HEALTH Experts offer ways to curb kids' obesity

Children with abnormally high weight risk early diabetes, kidney failure and even death.
By CAROLYN POIROT
KNIGHT RIDDER NEWSPAPERS
At age 12, Ricardo stands 5 feet 1 inch tall and weighs 196 pounds.
He says he watches television an average of five hours a day in the summer; his mother says it's more. He eats greasy snack foods, particularly potato chips, tortilla chips and Fritos "every day," soft drinks and candy bars "five days a week." He averages "about one" vegetable a day.
A sixth-grader, Ricardo (not his real name) says he participates in physical-education class during the school year but does no exercise at home because it's "too hot," he has "no stamina," and even walking is "too hard."
Both grandparents on both sides of his family have diabetes; both of his parents are obese. Parents, grandparents, uncles and aunts all have high blood pressure, according to the form his mother filled out at the Hispanic Health Fair on Aug. 3 at the Amon G. Carter Jr. Exhibits Hall in Fort Worth, Texas.
Ricardo's mother says he is reluctant to go outdoors and play with his friends because he's having a little difficulty running and jumping, and he is more comfortable inside, playing video games and watching TV. She buys his favorite snack foods because she loves him.
"The more he sits in front of the TV, the worse it gets. It's a vicious cycle that exacerbates the problem," says Ximena Urrutia-Rojas, who has a doctorate in public health. She is an assistant professor of social and behavioral sciences at the University of North Texas Health Science Center in Fort Worth.
The numbers
Urrutia-Rojas and Dr. John Menchaca, a Fort Worth pediatrician, screened 68 Hispanic children between the ages of 3 and 14 at the health fair and found 48.5 percent of them were overweight or obese, and 41 percent had at least two other risk factors for Type 2 diabetes.
The screenings identified an 11-year-old Fort Worth girl who is 58 inches tall and weighs 166 pounds, and a boy not quite 3 years old whose body mass index (BMI) was off the charts.
"My tables only went up to 30," Urrutia-Rojas says. "His BMI was higher than that. It will be difficult to reverse. That little boy was in pretty bad shape. It was so sad. It made all of us uncomfortable -- his parents as well as the volunteers. His parents said he lives on chips and soft drinks."
Body mass index is a measurement based on a person's height in relation to his weight. A BMI of 18.6 to 24.9 is considered "healthy weight." A person is overweight if his BMI is 25 to 29.9, obese if it's 30 or above.
Two years ago, Dr. Menchaca and Urrutia-Rojas did a study that found that 28 percent of 1,056 fifth-graders at 17 ethnically diverse Fort Worth elementary schools were overweight; nearly 23 percent -- 240 children -- were overweight and had at least two other risk factors for diabetes.
"We have seen 10-year-old children with high blood pressure, high cholesterol levels and high insulin levels as well as abnormally high weights," Dr. Menchaca says. "A lot of them have family histories of diabetes. ... The outlook does not look good."
Long-term risks
The children are in danger of developing diabetes in their early teens and could end up on kidney dialysis or dead by their late 20s, the doctor fears. (Kidney failure is one of several serious complications of diabetes.)
"We cannot emphasize the dangers enough. Families need to be aware," Urrutia-Rojas says. "Unless something changes, we can expect many of these children to develop diabetes, hypertension and cardiovascular disease, gallstones and osteoarthritis from carrying too much weight, sleep apnea and respiratory problems including more asthma than average, kidney problems and depression, low self-esteem, eating disorders and isolation."
If a child is overweight at 6, he has a 25 percent chance of becoming an overweight adult. If he is overweight at 12, there is a 75 percent probability he will be overweight as an adult, says Dr. William Klish, professor of pediatrics at Baylor College of Medicine in Houston.
"Overweight parents make overweight children," says Klish, former chairman of the American Academy of Pediatrics committee on nutrition.
Psychological factors
"But the greatest problem of obesity in children may be the lasting psychological effects," Klish says. "The lack of self-esteem is overwhelming. There is a lot of depression."
Klish warns against using food to comfort children and stresses the importance of children eating regular meals, preferably family meals while seated at a dining table, rather than grazing all day or eating off TV trays in front of the television.
And he encourages parents to offer a variety of foods and not let their personal food prejudices get in the way of promoting healthful eating.