Cover

Young and Large

Mark Nichols,Sharon Doyle-Driedger May 15 2000
Cover

Young and Large

Mark Nichols,Sharon Doyle-Driedger May 15 2000

Young and Large

Mark Nichols

As Karoline Kiddine puts it diplomatically, her daughter Karen, 11, and nine-year-old son, Colin, “are not the most streamlined kids around.” Two years ago, the dimensions of the Edmonton schoolchildren—Karen was somewhat overweight, according to their mother, and Colin was “mildly obese”—began to worry her increasingly. It also troubled Karoline that the children spent hours in front of the television and wolfed too many high-fat snacks. At school, kids teased Colin about his weight—to the point where some days he wanted to stay home. Then in January, 1998, Kiddine heard of a University of Alberta program designed to make children more willing to exercise, watch less TV and stick to a healthier diet. She enrolled the children, who attended the three-month program with their mother or father, Ron Kiddine, who are also overweight. The program, says Karoline, made the children more active and physically fit—but it did not make them thin. “Probably,” says their mother, “they will always be on the plump side.”

Sadly, experts say, in a country where about half the adult population is overweight, the number of Canadian kids who are chubby or obese is growing at an alarming rate. Obesity rates among children rose rapidly during the 1980s, to the point that by the early 1990s, about one-quarter of Canadian children were overweight or obese, according to the most recent figures from Statistics Canada. Physicians who work with overweight kids say the numbers have almost certainly grown since then. “The prevalence of childhood and adolescent obesity is on the rise,” says Dr. Oded Bar-Or, director of the Children’s Exercise and Nutrition Centre at McMaster University in Elamilton, “and it is approaching epidemic proportions.”

One of the pitfalls of obesity—as most overweight grownups know—is that surplus weight, once acquired, is frustratingly difficult to shed. For that reason, experts in child obesity emphasize prevention—diets and treatment programs for fat kids have a poor success rate. That means most tubby kids will grow up to be overweight adults, facing an increased risk of arthritis, some kinds of cancer, diabetes, heart disease and stroke. There are ugly social consequences as well. The price many children pay for being overweight, says BarOr, include “a lack of social adjustment, sadness, depression, distorted body image and a lack of confidence. The costs are very obvious in a 12or 14-year-old, when social interactions become prominent in their lives and teasing by other children can be cruel.”

Bar-Or at his clinic: ‘epidemic proportions’

One of the pitfalls of obesity is that surplus weight, once acquired, is frustratingly difficult to shed

What is behind the ballooning number of overweight kids? Experts point to lifestyle factors, including high-fat snack foods, television and computers, and genetic factors that may give 40 per cent of children a tendency to become overweight. But too little physical exercise is regarded by many as the principal villain. Like their parents, North American children have become dangerously sedentary. At a time when government funding cuts have forced many schools to reduce or eliminate phys-ed programs, many parents prefer to keep their children off streets and playgrounds after school hours for safety reasons. Stuck indoors, kids turn to TV and computers, spending more time—according to one U.S. study—gazing into electronic screens than on any other activity except sleep.

The result: it’s getting harder for many growing kids to burn off calories. North Americans and their offspring “are a very maladapted group,” says Dr. David Lau, Calgary-based president of Obesity Canada, which tries to spread awareness of the health risks faced by the overweight. “Our bodies are the same as when our ancestors were hunter-gatherers. But we have an overabundance of food and get less physical exercise.” The biology of weight gain is essentially the same for children as adults. “Our bodies try to conserve as much energy as possible in the form of fat,” explains Lau. “If a child eats a small bag of potato chips, that’s maybe 250 calories, and it will take at least half an hour of vigorous exercise to burn it. How many children these days are going to do that?” Treatment programs for overweight youngsters usually attack across a broad front, encouraging children to be more active, spend less time watching TV and follow sensible eating habits. Improving a child’s diet often means altering the whole family’s eating patterns, says Dr. Laird Birmingham, an authority in obesity and eating disorders at the University of British Columbia in Vancouver. “If the child lives in a family that doesn’t eat breakfast, snacks all day and has a gigantic dinner and lots of desserts,” says Birmingham, “it’s going to be pretty hard for a child to eat differently.”

Even when parents co-operate, most treatment programs have a disappointing long-term success rate. McMaster s BarOr, whose clinic sees between 150 and 200 new overweight children a year, estimates that more than 60 per cent of the kids he treats are less overweight when they finish the 12to 18-month program. But within a year, he adds, at least onethird will relapse.

In Edmonton, dietitian Geoff Ball knows just how frustrating trying to take excess weight off youngsters can be. While studying for a University of Alberta doctoral degree, Ball and his faculty supervisor worked with about 50 families with overweight children in a project aimed at evaluating different approaches. With one group—which included Edmonton’s Kiddine family—Ball and his team tried over a three-month period to encourage weight loss

by changing family eating habits and boosting physical activity.

With the second group, the researchers emphasized healthy nutrition, body image and selfesteem. At the end of the study, they found the same disappointing result in both groups. “Basically all the overweight kids stayed overweight,” says Ball. “I think that just takes us back to the need for prevention—not letting children become fat in the first place.”

For that to happen, experts say Canadian governments must establish public health strategies aimed at battling child obesity. One urgent need, they say, is for funding to help communities make playgrounds safer and provide more public sports facilities for children. Some steps aimed at making kids more active are already under way—the “walking school bus” movement, in which parents escort children to school on foot, has spread to hundreds of communities across the country. And officials of The Foundation for Active, Healthy Kids, based in Toronto, hope their Activ8 program, built around a series of “challenges” to make schoolchildren more active, will spread from Ontario schools into other provinces.

But mobilizing public funding for a war on juvenile obesity is not easy. “There are so many other pressing issues, like child poverty and smoking among children,” says Michelle Brownrigg, project manager for the foundation, “that programs to keep children active get low priority.” Until they get more attention, Canadas population of size-challenged children is likely to keep on growing.

With Sharon Doyle-Driedger