Diabetes Forecast

More Than a Growth Spurt

Battling Childhood Obesity in U.S. Courts and Communities

By Katie Bunker ,

With 9 million children in the United States struggling with obesity today, health care professionals and lawmakers are working harder than ever to find solutions to the growing epidemic. So far, a majority of the battle has been fought on the community level, with education and prevention programs. But what could be done on the federal level? That question was addressed July 16 when the Senate Subcommittee on Children and Families, chaired by Sen. Christopher Dodd (D-CT), held a hearing, "Childhood Obesity: The Declining Health of America's Next Generation."

"Since 1990, the prevalence of obesity has tripled among our children and adolescents," testified former ADA President Francine R. Kaufman, MD. She also told stories from her personal experience. "I saw one of the first children who heralded in the type 2 diabetes epidemic in youth," she told the subcommittee. "She was a 13-year-old girl with a blood sugar level of 427 … she weighed 267 pounds. This young girl left my office taking five medications, but she remained at high risk. I knew it would be hard for her to control her diabetes. I knew that 15 years would likely be taken from her life."

Kaufman, other experts who testified at the hearing, and even audience members cited issues that need to be addressed to combat the epidemic. "Senator Dodd did something he said he'd never done before—he started asking people who were in attendance to comment; it was quite a number of people," Kaufman recalled later. Many of those who spoke up shared enthusiasm for requiring restaurants to include nutrition labels on their menus and reevaluating school menus and physical education, she added.

"The economy is not going to make this easier. Healthy food costs more, and it's harder for the people who need it the most," Kaufman says. "That's where federal programs can really make a difference. Between food services in schools, WIC [the Special Supplemental Nutrition Program for Women, Infants, and Children], and the food stamp program—we could [offer incentives to] people to make healthier choices."

Another obstacle? The safety and availability of physical activity. "Another patient [I had was] a girl who developed type 2 diabetes," Kaufman recalls, "and we tried to get her to lose weight. We got her all enthusiastic about a walking program, with a pedometer and music she could walk to. But she got shot walking in her neighborhood." Fortunately, Kaufman's patient recovered, but the threat of violence where many kids live can limit their amount of physical activity. Kaufman says that we need to find new solutions—say, with athletic programs in schools.

Still, there's only so much that can be done given the current health care system, says Kaufman. "We need to roll out, over time, health care reform [that is] paying for prevention, and paying for nutrition and lifestyle change, and have that be a core," Kaufman explains.

ADA is currently supporting two bills in Congress aimed at preventing obesity in children. The Child Nutrition Promotion and School Lunch Protection Act requires the U.S. Department of Agriculture to update the nutrition standards that determine what foods and beverages are permitted to be sold in schools outside of regular school meals. The Fitness Integrated in Teaching (FIT) Kids Act, meanwhile, addresses physical education by requiring schools to report on the quality and quantity of students' physical education as well as schools' progress toward a national goal of 150 minutes of weekly physical education in elementary schools and 225 minutes in middle and high schools.



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