Experts advise docs to be blunt, call kids ‘obese’
Fuzzy terms used for tact don’t properly define weight issue, group explains
June 12, 2007
CHICAGO - Doctors ought to quit using fuzzy terms to define
children’s weight problems and instead refer to truly fat kids as overweight or obese, a committee of medical experts
Less blunt terms
used by the government and many doctors diplomatically avoid the term “obese.” Instead, they refer to children
many would consider too fat as being “at risk for overweight,” and “overweight” for those others would
don’t adequately define the hefty problem, according to the group, which was convened by the American Medical Association
and funded by federal health officials including the Centers for Disease Control and Prevention.
The nonbinding recommendations
are designed as guidelines for pediatricians and other medical professionals who work with children. The CDC will consider
whether to adopt the recommendations; the AMA has no plans to endorse them.
Dr. Reginald Washington,
a committee spokesman and member of the American Academy of Pediatrics, said Tuesday that some doctors have avoided the blunt terms for
“fear that we’re going to stigmatize children, we’re going to take away their self-esteem, we’re going
to label them.”
The recommended terms
cut to the chase, at least medically, but don’t mean that doctors should be insensitive or use the label in front of
every patient, he said
“We need to
describe this in medical terms, which is ‘obesity.’ When we talk to an individual family, we can be a little more
cognizant of their feelings and more gentle, but that doesn’t mean we can’t discuss it,” Washington said.
“The evidence is clear that we need to bring it up.”
About 17 percent
of U.S. children are obese and one-third are overweight, using the committee’s recommended definitions. Those numbers
are rising, putting children at risk for diabetes, high blood pressure, cholesterol problems and other ailments more commonly
found in adults.
off the hook
The overweight category — the CDC’s “at risk” — refers to children
with a body-mass index between the 85th and 94th percentiles. The obese category — the CDC’s “overweight”
— is kids with a BMI in the 95th percentile or higher — or greater than at least 95 percent of youngsters the
same age and gender.
With current obesity
rates, that sounds mathematically impossible, but the percentiles are based on growth charts from the 1960s and 1970s, when
far fewer kids were too fat.
To some extent, the
fuzzier labels let pediatricians “off the hook,” allowing them to avoid counseling patients who clearly need to
lose weight, said Dr. Peter Belamarich, a pediatrician with Children’s Hospital at Montefiore in New York City.
The blunter terms
make sense if they motivate doctors to work with more kids who need help, “but you have to be real careful about labeling
or saying it in front of a child,” Belamarich said.
had mothers ask me not to use the (obese) label,” he said. “Sometimes you can see it in the child’s face.
The change in terms
is among several recommendations the committee, comprising 15 medical organizations, is promoting to help doctors prevent,
diagnose and treat obesity in children. Other recommendations include assessing weight and body mass index at least yearly; and evaluating eating
habits and activity levels at all well-child visits.
of these recommendations is great,” but expecting pediatricians to implement them thoroughly at already overburdened
well-child visits is unrealistic, Belamarich said.
The change in obesity
terms is the most controversial recommendation and Dr. William Dietz, director of the CDC’s division of nutrition and
physical activity, said the agency will discuss whether to adopt the new terms.
were posted on the AMA’s Web site last week. They have been endorsed by most of the organizations on the committee,
including the American Academy of Pediatrics, the American Dietetic Association, the American Academy of Child and Adolescent
Psychiatry and the American College of Preventive Medicine, an AMA spokesperson said.
||High body mass and its health
|Relative risk* of developing various medical conditions by body mass index|
||BMI of 30.0 to 34.9
||BMI greater than or equal to 40|
|Coronary heart disease
|* Relative risk of 2 indicates a person is
twice as likely to develop condition as a person with a normal body mass index (18.5 to 24.9). A body mass index of 30.0 or
higher is considered obese.|
** Relative risk of developing kidney cancer rises to 4.75 in women with BMI greater than or
equal to 40.
SOURCES: American Obesity Association; American Cancer Society; New England Journal of Medicine
For in-depth nutrition & diet information to actually change your lifestyle diet into a lifestyle "healthy"
diet for you and your family, click here
, to visit "changes" of the emotional feelings network of sites!
Much More Than a Diet
A Healthier You is about our
diet—what we eat. But it's not a "diet book." It's different. It's about helping us find our way to better health by
making smart choices about nutrition and physical activity—two keys to a healthy lifestyle.
Sure, this raises a number of questions: "What exactly does
a healthy lifestyle mean? Deny myself the very pleasures of eating? Is this the end of eating out? What about my hectic life?
Seriously, how much physical activity do you really expect me to get each day?" Sometimes, it's hard enough to get everything
done in a day—let alone physical activity!
