Dietician Suggests Child Obesity Starts in the Womb

A well-publicized study by the National Institute of Medicine suggests child obesity is the result of a myriad of factors, including too much TV, too many videogames, a lack of physical activity in preschool and child care, and unhealthy sleeping practices.

Karen Astrachan would like to add something else. "I think we need to target the pregnant mom," says Astrachan, a registered dietician with the Palo Alto Medical Foundation. "The reality of it is that if a child is born at the 85th or 95th percentile (of acceptable weight compared to height), to try to get them less than that is really telling the parent they have to limit portions and control that child's weight, and that's not realistic.  The child was born that way because of what happened with the mom during pregnancy."

The IOM study found 10 percent of infants and toddlers in the United States carry excess weight for their body size, and more than 20 percent of children between the ages of two and five are already overweight or obese.

The study goes on to recommend things most parents are aware of: keeping children active throughout the day, providing them with good diets, ensuring sound sleep patterns, and limiting sedentary activities like tv and videogames. It suggests caregivers play a part as well, especially with children they supervise in preschools.

A recent concern tied to children's weight has nothing to do with genetics. Public schools everywhere are cutting back on physical education classes during the day because of teetering budgets. "It is a big concern; it's very sad that they've cut back in the school systems, to once a week or twice a week," says Astrachan. "'It puts the responsibility back on the parent to have play time, and fun time, and active time."

Get Healthy San Mateo County has been addressing childhood obesity since 2005. Their stated goal is to "work to develop strategies that will reduce and prevent obesity and other health risks of unhealthy eating and lack of physical activity among all children in San Mateo County. "

In 2010-2011, GHSMC awarded grants to local organizations for projects such as:

• $15,800 for Youth Organizing San Mateo County (YO! Mateo) youth to work with neighborhood corner stores in the North Fair Oaks community of Redwood City to increase access and attractiveness of healthy food options and decrease unhealthy messages while increasing the skills, knowledge and leadership of youth participants
•  to actual trails to improve safe access to several destinations for youth and older adults (library, Carlmont Shopping Center, Cipriani Elementary, etc).
• $4,400 for the , undertaking the process to become a certified producer and sell the produce at the Coastside Farmers’ Market, sharing the produce with the Senior Center across from school, and providing opportunities for interaction between seniors and students.
• $5,900 in collaboration with the Farm Institution subcommittee of the San Mateo Food System Alliance, working with two school districts in the county to implement a Farm to School Vision Plan as a means to increase local fresh fruits and vegetables in schools, and strengthen the local economy.

All these programs, though, address a problem that really begins much earlier if the newborn child begins life with extra girth. After birth, adolescent dieting rarely works. "If you put a child on a diet, research shows it just backfires," says Astrachan. "As soon as the child is able to go to the refrigerator, go to a friend's house, they overeat, and they become more obese than genetically what they would have been in the first place."

The Palo Alto Medical Foundation offers a pediatric weight management program developed by Astrachan called Healthy eating. Active lifestyles (HeAl).  It is a seven-week program for parents of ages two to six-years-old, which emphasizes getting an obese youngster back on track to grow up to have the body that is right for the child.  Classes are offered throughout the Bay Area. The current Web site's dates are old, so Astrachan sent Patch details of classes starting soon.

There is data that indicates, at least in California, cases of child obesity have leveled out over the past ten years. According to Kid's Data.org, in 1999 67% of California 5th graders were at a healthy weight. Roughly 10 years later, in 2010, that percentage was similar, at about 69%. Strikingly, in the same data, racial and ethnic disparities are apparent: only about 56% of Pacific Islander 7th graders are considered to be at a healthy weight compared to over 81% of Asian Americans and nearly 78% of Caucasians.

Kid's Data is a project of the Lucille Packard Foundation for Children's Health in Palo Alto.