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Thinking about Childhood Obesity

Childhood obesity is a real problem. The results are pretty clear: Higher chances of chronic disease and illness, higher health costs in the long run, and significant reductions in lifetime productivity and enjoyment. I’m starting to think more about issues like childhood obesity because of the opportunity the Affordable Care Act gives us to address our country’s sorry state of preventive medicine. As we move toward most people getting affordable health coverage, we need to think about how to make health care better and not just more widely available.

In addition, I’m interested in the relatively new research being done around childhood obesity. More than ever, it is becoming clear that the reasons a child is obese have much less to do with the personal choices of that child and parents and much more to do with the environment we’ve created around food. Encouraging parents to make responsible choices about screen time, exercise and family dinner is a good thing to do. However, parents don’t raise kids in a vacuum and the world around us does little to help promote these healthy choices. Consider a few facts found in the March issue of the respected journal “Health Affairs”:

* Inflation-adjusted food prices have been falling from 1997 to 2003 except for prices for fruit and vegetables which have risen by 17%.

* Children ages 2-6 consume 182 more calories per day than they did 30 years ago.

* While over the last 20 years adolescents have become more personally responsible in many ways – lowering alcohol use, refusing in larger numbers to ride with impaired drivers, wearing seat belts at a much higher rate – that same focus on personal responsibility hasn’t translated into more responsible eating and exercise habits.

* Sugar-sweetened beverages, like my favorite, Mountain Dew, are the “single greatest source of added sugar in the American diet,” accounting for the vast majority of the 22 percent increase in consumption of sweeteners in the US diet since 1977.

So, food that has vastly more calories is cheaper and much more widely available than when I was a kid. Couple this with the lack of parks, sidewalks and bike paths in many communities, an emphasis on screen time for many kids instead of going outside, and relentless advertising of soda and fast food and you get the childhood obesity problem.

Solutions aren’t simple and don’t lend themselves to easy categorization. Clearly, just saying it’s up to parents to make better choices isn’t going to work as a sole strategy. Parents do need to make better choices, but the environment they make those choices in has to improve too so those choices are supported. The cheapest Mountain Dew in 25 years sitting alongside expensive fruit and vegetables isn’t a framework for success. Some combination of asking for changes in personal decisions coupled with more balance in the environment will be a start.