Feet, Forks, Fat – Protecting our Children

February 23, 2011 in Diabetes, Fitness, Health, Mediterranean, Nutrition, Weight Management by Joyce Bunderson

The problem of childhood obesity, which has been rising at frightening rates for decades, has probably not escaped the attention of many of us. According to the Centers for Disease Control and Prevention (CDC), almost one in every three children in the United States is overweight or obese. A year ago when Michelle Obama announced her initiative Let’s Move!, I was so delighted that she had chosen childhood health/weight management as her focus.

Essentially, the program encourages children to play outside or in the gymnasium for an hour each day; eat fruits and vegetables with each meal, drink water or low-fat milk instead of soft drinks; and to eat as a family. Many of the First Ladies have used their influence and have adopted an issue to champion; some examples are: ‘Just say no’ – drugs; mental health; reading; women’s rights; art; U.S. made clothing; preserving, arts and culture in the White House; volunteerism; handicapped children; literacy; and child advocacy.

It’s embarrassing to me as an American, to learn that some people, including powerful politicians and commentators, have been disrespectful and critical of Michelle Obama’s Let’s Move! Initiative. It seems to me that many are living in a world of politics without principle, turning anything and everything into something to be hateful about. What ever happened to civil discourse? The partisan viciousness against her championing this difficult, VERY DIFFICULT PROBLEM, is absurd. Why would any citizen of this country want to turn this effort into a political target for cheap shots? This is a difficult issue deserving of bipartisan effort. Divisions and uncivil discourse are damaging to the victims who need help. I for one am grateful that someone took on this issue; especially ‘a someone’ with prominence. Today I decided to write about childhood weight management, but stumbled upon a large volume of political criticism of Michelle Obama and the Let’s Move! Initiative; I don’t want to get in the quagmire of the nasty politics, but do want to spend my time in a way that will hopefully help parents and caregivers of children. For me, one citizen of this great country, I want to share my feelings of gratitude for her endeavor; recognizing that this should not be about politics, but about a worthy goal. Thank you Michelle Obama!!!

The foundational cause of obesity

The cause of obesity sounds very simple; it is essentially an imbalance of energy. That is a relatively new problem; the base of the problem is modern life. For the history of humans, it has been difficult to get enough calories, (thus famines/starvation) and physical activity was part of every day life. Our modern life provides a surplus of calories and many disincentives against physical activity. The calories have been attractively packaged and made ubiquitously available, researched to induce craving, thus leading to eating more than the body needs. These fudes have been impoverished of nutritional content to increase profit margins. This reduction in nutritional properties includes especially those that fill one up and reduce hunger. Instead, these fudes induce us to take mouthful after mouthful.

In Unfattening our children: forks over feet. David L. Katz of Yale University builds a strong argument for choosing ‘forks over feet’. He says, “The modern world makes it very easy to out-eat exercise, and nearly impossible to out-exercise excessive eating. I will elaborate on his article a bit, as it encapsulates much of the argument we are making in this blog, while adding the excellent logic of the slogan “forks over feet”.

Where is childhood overweight and obesity taking us? Quick answer: Nowhere good.

1. Diabetes

Childhood obesity has led us to a time in history where type 2 diabetes has been transformed from a disease that occurred almost exclusively after middle age to a condition that is a pediatric epidemic. When I studied nutrition in college, type 2 diabetes was always referred to as ‘adult onset’ diabetes. The name needed to be changed, because of the pediatric epidemic.

2. Cardiovascular risk

Cardiovascular disease has been shown to have its foundation in childhood obesity, diabetes, hypertension, and dyslipidemia. In addition, children and adolescents were once considered to be at low risk for cardiovascular disease, but childhood lifestyle has now positioned these as serious problems, yet they are largely preventable problems.

3. Primary hypertension; hypercholesterolemia, hyperinsulinemia, insulin resistance, hyperandrogenemia, gallstones, and sleep apnea.

These problems have all been shown to be linked to childhood obesity.

Back to Katz: He explains that energy intake is entirely a result of one single activity – eating. Energy output is broken down to regulating body temperature (thermogenesis); moving the body (physical activity); doing everything a body needs to do to keep it alive (basal metabolism); and growing. Basal metabolism is generally more than half of calorie expenditure (65%). Therefore, whenever we eat more calories than it takes to keep us warm, and enable us to move, grow and do the metabolic functions – we gain weight.

Katz says that, “Everything that makes tasty, tempting, energy dense, nutrient-dilute food items available, convenient, ubiquitous and relatively inexpensive is part of the problem. The marketing of such products to children is part of the problem. Every technological advance that provides a replacement for something muscles used to do is part of the problem. The elimination of recess and physical education from the school day is a part of the problem. Lack of time, attention and aptitude for cooking is part of the problem. Suburban sprawl is part of the problem.”

Katz says that we need to ‘reverse engineer’ the obesigenic environment – that brings us to his feet verses forks solution. Although he recognizes the fact that physical activity is both fundamental and vital to the health and well being of children, he builds a case that the greater focus should be on intake. He presents ample research-based evidence showing that although exercise plus caloric restriction may work better than either alone, that restriction of calories is a more reliable predictor of weight loss than exercise.

Recognizing the ease of out-eating exercise calories

Here is an example of a child increasing exercise to burn an extra 300 calories – an hour of moderately fast biking. One large soda (310 calories); a small order of French fries (230 calories); or one ounce of ‘cheese snacks’ (160 calories) or innumerable foods like them, could restore the calories burned in the fairly intense, hour-long bike ride in a matter of minutes.  Katz’s point is well taken; we will make little progress with weight-loss goals, if we fail to improve the quality and overall quantity of children’s diets.

Foods close to nature – reducing the number of calories needed to be full

Katz adds his voice to many of us who advocate for foods ‘close to nature;’ saying that they generally offer an array of properties that would tend to reduce the number of calories required to achieve fullness, including but not limited to their volume, water content, fiber content, glycemic load and energy density. Certainly, we have spent considerable effort in helping the public identify this type of food on the Dr. Grandma’s website. The Mediterranean-style of eating is definitely all about foods that are ‘close to nature’ and have the attributes of reducing the calories needed to be full and achieving the other qualities of foods that can do the job of supporting weight management.

The forks vs. feet point is well made; there can be no choosing between physical activity, as it is the vital, conditioning work of the human machine and diet is its fuel. But if we’re forced to choose a side of the energy balance to favor in weight control, it is forks over feet for the fundamental reasons of modern living. It’s just too easy to out-eat even somewhat extraordinary levels of physical activity and nearly impossible to out-exercise excessive eating.

If you or your child need to lose weight, begin to discover how to replace calorie dense and processed ”fake, fattening fudes” with foods that are closer to nature; foods you can fill up on – that will protect you and your child from the discomfort of hunger while they gradually learn new ways of eating. Possibly consider reviewing some of our Mediterranean-style of eating posts or check out the Let’s Move! Website for more ideas. Also, I will be posting The Yin and Yang of Snacks next week; which will be chock-full of healthy snacking ideas.

In the mean time, check out some of Dr. Grandma's "close to nature" products.