Childhood obesity is the most prevalent pediatric disease in the United
States, with the number of obese children in America tripling in the past
three decades. As one of the most serious health problems in our nation,
obesity is associated with significant health problems in children and
Body Mass Index (BMI) for age percentile is the most common tool used to
screen pediatric patients ages 2 through 18 for indicators of being overweight
or obese. BMI measures the height and weight of the individual –
a BMI for age percentile with 85 to 94 percent is considered overweight
and results greater than or equal to the 95th percentile are defined as obese.
What factors contribute to being overweight or obese?
High energy, high fat diets and sedentary lifestyles are thought to be
the major factors in increased weight. Food habits and preferences are
established during pre-school ages influence food habits throughout life,
so poor habits early on can have long-lasting effects.
How can this trend be reversed or avoided?
Prevention is the preferred approach to winning the war on obesity. Starting
at birth, all children should be encouraged to adopt healthy lifestyles
that prevent obesity.
Strategies to prevent obesity include:
- Limiting sugar-sweetened beverages, including juice
- Encouraging consumption of recommended amounts of fruits and vegetables
- Limiting screen time – television, computers, video games, smart
phones and tablets – to less than 2 hours per day
- Eating breakfast every day
- Limiting eating out at restaurants, fast food establishments and takeout
food to one time per week
- Limiting portion sizes. Using MyPlate, the current nutrition guide published
by the U.S. Department of Agriculture, as a guide and following the 2010
dietary guidelines for Americans
- Engaging in at least 60 minutes every day of moderate to vigorous physical activity
When in doubt, follow the 5 – 2 – 1 – 0 rule:
- 5 servings of fruits and vegetables per day
- 2 hours or less of screen time per day
- 1 hour of physical activity per day
- 0 sweetened beverages
The goal for treating children who are overweight or obesity is to develop
lifelong healthy eating and physical activity behaviors for the child
and his or her family. Healthy behaviors stress family meal time –
meals should be eaten at a table with no distractions (no TV!), and food
should never be used as a reward.
Because children need adequate nutrition for growth and development, it
is important to make smart changes that include all the food groups. In
doing so, parents should focus on decreasing added sugars and added fats
while increasing whole grains; fruits and vegetables; lean protein and
foods rich in calcium.
Maintaining weight while gaining height can be the best strategy to treat
obese children. This approach allows the child to “grow into his
or her weight” and to lower the BMI percentile.
An evidence-based analysis of intervention literature showed positive effects
of multicomponent family based programs for school-age children and adolescents,
such as the Shapedown program offered at Barnabas Health. Shapedown is
the nation’s leading weight management program for children, teens
and their families. The program is held quarterly, with the next program
starting January 15 at the Pediatric Specialty Center located at 375 Mount
Pleasant Avenue, Suite 105 in West Orange.
Click here for more details.
Leslie Zarra Killeen is a registered dietitian and Certified Diabetes Educator at the Barnabas
Health Pediatric Specialty Center, a member of Barnabas Health Medical
Group. Killeen is trained in child, adolescent and adult weight management.
At the Pediatric Specialty Center, located in West Orange, Killeen oversees
nutrition education needs related to outpatient pediatric patients with
a focus on childhood obesity, type 1 and type 2 diabetes, endocrine disorders,
cystic fibrosis and gastrointestinal disorders. She earned an undergraduate
degree from Montclair State University and earned a Master of Science
in Clinical Nutrition from New York University. She is an adjunct instructor
at Montclair State University.