The Role of Family Habits in Addressing Child Obesity

Currently, a third of American kids – 1 in 3 children – are overweight or obese, and struggling with metabolic dysfunction (they have trouble turning glucose into energy, so it stores as fat tissue). Trending alongside childhood obesity are increasing rates of childhood T2D diagnoses. Once called Adult Onset Diabetes, this lifestyle disease has been renamed T2D to capture children, including those as young as two and three years of age. Teenagers are also struggling with this epidemic, as one in four teenage boys has pre-diabetes or T2D.

Obesity often has long lasting effects as it follows children into adulthood. Children with obesity are 70% more likely to continue being affected by obesity into adulthood, and can expect an average lifespan decrease of 13 years. Additionally, these children are at greater risk for other medical issues in both childhood and adulthood such as:

• Heart disease
• High cholesterol
• High blood pressure (hypertension)
• Sleep apnea and disordered airway 
• Cancer
• T2D (both insulin- and non-insulin dependent types).

Physical health conditions aren’t the only concerns for these children: their mental and emotional wellbeing can suffer as well. Children with obesity are more prone to social discrimination and bullying, both of which can lead to low self-esteem and depression.

So what’s driving obesity increases and comorbidities such as diabetes, high cholesterol, and hypertension in children?

There are many factors that include:

• Epigenetics, or how genetics express in response to environmental factors 
• Mother’s pregnancy and her ability to regulate blood sugar 
• Breastfeeding vs formula use 
• Nutritional choices throughout childhood
• Food marketing aimed at children
• Environmental toxin exposure, including in food packaging and personal care products 
• Gut health
• Frequency and intensity of movement
• Social economic factors
• Stress on parents and kids
• Federal policies

In addition to obesity and T2D, it’s not uncommon to find impacted children simultaneously and ironically malnourished: Obesity can stem from ongoing consumption of “empty calories,” or foods that are high in calories but low in nutrients. Researchers indicate that children ages 5 to 18 are consuming approximately 720 to 950 empty calories every day within their overall diet, a large percentage of the total recommended 1600 to 3100 calories per day depending on age group and gender. The total calorie recommendations are set with the intention of exposing American children to the full range of nutrients necessary for optimal health and growth. Yet despite achieving adequate caloric intake, given the high percentage of empty calories consumed, young people are still falling short of the recommended consumption of fruits and vegetables, and along with it, nutrients such as fiber, folate, vitamin K, magnesium, and potassium. Instead, their calories come from added processed fats and sugars, which have little nutritional value. This leads to a triple whammy of being overfed, inflamed, and undernourished.

Treating obesity in children and adolescents differs from treatment in adults. Rather than solely focusing on the individual, it’s important to establish healthy patterns across the entire family. Humans, especially children, are impressionable and want a sense of belonging. The actions and choices they see their families and friends making are imprinted and follow them into adulthood.

Here are some strategies and solutions to establishing healthy habits amongst your family. 

