Childhood Obesity
Today's kids are heavier than ever - here's why and what you can do about it.
Nerys Perry

Outside my son’s kindergarten class there is a giant tick-like bug made of black and red construction paper. On its back cluster a dozen or more smaller insects on which anonymous children have written what really “bugs” them about bullying. One in particular strikes me; it is a long-antennaed beetle that reads: “It bugs me when people say I am ugly and I am fat... .” the printing is in alternating pastel shades of pencil crayon and is written with such care that I can’t help but admire the child who had the strength to post publicly – to make beautiful even – what has become an all-too common, all-too unspoken problem: childhood obesity.

The most recent statistics confirm that our children are heavier now than ever before. In 2004, 26% of young Canadians aged 2 to 17 were overweight or obese – an increase of almost 75% since 1978/79. Of particular concern: adolescents, whose overweight rates more than doubled and whose obesity rates tripled.

This news has medical and health professionals pressing panic buttons. Brian McCrindle, cardiologist at the Hospital for Sick Children in Toronto, told Canadian Press that, “this epidemic of paediatric obesity may become the most important and devastating public health challenge of the 21st Century.” The World Health Organization agreed in a 1997 report: “The spectrum of [health] problems [associated with obesity] seen in both developing and developed countries is having so negative an impact that obesity should be regarded as today’s principal neglected public health problem.”

Baby fat, we used to call it. It was something children grew out of. Now those extra layers of childhood padding could be more dangerous than we once thought.

The Canadian Paediatric Society reports that obese children are at increased risk for a host of chronic illnesses, including respiratory disorders, cardiovascular and orthopaedic diseases, type 2 diabetes and psychological disorders, such as low self-esteem and depression. Recent reports from the U.S. also link obesity to increased asthma and migraine rates.

And while the jury’s still out on whether or not there is a significant health risk to kids who are overweight, but not obese, it doesn’t mean that being overweight has no effect on your child. Overweight children are bullied more often and are more dissatisfied with their bodies than peers at healthy weights. They are also more likely to become overweight or obese adults who are prone to a host of chronic conditions including type 2 diabetes and coronary disease.

With almost one in two adults already overweight, this has many health professionals wondering how our health care system will manage. Costs associated with treating obesity-related health issues in adults are already so high, estimated at $4.3 billion in 2000/01, that experts are calling obesity “the new tobacco.”

Obesity, defined as excess body fat, is measured in adults using the Body Mass Index (BMI), a calculated kg/m2 based on weight, height and age. Because a child’s BMI changes as he or she grows, adult classifications cannot be extrapolated directly to youth. Instead, the Canadian Paediatric Society and other experts recommend using a BMI-for-age chart (www.cdc.gov/growthcharts/). Results are reported in percentiles, which show how a child’s BMI compares with his or her peers. Children who fall below the 5th percentile are classified as underweight, those between the 85th and 95th percentile are overweight, and those at or above the 95th percentile are considered obese.

While these classifications are useful for identifying population trends, parents should use the BMI only as a guide. “Make sure that your child has a proper health assessment,” advises Susan Hubay, registered dietician and public health nutritionist for the Peterborough County-City Health Unit. “The growth charts that doctors and dieticians use are different than BMI and measure growth over time. This has to be looked at in conjunction with the parents’ history.”

Experts agree that a solution to overweight/obesity in children must be found, and have undertaken many studies in recent years to try to understand the key factors that contribute to the alarming trend toward more plus-sized youths.

The primary cause of obesity, says the Canadian Paediatric Society, is “a chronically positive energy balance.” In other words, overweight and obese children are consistently consuming more energy than they are expending.

This isn’t surprising when you consider that the calorie intake per person in Canada has increased by 17% in the last ten years after almost twenty years of relatively stable calorie consumption. People are also eating more fats and oils, and almost twice the volume of soft drinks than they did thirty years ago.

While data on children’s nutrition is limited, a recent study found that the majority of children were not eating enough fruits or vegetables, a habit that has long been linked to poor eating habits. Another study reported that almost 30% of children in grades 6, 8 and 10 ate candy or a chocolate bar every day, and between 15 and 22% of grade six children ate potato chips every day.

Physical activity rates are going up, but not enough. More than half of today’s adolescents are still not active enough for optimal health. Sedentary “screen time” is also on the rise, with Ontario children watching an average of 15.5 hours of television every week, and spending more time playing video games than most other places in the world.

But this is nothing new. We’ve been told for years that our children have to turn off the tube, eat better and move more. What is now coming to light is how many other factors exert a heavy influence on our children’s weight.

Easy to get fat

We are living in what the Ontario government calls an “obesogenic environment”, or a world in which it is all too easy to get fat, and all too hard to maintain a healthy weight. Mechanized homes and workplaces, urban sprawl, super-sized foods, increased junk food advertising, longer commuting times and working hours – all these have been linked to obesity.

“As a society, we are so busy,” Hubay says. “That, combined with a real disappearance of cooking skills, means we have handed over cooking to other people. As a result, we have become dependent on foods that can be higher in fat, sugar and salt.”

“We hear about busyness all the time,” adds Rachel Moon-Kelly, registered dietician and public health nurse for the Haliburton, Kawartha, Pine Ridge District Health Unit. “The ability to build [healthy habits] into our lives naturally has decreased over time.”

And while our environment and busy culture play key roles in thickening waistlines, socioeconomic factors, like education and income, are also important.

Obesity was once called the disease of affluence. But researchers now recognize its link to poverty. A recent Canadian study reported that poor children are almost twice as likely to be overweight or obese as kids with wealthier and better educated parents. Poor children are also less likely to be enrolled in organized sports, and have more difficulty getting food when they need it. In Peterborough and Northumberland, one in five children live in poverty. “Historically, the tendency has been to focus on individual approaches [to combat obesity],” Moon-Kelly says. “While these approaches are valuable, research shows individual responsibility can have its full effect only where people have equitable access to a healthy life, and are supported in making healthy choices.”

The Ontario government appears to agree. In June 2006 the Ministry of Health launched its $10 million Action Plan for Healthy Eating and Active Living, which call for help from all sectors to combat obesity. The government has committed to rewarding schools that promote healthy eating and active living, providing fruits and vegetables to children in northern schools, and setting up a free web and phone-based dietary advisory service.

Through local and national educational programs like “Let’s Get Active”, governments, associations and community groups are cheering us up off our living room couches and into the gym, away from super-sized fast food outlets and into the produce aisles.

But the question is: will we do it? Can the childhood obesity/overweight trend be reversed? In five years, will there be fewer or more long-antennaed beetles outside my son’s class with the words “fat” and “ugly” printed on their backs?

Nerys Parry is a freelance writer and mother of two living in Port Hope.

For further information on obesity in Canada:

For the Paediatrician’s of Canada Public Policy Statement On The Use of Growth Charts for Assessing and Monitoring Growth in Canadian Infants and Children, a collaborative statement from the Dieticians of Canada, Canadian Pediatric Society, The College of Family Physicians of Canada, and Community Health Nurses Association of Canada , see the Canadian Journal of Dietetic Practice and Research, Vol. 65, No. 1, Spring 2004, pp. 23–32, available at www.dieticians.ca.