Emphasizing Nutrition, Physical Activity and Sleep Can Help Address Growing Rates of Childhood Obesity

by Brigitte Chorey

Associate Vice President, Vizient Strategic Sourcing Partnerships and Programs

We’re approaching the very real possibility that children born in the 21st century will have a shorter lifespan than their parents. This concern is largely born from an increase in childhood obesity — currently, more than 150 million children globally have obesity, a number that is expected to jump to 206 million by 2025. 

Obesity — defined as a body mass index at or above the 95th percentile of the Centers for Disease Control-specific BMI-for-age growth charts — can lead to an increased risk of significant health conditions, including high blood pressure, high cholesterol, heart disease, liver disease, certain types of cancer, breathing issues such as sleep apnea and asthma, and Type 2 diabetes. Recent Sg2 data indicated that 5,000 youths are diagnosed with Type 2 diabetes annually, with one in 400 people younger than 20 having been diagnosed. The data also suggests the incidence of Type 2 is increasing in children and young adults. 

Additional health risks include bone and joint problems, gallstones and gallbladder disease, early onset of puberty, eating disorders and skin infections. Several factors can contribute to obesity, including: 

• Eating patterns 
• Lack of physical activity  
• Medications, such as steroids, lithium and gabapentin 
• Genetics 
• Lack of sleep 
• Psychological factors 
• Social determinants of health, such as living in food deserts or not having a safe place to exercise 

Considering that more than half of children over the age of 6 with obesity continue to have obesity into adulthood — and that the annual obesity-related medical care costs in the U.S. total nearly $3.38 billion — it’s important to educate both children and adults about how to maintain proper nutrition and physical activity levels that will help to head off major health risks. 

Nutrition 

First things first: Do not put children on a “diet” without consultation from a healthcare provider. The goal for children is to reduce excessive weight gain while still supporting normal growth and development. The most important approach is to help children develop healthy eating habits by: 

• Encouraging more consumption of fresh fruits and vegetables 
• Limiting sugary drinks, as well as high-fat, high-sugar and salty foods and snacks commonly found in fast food and vending machines. 
• Adding sources of low-fat dairy and lean protein to meals 

Free resources such as the U.S. Department of Agriculture’s My Plate can help children and parents visualize proper portions and food group selections. The MyPlate Plan identifies food group targets, including what and how much to eat within a specific calorie allowance based on age, gender, height, weight and physical activity level. The site also includes healthy recipes, and the USDA’s Nutrition.gov also offers a variety of interactive websites and games to teach children the importance of nutrition and physical activity. 

The My Plate application has a Shop Simple program that assists consumers in locating healthy, budget-friendly foods in their neighborhood. For instance, inexpensive fruit choices include bananas, apples, raisins and fruits canned in water. Protein choices included canned black beans, tuna packed in water, peanut butter, and chicken drumsticks or thighs. Several simple recipes highlighting these foods are available as well. The user simply inputs their zip code and the program identifies local farmer’s markets, SNAP retail stores and online SNAP stores. Other strategies include planning a week’s worth of meals, supporting local farms by joining a Community Supported Agriculture (CSA) program and using coupons.  

Physical activity 

Regular physical activity is essential to children’s overall wellbeing, especially when it comes to blood pressure and bone and joint health. The ideal duration and level of activity differ based on age — the CDC, for example, recommends children ages 3 to 5 be physically active throughout the day for growth and development, while children ages 6 to 17 should engage in 60 minutes or more of moderate-to-vigorous activity each day. Most daily activity should be aerobic (including moderate activities such as walking and vigorous activities like running), with three days per week set aside for muscle-strengthening activities such as climbing or push-ups and bone strengthening activities like jumping or running. The CDC also offers physical activity guidelines for children with disabilities. 

Of course, it’s important to ensure children are engaging in activities that are age appropriate. For example, younger children might meet daily requirements through gymnastics or playing tag, while older kids could participate in school-sanctioned sports, weightlifting or yoga. One of the best ways to ensure that physical activity is a regular, and important, part of a child’s life is for the adults in their lives to lead an active lifestyle too. 

Educators also can play an important role by identifying ways to incorporate more physical activity into the classroom — something that’s especially important for children who live in areas that do not have safe or accessible settings for outdoor activities. Plus, adding more movement in the classroom is beneficial to both physical and mental wellbeing, as it can improve concentration and reduce disruptive behavior like fidgeting. 

And limiting sedentary time to no more than two hours per day also is key. That means unplugging from TV, video games and Internet and finding a fun, more active alternatives. 

Sleep 

Sleep is as important as diet and exercise when it comes to health. A study in Academic Pediatrics found that insufficient sleep in school-age children can affect neurobehavioral functioning, while a study from the University of Maryland School of Medicine compared children who got the recommended amount of sleep for their age — nine to 12 hours a night — with those who slept less, uncovered differences in brain regions responsible for memory, intelligence and well-being. That’s especially concerning considering that the National Institutes of Health have found that 9- to 13-year-olds average seven hours and 45 minutes of sleep per night.  

So how can we address this pervasive issue? One, make sure you know the recommended amount of sleep for children based on their age. It’s also important to make bedtimes consistent and design a bedroom environment that’s conducive to sleeping (a dark, cool, comfortable space). 

Attitudes 

As obesity and overweight continue to increase, so too does weight bias and obesity stigma. Often, this bias is rooted in the misconceptions that body weight is easily controlled by diet and exercise, that the person lacks self-control and that obesity is caused by emotional problems. However, factors such as genetics, socioeconomic environment and medications should also be factored in. School-age children who have obesity or overweight face biases such as peer victimization and stereotypes. It’s essential for everyone to remember that acceptance and self-confidence are important components of embracing lifestyle changes and developing realistic, sustainable health practices.  

Clearly, childhood obesity is complicated. However, making healthy food choices, increasing physical activity, and getting proper sleep are the starting points for achieving greater health.  A support system of family, educators and friends is crucial as well — as is rewarding and celebrating the small, incremental steps toward important lifestyle changes.