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04-01-04 Overweight in local children nears epidemic

By Betty Lawrence
blawrence@dailystandard.com

Editor’s note: Childhood obesity has reached epidemic proportions in the United States. This is the first in a two-part series addressing the major causes associated with childhood obesity, how to combat the situation and local efforts to address the problem.
   Mercer County is not exempt to the national trend of increasing numbers of overweight youth, says Renee Eyink, a registered dietitian with the Mercer County Women, Infants and Children (WIC) program.
   “I have been seeing more and more overweight children,” Eyink said during a recent interview at the Celina WIC office.
   So many, that Eyink finds herself sending out three or four physician referrals daily for overweight children.
   Celina pediatrician Dr. Manuel Lugo also says he sees overweight children in his office every day.
   Dr. Daniel Preudhomme, director of the lipid clinic at Dayton Children’s Medical Center, works with overweight children ages 2-17 and says the “problem has reached epidemic proportions.”
   “As much as 30 percent of our children, one out of three, are overweight,” he said.
   Preudhomme, who also is a pediatric gastroenterologist and certified nutrition specialist, said he is seeing more and more health complications in children due to obesity.
   “Just the other day I saw three kids suffering from back pain, problems with their spine and silicosis, all caused by being overweight. Right now I have 25 kids with Type II Diabetes, the youngest of which is 11. You usually don’t see this disease until you are 40-50 years old,” he said.
   Other health problems from obesity he has seen increase include cirrhosis of the liver, severe headaches and high blood pressure.
   Preudhomme said the problem needs to be tackled on the homefront, which is just what the WIC program is trying to do.
   Eyink said WIC, which assists women, infants and young children who are at health risk, automatically checks a child’s weight and height and marks it on a body mass index (BMI) codet. A child is considered high-risk for obesity if his or her body mass index (BMI) is over the 95 percentile mark.
   “We always have taken their weight and height for their age to see where they stand at. About a year ago, we started going with the BMI,” she said, a change that was mandated by the Ohio Department of Health.
   Eyink also fills out a health history and food frequency form, gives advice on nutritional changes and makes a referral to a physician if the child is overweight.
   “Then we bring the parents and child back here to the WIC office every three months for a weight check and go over their diet. We monitor it,” Eyink said.
   Eyink said she is disappointed in the lack of support from area physicians. Also, she said many parents often don’t worry about their child’s weight until the problem is noticeable.
   “Until parents can actually see fat rolls, they just don’t worry and figure their child will outgrow it,” she said. “That’s why I like the BMI’s. They help us identify when a child is at risk and the issue can be addressed at an early age. We can work with the parents and try to stop it before it gets to the point of obesity. It helps in the long run, when they are older.”
   Dr. Lugo agrees, saying doctors and parents need to be proactive on the issue. He often stresses a decrease in the child’s calories and an increase in activity level.
   “I never use the words diet and exercise. Young children are still growing and need the nutrients. Parents should never starve a child or put them on a diet. They just need to make healthier food choices and follow the food pyramid,” Lugo advised.
   The food pyramid was developed by the U.S. Department of Agriculture as a tool to help families make healthy food choices.
   But Lugo’s advice often is not followed.
   “When I do get through to the parents, I feel successful. But truthfully, it doesn’t happen often. Many families just don’t want to change their lifestyle,” he said.
   Eyink also stresses proper nutrition and said that may mean cutting out the juice.
   “A lot of kids are overweight because they are big drinkers of juice and Koolaid. Parents are not pushing water enough. The American Academy of Pediatrics recommends 4-6 ounces of juice a day and parents often are giving their kids 20 ounces a day,” Eyink said. “At a conference I went to recently, a doctor who spoke on childhood obesity called juice Ôliquid candy.’ If you must give your child juice, then dilute it with water. I recommend that to all my clients.”
   Dr. Preudhomme also advises parents to keep their children away from soda.
   “That’s a big thing for me. You can add 400-500 calories a day just from drinking pop. Diet pop is okay, but even that should be limited to one can a day,” he said.
   He said parents should expose children to a variety of foods, saying it may take up to 10 trys before a child accepts a new food.
   “Parents need to set an example because the child will do what the parents do. Follow the food pyramid and expose your child to a large variety of food and keep exposing the child to it,” he said.
   According to Nancy Zwick, a registered dietitian with the Dairy Council Mid East, statistically, if a child is overweight, the chances are 50 percent the child will be overweight as an adult. If the person is an overweight adolescent, the chance increases to 70 percent.
   Parents who suspect their child is overweight should first go to a pediatrician and then talk to a dietitian, Zwick said.
   She counsels overweight children at her office in Walton, Ky., and said there is no easy answer to treating overweight children.
   “They want it to go away and they want an instant fix, but it’s not out there and never will be,” Zwick said.
   An overweight child cannot tackle its weight problem alone and it is very important that parents be role models for their children, she said.
   “The successful families are those who do it together, when all are trying to eat healthy. Everyone needs to be educated on eating healthy,” Zwick said.
   She also advises watching portion sizes and limiting fast food.”And parents, don’t nag your children about their weight. That only makes it worse. Believe me, they know they weigh too much and feel bad about it already,” she said.
   Obesity can be conquered, Zwick continued, but it has to become a priority for families.
   “It will take a whole community with each community tackling the problem on their own,” Preudhomme added.
   — Tomorrow’s article will deal with exercise advice from experts and local efforts to address the issue.

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