1. Breastfeeding: If you’re a new mother, breastfeeding your baby may prevent obesity. Breastmilk provides your baby with food that is easy to digest and is high in nutrition. In addition, it helps to regulate your baby’s food intake as they decide how much to eat and when. Both the breastmilk itself and the way your baby feeds help him or her to develop healthy eating patterns, which can follow them into later years. Breastmilk also contains bioactive components and specific microbes that influence appetite and weight gain, including growth factors and hormones, which are not present in infant formulas. If you are struggling with breastfeeding, we highly recommend seeking the support of a local IBCLC to determine the cause of the issues and get you back on track. 
2. Optimize the Gut Microbiome: The medical community used to believe that obesity was a result of eating too many calories and not moving enough. However, now studies are confirming that the microbes living in our gut aren’t only associated with obesity, but can also be a cause. Some of the ways in which the gut microbiome can contribute to obesity include production of increased levels of short chain fatty acids (SCFAs), which provide an extra energy source for human gut cells and then get stored as fats or sugar when in excess. Another means of contribution includes increased levels of a bacterial byproduct called Lipopolysaccharide (“LPS”) that can lead to low-grade inflammation and insulin resistance. Additionally, in infants, the changes in the microbiome from the use of breastfeeding vs. formula feeding impact how the babies store and use energy. To optimize, we first recommend ensuring consumption of whole unprocessed foods and adequate fiber in the diet from fruits, veggies, and whole grains. 
3. Pack School Lunches: A 2009 study published in Preventing Chronic Disease found that adolescents who usually brought their lunch from home 5 days per week “ate fast food on fewer occasions, consumed fewer servings of soda, fried potatoes and high-sugar foods, and ate more fruits and vegetables compared with adolescents who never brought their lunch to school.” Get your child involved in the process.  Give them some healthy food choices and allow them to choose what they’d like to include. Once you’ve planned the meals together, allow your child to shop and prepare the lunches with you. Being involved in the decision making and preparation builds their confidence, teaches them how to make decisions, gets them excited to eat healthily, and establishes lifelong healthy habits.
4. Cook Meals at Home: Research shows that families spend about 40 percent of their food dollars on food away from home. At these establishments, children are often served portions that are too large, too high in calories, and too high in sodium and/or sugar. Many of these meals are often also high in fried or processed carbohydrates, white carbohydrates (e.g. white bread, french fries, mashed potatoes), harmful fats, with minimal colorful fruits and vegetables. Eating meals outside of the home on a regular basis increases you and your child’s risk of obesity. Be sure to include an abundance of vegetables, proteins, and healthy fats at each meal and make meals a time to come together as a family. 
5. Increase Physical Activity: Data shows that young people who are more physically active have lower levels of body fat than those who are less active. The CDC recommends at least one hour of physical activity every day for children and adolescents from the ages of 6 to 17. Moving regularly will decrease the risk of developing childhood obesity while also reducing stress and anxiety levels, promoting mental health, and building strong bones and muscles. Beyond just needing more physical activity, movement in nature has even more beneficial impacts than simply reducing risk of obesity. Playing out in natural play spaces provides more diverse forms of playing, thereby enhancing children’s creativity, problem solving skills, communication with other children, developmental and proprioceptive capacity (understanding where their body is in space and developing gross motor skills), and increasing physical activity. Lastly, playing in nature exposes children to a diverse array of microbes that can help establish balanced immune systems.
6. Ensure Ample Sleep: Most kids are not sleeping enough, and that has a huge impact on their metabolism. Sleep deprivation increases the risk of weight gain by means of increasing blood sugar, insulin, and an appetite-inducing hormone called ghrelin, which makes them hungry and have cravings for quick energy foods such as refined carbs. Essentially, when kids don’t sleep enough, they’re hungrier and crave more sugar and carbs, which then also increases inflammation. Teenagers need 8 to 10 hours of sleep per night, 6 to 12 year old’s need 9 to 12 hours of sleep at night, and 1 to 2 year old’s need 11 to 14 hours. Additionally, children that go to bed before 8pm have a lower rate of weight gain and a lower risk of obesity.
7. Lead by Example: According to new research, children who have parents that are overweight are 80% more likely to suffer from childhood obesity. Children imitate their parents, which means habits are inherited more so than genes. Leading by example doesn’t call for perfection by any means. In fact, if adults can learn from their mistakes and can pass on those lessons to their children, the kiddos benefit greatly.

Raising a family isn’t always easy. You and your kids are busy running from various events, but the stakes are high. Studies have proven that if you’re overweight as a child, you’re more likely to have weight issues as an adult. While it may seem daunting to make changes to your life, the truth is, it’s easier than you might think. Instead of trying to overhaul everything all at once, make tiny tweaks to what you’re already doing. Perhaps get the entire family involved in deciding which tweaks should be made first and which slowly evolve over time. The most important thing is to make the process fun for everyone and know that the habits you’re creating for your family now will influence their choices into adulthood. 
If your family is struggling to make changes, our health coaches can help! Please reach out to find out more information about health coaching services.