A Healthier You is not
about what we deny ourselves, but instead:
It's about choices. The food and physical
activity choices we make every day affect our health. The more we know, the better choices we can make.
It's about balance. We need to learn to
make more room in our lives for things that make us happy, healthy, and productive.
It's about a healthy lifestyle. To get
the most out of our lives starts with small steps— a slow, steady approach to being healthy that we can live with each
day—or most days. Hey, nobody's perfect!
At some level, we all know that a lot about being healthy comes
down to taking care of ourselves: what we eat, how much we eat, and how much physical activity we get. We don't need to be
rocket scientists to figure this out. A Healthier You already gives us the state of the science
from the Dietary Guidelines for Americans to help us:
- make smart choices from every food group
- find our balance between food and physical activity
- get the most nutrition out of our calories.
Good to know, right? But let's face it, healthy habits take
some effort. There's no magic pill that instantly does the trick.
How often have we told ourselves, "I'm going to start eating
better and moving more." And, we mean it. We make the pact with ourselves at least every New Year. Too often, however, it's
easy to get derailed and fall back into unhealthy habits. We don't mean to. But, the truth is—it takes a real commitment
to change our behavior, especially for the long haul.
We basically know that we eat to live, but today, some of us
seem to live to eat. Food represents a lot of things to us. To some it's a stress reducer—"I'm stressed. I'm tired and
just want to go home and eat." There's often nothing like the emotional comfort of a pint of ice cream. Sometimes, food is
our way of celebrating or a reason for coming together for special events like block parties or family reunions. Food is part
of our social fabric. It's one way we pass traditions down from generation to generation and sometimes preserve our cultural
identities. We hear stories from people talking about how food is part of their heritage. The secret ingredient in Nana's
strudel is "love" to be sure, but there's also "lard" in that strudel! From Sunday family dinners serving spaghetti and meatballs
to the best barbecue for a handful of nieces and nephews, extended family, and friends…sometimes, the entire neighborhood—we
all love to kick back and relax with our favorite foods and enjoy ourselves!
There are ways, though, to make a healthier lifestyle doable
and still enjoy Nana's cooking at the reunion. It's the day-in and day-out choices that we really need to think about. Whether
this means finding the motivation to be our own personal trainer, using easy-to-make recipes to prepare our own meals in about
as much time as it takes to head out to the nearest fast-food place, doing our best to eat healthfully on a budget, or making
better choices when eating out—the little things do add up and make a big difference. Self-discipline may take some
getting used to, so A Healthier You offers words not only of encouragement but also about the know-how
to get started and keep with it!
Being Healthy Matters to You
In the big picture, a number of things, in addition to food
and physical activity, affect our health. Some of us struggle with reducing stress, getting enough sleep, or trying to quit
smoking. Everyone is different. Today's decisions affect our health today, tomorrow, and beyond. Only we can figure out what
is right for our lifestyle, but these decisions start with having the right information. That's where A Healthier
You can help.
It almost goes without saying that there are many benefits to
improving our health. Developing good habits early in life helps, yet it's never too late to start. There is something to
be said for starting to live a healthier life before gaining too much weight or becoming at risk for serious illness—to
incorporate change while it's our decision. Why wait for a health scare to "get it together"? Wherever we are in life…whatever
the reason…we can prevent many bad health consequences and gain quality time to enjoy things that really matter to us.
Whether we are 15, 25, or 65, any time is a good time to start!
A lot of us have tried diets or started fitness programs. We
stick with them for a while, then stop. The weight comes right back, or our cholesterol and blood pressure go back up.
Right now, wherever we are today, let's give ourselves a break. Make it a day to start with a clean slate.
Our past choices are just that—past. Recognize that by taking small steps to eat better and be more physically active—even
if we are starting from scratch— we can improve our health. And it doesn't take a lot to begin to have an impact.
Say to yourself, "This time it's going to be different—my
efforts are going to result in a better, healthier me."
We want to recapture that feeling—"me at my best." It's
hard to describe, but you definitely know it when you feel it. People say, "When I'm eating healthy and being more active,
it's like I'm energized" or "on top of my game!" Sometimes, don't you just dread the idea of taking time out for physical
activity? Especially if it means getting out of bed a half hour earlier or squeezing it into a packed day. But afterwards,
do you ever regret it? In fact, doesn't it change your mood for the rest of the day? It's empowering when you know you are
taking control and making healthy changes that will make a difference for the rest of the day…the rest of your life.
It's about looking and feeling better, knowing you are healthy inside and out. Wouldn't it be great to feel a renewed confidence
in yourself or to simply take small steps to be your very best every day?
