Letters to the Editor

Viewpoint: The obesity problem is real

‘Oh no,” you think, “not another commentary on obesity!” It seems as if every form of news media you encounter contains mentions of some aspect of this epidemic problem. Unfortunately, the problem is real, and as pediatricians in our county for more than 30 years, we feel there may be value in putting a local perspective on the issue and adding our thoughts on some key ways of dealing with it.

To put the problem into perspective, in the spring of 2009, 500 local children, pre-schoolers aged three and four years old, were weighed and measured. The findings were alarming. Of the children measured, 37 percent met the criteria for overweight (85th percent body mass index for age) and 17 percent were considered obese (95th percent body mass index).

The consequences of the problem have been well chronicled: On an individual basis, the short- and long-term health outcomes for obese children are disturbing. The threat of Type 2 diabetes, high blood pressure, elevated serum lipids, etc. are all very real. And, yes, we continue to see all of these clinical problems in the office!

Additionally, on a populationwide basis and in a time of national health care reform and its attendant costs (as well as the overwhelming California budget deficit), the costs of the obesity epidemic become even more pressing.

Answers to the problem of childhood obesity are slow in coming, though the work in the field is great. From a pediatrician’s point of view, the most appropriate response is disease prevention. Practices such as breast-feeding, early promotion of healthy eating habits, limitations on screen time, encouraging children’s autonomy in self-regulation of food intake, setting appropriate limits on choices and modeling healthy food choices are all critically important.

Preventative health care in our office includes careful and regular monitoring of the individual child’s growth parameters, including the body mass index (the right weight for height). Identification of upward trends early can alert the caregiver of impending problems.

Concerning treatment, it still comes down to calories in and calories out. A recent Kaiser Family Foundation study found that United States kids ages eight to 18 are consuming more media than ever.

According to the survey, children and teenagers are now using their phones, computers, TVs and video game systems for a total of 7.5 hours a day or 52.5 hours a week!

We’re sure that your experience confirms this observation. We need to limit these sedentary activities and find creative ways to encourage the calories out. We need to routinely promote physical activity, including unstructured play, at home, in school and in child care settings throughout the community.

Concerning calories in, the average person in the United States consumes almost 175 pounds of sugar a year. The biggest source may be sugary drinks including sodas and fruit juices. Consider doing one of the following: drink more water and consider healthy drink alternatives such as fruit-flavored water. Dietary practices should be fostered that encourage moderation rather than overconsumption, emphasizing healthy choices rather than restrictive eating patterns.

Fortunately for our community, there is an important local effort being made to address this problem. In 2006, the County Board of Supervisors endorsed the creation of a Childhood Obesity Prevention Task Force to develop a countywide strategic action plan. County leaders funded the San Luis Obispo County Community Foundation to convene and facilitate the task force.

The task force transformed into HEAL-SLO, a comprehensive consortium to monitor all the efforts in the County to combat childhood obesity. HEAL-SLO is now funded by a grant from The California Endowment and the Community Foundation. Recently, the Community Foundation granted $5,000 each to three groups in the County to help combat childhood obesity.

The first was the Cal Poly Corporation. It will be able to implement an interactive nutrition educational curriculum for parents of young children. The second was a grant to the Community Action Partnership of San Luis Obispo County Child Care Resource Connection to implement a barrel garden program to promote healthy eating and increase the number of fresh vegetables and fruits served to children in 30 family child care provider settings.

The third grant was to the YMCA of San Luis Obispo to implement a nutrition and physical activity program in two YMCA preschools (San Luis Obispo and Paso Robles) by expanding the Wee Creative Fitness Academy and adapting the hands-on Zoo-Phonics program to incorporate nutrition activities for approximately 40 to 50 children. Those grants represent only a few of the wonderful things going on in this county to address this pressing problem.

Finally, as physicians and parents, we ask you to please join us in advocating for healthy children. Encourage other parents, teachers, coaches and those who influence youth to discuss optimal nutrition and appropriate activity as part of their efforts to control overweight and obesity.

Dr. Brian David Patterson and Dr. James Tedford are both pediatricians in private practice in Atascadero.