach most often turned to when dealing with childhood or adult obesity, the “calories in vs. calories out” method of weight loss.
I may have majored in the social sciences and nutrition, but math too was one of my strong points and there was a part of me that loved the ease and orderliness of a concept that allowed you to tally up intake calories for the day and balance it out against soccer game, stair climbing or lap swimming energy expenditure. In as little time as it took for the calculator to flash up a total, it could be determined whether you were moving toward weight loss goals—and therefore could give yourself a pat on the back—or failing in your endeavours, and needed to head out for a brisk walk around the block before bedtime.
The simplicity of the theory also made it easy to look at those who carried excess weight, and chalk up the lack of success in their reaching a healthy size to one or both of two reasons: an inability to make good food choices and a lack of effort in lacing up a pair of runners and getting to the gym. The belief that taking in fewer calories worth of food than you expended in physical activity would, across the board, produce a healthy weight made sense on paper. It gave simple and defined ways to plan a weight loss strategy and made it easy to know where to place blame for those who were not in a healthy weight range.
What, however, if it wasn’t that simple?
Earlier this year, Statistics Canada released a report from the 2007-2009 Canadian Health Measures Survey . If the war on childhood obesity could be won with simple caloric mathematics, you would think the survey would have found children that are overweight engaging in less physical activity than those that were trim and fit. Not so. Though very few Canadian adults or children met the recommended levels for weekly vigorous activity, there was, in fact, little (with boys) if virtually no (with girls) difference in activity levels between children and teens that were overweight or obese and those that were lean.
The usual response would be that if activity levels are the same, then the caloric intake of children and teens that are overweight must be higher. Studies seem to indicate while that fact is often true, it might not, however, be the complete answer. Several recent reports have shown that deficiency in key nutrients can play a significant role in an inability to lose weight[2,3], and a recent study in Germany seems to indicate that while excess calories and insufficient activity contribute to obesity, that children and teens in a higher BMI range might actually be more sensitive to those excess calories and lack of exercise than their healthy weight range peers .
The ripple effects of study results such as these are many, not the least of which is that the standard weight loss tool of a nice and tidy two-columned ledger for caloric intake and caloric expenditure, may, as with many of the best laid plans of overweight mice and men, look good on paper, but not prove a consistently effective tool in real life.
For nearly a decade the foundation of my nutritional consulting was recommendations for natural food, as close as possible to it original form; eating until comfortably full; and ensuring healthy whole grains and vegetables, lean protein—preferably of vegetable origin—and minimal amounts of good quality fats were the mainstay of each meal. The back to basics approach initially worked well for every one of my clients. But let’s get serious, you can’t stop eating copious amounts of refined grains and sugars, nix the soda pop, add 6-8 servings of vegetables to your daily food intake, become more physically active and make water your beverage of choice without having some positive benefits.
Fifteen years ago, however, as I saw that not all my clients continued to do well long-term on my dietary plan, I had to sit down and reevaluate my mantra. If weight loss was plain and simple about calories in vs. calories out why could I have two similarly overweight clients doing almost exactly the same amount and intensity of exercise, on the same dietary intake and yet, at some point, be getting two very different results. Why did some of the children and teens I worked with plateau in their health, wellness and weight loss efforts and others continue to soar forward, reaching health goal after health goal, not without effort, but certainly not with great challenge.
After a lot of thought, observation and research, my adjusted “how to reach a healthy weight” game plan factored in differences in body type, the types and ratios of protein, carbohydrate and fat that would make up an individual’s fuel mix, the need for increased or different types of exercise for different clients and the unfortunate but true recognition that some of the children and teens I worked with would need an attitude adjustment in order to prepare for a longer and more demanding and purposeful journey toward health.
A road with steeper hills and challenging obstacles to overcome can be discouraging. Throwing in the towel, proclaiming the “it’s in my genes” excuse and settling for less than healthy, however, are not the answer. But if we can recognize there is more to solving the childhood obesity dilemma than less food and extra movement, the denial and blame can be set aside and we can begin cooperatively working on the real food and real body solutions that will produce real health.
- Physical activity of Canadian children and youth: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey by Rachel C. Colley, Didier Garriguet, Ian Janssen, Cora L. Craig, Janine Clarke and Mark S. Tremblay (http://www.statcan.gc.ca/pub/82-003-x/2011001/article/11397-eng.htm)
- Medical College of Georgia (2009, March 16). Not Enough Vitamin D In The Diet Could Mean Too Much Fat On Adolescents. ScienceDaily. Retrieved September 21, 2011, from http://www.sciencedaily.com /releases/2009/03/090312140905.htm
- Econ Hum Biol. 2007 Dec;5(3):471-83. Epub 2007 Mar 23. Micronutrient deficiency and the prevalence of mothers’ overweight/obesity in Egypt.
Asfaw A. Source: International Food Policy Research Institute (IFPRI), Washington, DC 20006, USA. firstname.lastname@example.org
- Risk factors for obesity: further evidence for stronger effects on overweight children and adolescents compared to normal-weight subjects.
Beyerlein A, Toschke AM, Schaffrath Rosario A, von Kries R. PLoS One. 2011 Jan 20;6(1):e15739.