There's a lot of information about healthy living, but how do
you find success for you—just for you? Take a moment. Think about what you want. You have a vision of who you want to
be. Ask yourself, "What is ‘me at my best'?" Write it down if you need to. Now, let's get started and find that healthier
It's in the news....
TV's influence on eating habits re-examined: 1/4/2007 - Watching television, eating
family meals & the safety of the neighborhood all play a role in children's weight, according to researchers at the University
US get worst health marks
- Even though Americans are willing to spend money on healthy products, they are less likely than other nationalities to make
long lasting behavior changes, according to a new report from Business Insights.
Additional Information for Parent to get educated with!
National School Breakfast Program Served
Record 7.7 Million
Low-Income Children in 2005-2006
Washington, D.C. Participation in the School Breakfast
Program continued its steady increase, with a record 7.7 million low-income children receiving free & reduced-price breakfasts
on an average day during the 2005-2006 school year.
The Food Research & Action Center’s School Breakfast
Scorecard 2006 finds accelerating growth in school breakfast participation by low-income children – up by 622,000 children
(8.7%) over the past 2 school years.
The School Breakfast Program began as a pilot program in 1966
with the intent of making sure children started the school day with the boost breakfast can give. Studies continue to demonstrate
the links between breakfast & learning, making the case stronger for more schools to expand breakfast participation &
make sure all children participate.
There are now 44.6 low-income children receiving breakfast for
every 100 eating lunch, compared to 31.5 for every 100 when FRAC first began the scorecard in 1991 & 43.1 per 100 during
the 2003-2004 school year.
“Reaching a lot more children with breakfast in schools
is probably the most cost-effective & fastest way to improve children’s learning & health, improve attendance
& of course, reduce hunger,” said Jim Weill, president of the Food Research & Action Center (FRAC). “It’s
essential that more schools serve breakfast, adopt steps like breakfast in the classroom & reach out to more children.”
To measure the reach of the School Breakfast Program, FRAC compares
the number of schools & low-income children that participate breakfast as compared to the broadly utilized National School
In 2005-2006, 83% of schools that offered school lunch also
had a breakfast program – an increase from 81% during the previous school year.
FRAC also sets a goal for states as a way to gauge state progress
& the costs of underparticipation in the program. If states were able to increase participation in the program so that
there were 60 children eating breakfast for every 100 eating lunch, a very attainable goal, 2.7 million more low-income children
would be eating school breakfast around the nation.
And, states would have collected an additional $558 million
in federal child nutrition funding. As it is, state participation rates range from a high of 58.5 in West Virginia to a low
of 29.3 in Wisconsin. The FRAC report gives these & other data for every state.
“We’re glad that schools are seeing & supporting
the vital links between education & learning,” said Lynn Parker, FRAC’s director of child nutrition. “Skipping
breakfast in the morning can become an unhealthy routine for some children. We’d like to see more schools move to universal
breakfast, which provides school breakfast at no charge to all children who wish to eat, more schools offer breakfast in the
classroom to ensure children’s access & more districts & states aggressively market the benefits of breakfast
to parents & children. These are all proven strategies for success.”
My personal concern:
I have kids who have participated in the school lunch program in the state of Ohio. I've seen what these kids get for breakfast
& it's mostly doughnuts, pop tarts & other sugary foods. Is it better that kids eat this sugary breakfast rather than
none at all? I have questions concerning that topic that can mostly be directed towards the Dayton Public School System!
I tutored children in the Dayton Public School System
for the Proficiency Testing for reading and reading comprehension. The girls that I personally tutored said that their parent
(mostly single family homes) did not have a concern for the child to eat breakfast. When I asked what foods were available
for the child to eat, the answers revolved around frozen foods such as: bagel bites, frozen pizza, ice cream & other junk
After I began bringing these students fruit, granola
bar and milk for breakfast on the days I tutored them, their attention spans were much better, they were happier to know that
someone cared that they eat the right things & they appeared more eager to work on their studies.
New Farm Bill to promote fruit, veg in schools: 2/1/2007 - Improving nutrition in schools
and fighting trade barriers are two priorities of the US Department of Agriculture’s (USDA) 2007 farm bill proposal,
unveiled yesterday by Agriculture Secretary Mike Johanns.
TRANSCRIPT OF REMARKS BY AGRICULTURE SECRETARY MIKE JOHANNS AS HE UNVEILED USDA'S 2007 FARM BILL
Most fruit products targeting kids are misleading, claims study: 1/30/2007 - Over half of the most heavily
advertised children’s food and beverage products that clearly feature fruit on their packaging contain no fruit at all,
according to a study released last week.
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