Illustration: Staff photo (color) by JOE FUDGE
Caption: JaQuan, Allen, 6, chooses between a sugary snack and a package of crackers at his home in Hampton. Allen is a patient at CHKD's Healthy You Clinic, which helps overweight kids learn healthier eating habits.
Teacher Darlette Ambrose gets her students moving Friday as part of a Newport News program aimed at promoting exercise for preschoolers.
Above, physical therapist Tina Dolento checks six-year-old patient JaQuan Allen's flexibility at CHKD's Healthy You clinic in Norfolk. The clinic helps overweight kids learn healthier habits.
At right, registered nurse Babs Benson checks JaQuan's height during a clinic visit. You can read more about the clinic and JaQuan in today's Good Life section.
Summary: A Hampton Roads pediatrician says childhood obesity is the country's No. 1 health problem. So what's being done locally to save our kids from a lifetime of chronic disease?
Many of today's pediatricians never learned about Diabetes 2 as a childhood disease in medical school. That's because it didn't exist. Now it's a diagnosis they hand out more and more often.
"It shouldn't show up until your 60s or 70s," says Donald Lewis, chair of pediatrics at Eastern Virginia Medical School. Diabetes 2 affects the eyes, heart, kidneys and blood vessels.
The doctors attribute it to the rapid increase in obesity rates in younger and younger children, a national problem of epic proportions. "It's the country's No. 1 health problem," says Lewis.
In just the past 10 years children are significantly heavier than in previous decades. And that's one of the reasons the numbers of overweight children in the nation - one in three - are deemed to be a major public health problem. (In Virginia the rate is 31 percent, a smidgen below the national average.)
Not only are they driving up health-care costs with chronic diseases associated with obesity, such as hypertension and cardiovascular problems, but for the first time ever today's youth can expect a shorter lifespan than their parents.
"That should catch people's attention, if nothing else does," Lewis said.
Lewis describes childhood obesity as being more widespread and destructive than polio before the development of Jonas Salk's vaccine.
There is no vaccine for obesity: Health professionals and social workers agree that it's a multi-factored problem driven as much by public policy and societal norms as by individual behaviors.
In an ongoing series, we'll examine what's being done locally to combat this national problem - in the health-care field, in the schools and in the community and families. (Read about JaQuan Allen and Healthy You clinic in today's Good Life section)
WHAT IS CHILDHOOD OBESITY?
Any child who measures in the 85th percentile or above on a weight chart for his or her age is considered overweight (the chart was reformulated and updated in the 1980s), over 95 percent is considered obese; or having a body mass index of more than 25.
Associated health problems include high blood pressure and hypertension, asthma, elevated cholesterol, joint pain, gastrointestinal problems, sleep apnea, insulin resistance, diabetes, some cancers, liver disease and depression. More than 75 percent of the patients at the Healthy You clinic, a CHKD weight management clinic for children, have some form of anxiety or depression that most times has not been clinically diagnosed, according to Dominique Williams, the clinic's physician.
WHAT CAN BE DONE?
Intervention can't be soon enough.
"We have to change the way people think," says Lewis. "It's essential to stop parents from equating feeding with love."
Clinic director Williams says people "like a big chunky baby" and don't realize the health consequences. Her words are echoed by John Harrington, an associate professor at Eastern Virginia Medical School, who released a groundbreaking study this year. "Identifying the 'Tipping Point' Age for Overweight Pediatric Patients," showed that for half of all overweight children the predictors for a lifetime of obesity already are in place by age 2, and for 90 percent by age 5. He also posits that babies can start on the path to lifelong obesity as early as 3 months.
Increasingly, research is showing that the problem can even start with maternal weight gain. A recent Yale University study published in the National Academy of Sciences found that the brain may be wired for fat before birth and its lead researchers are now looking at what role maternal obesity plays in that determination.
Williams, a board-certified pediatrician with a degree in nutrition, also believes weight control must start pre-conception. "If at least one parent is obese it increases the risk for the child by 50 percent," she says. That number jumps to 80 percent when both parents are overweight.
Other acknowledged contributing factors include bottle feeding, food marketing and pricing that encourage the consumption of calorie-dense nutrition-poor foods, fast food, sedentary lifestyles, hours spent in front of computer and TV screens, and the shortage of safe play areas.
"It's much more than individual behavioral change. We need to change our environment, our policies," says Kelly Jackson, director of the Center for Regional Citizenship for WHRO, a group working on awareness of the issue.
"We've talked a lot about how ineffective programs can be. They might work for a little bit, but they're not sustainable. The only way to turn the tide is if we change our systems to make healthy choices easier."
HEALTH NEWS ONLINE
Get information, answers and resources for you health at dailypress.com/health
IS YOUR CHILD'S BMI TOO HIGH?
Use the calculator at dailypress.com/health to determine your child's body mass