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Living Too  Large

Living Too Large

A Look at the Chicago Childhood Obesity Epidemic

By Morgan Lord

When it comes to childhood obesity in Chicago, there’s good news,­ and there’s an overwhelming amount of bad news.

Here’s the bad news first. “Childhood obesity is definitely becoming a bigger issue in Chicago,” says Dr. Mary Westerholm, a physician at Central DuPage Hospital (CDH). The rate of obesity for children aged 2 to 5 years in Chicago is more than twice as high (22 percent) as the national average (10 percent).

The good news? Obesity rates in children entering kindergarten have fallen from 24 percent to 22 percent in just five years, according to the most recent data collected in 2008 by the Consortium to Lower Obesity in Chicago Children (CLOCC), a childhood obesity prevention program within Lurie Children’s Hospital.

But then we’re brought back to the bad news because the obesity rates for students entering sixth grade are not as positive. While the number of obese kindergartners has dropped, the weight is back on by junior high school, with 28 percent of the kids walking into class being obese. That’s over 50 percent higher than the national average for the same age group. So why is the problem of childhood obesity so great in Chicago?

“That’s the million-dollar question,” says Dr. Adam Becker, executive director at CLOCC. “And we don’t know the answer.”

When comparing Chicago to other large cities, such as New York City, where the issue of childhood obesity is not as high, Becker points to the condensed geography of NYC and the fact that the city is not as isolated and segregated as Chicago. In a city like New York, people have greater accessibility to grocery stores, healthcare and green spaces, Becker says.

Another issue in sprawling Chicago is that poorer neighborhoods have less-safe parks and breed crime and safety issues, which inhibits children from playing, walking and exercising outside. According to Becker, it should also be noted that not all cities document obesity statistics to the rate that we do in Chicago, which could attribute to skewed data, when comparing our rates to those of other large cities.

One contributing factor could be an influx of African Americans from the Gulf South to the Midwest in the 1950s and 60s. “The Gulf South has some of the highest obesity rates in the country,” Becker says. This population could have a genetic disposition to packing on the pounds, and that group has migrated to the Midwest.

The epic issue of childhood obesity finds a home here in Chicago, but now what?

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“We need to maximize opportunities for Chicago children and families to make healthy food and physical-activity choices,” Becker says. “We also need to keep advocating for policies that promote healthy living.”

Over the past 30 years, the “obesity rates have increased exponentially,” Becker says. And it’s not just a problem affecting Chicago; it’s a nationwide epidemic—since 1980, obesity prevalence among children and adolescents has almost tripled, according to the Centers for Disease Control and Prevention (CDC).

With the influx of childhood obesity comes a slew of other diseases. “Children are now experiencing diseases [traditionally manifested in adulthood],” Westerholm says. “Along with obesity, kids are dealing with type 2 diabetes, high cholesterol, heart disease, asthma, sleep apnea and acid reflux—diseases that pediatricians never had to deal with,” Becker says.

A City Divided

Nationwide, when it comes to childhood obesity, there are significant racial and ethnic disparities, according to the CDC. Here in Chicago, the same rings true. Some of the highest rates of childhood obesity and type 2 diabetes are in the lower-income neighborhoods such as Humboldt Park, West Town, South Lawndale, North Lawndale and Roseland. In fact, according to a 2004 Sinai Health System Community Health Survey, in these neighborhoods, two out of every three children (that’s 58 percent – 68 percent) were either overweight or obese.

According to the same survey: “It is worth noting that 20 percent of black children nationally and 23 percent of black children in New York City are obese. Compare this with 52 percent in North Lawndale and 51 percent in Roseland. Also, with the exception of Norwood Park (a predominantly non-Hispanic white, middle-class community), obesity rates for children aged 6 to 12 years ranged from 33 percent to 52 percent. These figures are nearly two times greater than what was
reported for New York City as a whole, and more than three times greater than national figures.”

“There are a number of increased risk factors at play here, including socioeconomic factors, lack of resources, cultural thinking and genetic disposition,” Westerholm says. “Obesity and type 2 diabetes are preventable diseases, but preventing childhood obesity is a whole-family effort. Kids aren’t the ones going grocery shopping and cooking, so we need to provide the resources to help children and parents make healthy choices.”

What Is Chicago Doing?

In some neighborhood grocery stores, it’s difficult to find fresh vegetables and far easier and cheaper to eat what’s highly caloric. It can even be too dangerous to play outside, which leads to children being sedentary in their homes. Thankfully, CLOCC and the city of Chicago have been incredibly proactive over the last decade, Becker says.

With the creation of Healthy Places—a joint partnership between the Chicago Department of Public Health and CLOCC—the city is working to “implement sustainable policies, systems and environmental changes that address obesity in Chicago by creating healthier environments where Chicagoans live, work, learn and play,” according to CLOCC.

Chicago is increasing access to fresh and healthy foods through healthier vending-machine options throughout city parks; mobile produce carts that bring in affordable, fresh fruits and vegetables to lower-income areas; community gardens; and corner stores with healthy options. The city has also stressed the importance of physical activity by designing street and sidewalk access for bikes and walking paths as well as safe access to parks.

Chicago Public Schools are also on board with healthy food options on their menus and an increase in physical activity during school and after-school programs. Nutrition and wellness education is stressed not only in schools but citywide. CLOCC promotes the media campaign called 5-4-3-2-1 Go!, which promotes a healthy lifestyle for kids and families. Each number represents a healthy daily plan: In hospitals, the city has been increasing its support for breastfeeding—which has been shown to decrease childhood obesity—through the promotion of what healthcare professionals are calling the baby-friendly hospital initiative, which works to promote a breastfeeding environment in Chicago hospitals and educate the community about breastfeeding benefits.

In January 2013, CLOCC will be issuing a detailed report—a “blueprint for accelerating progress in childhood obesity prevention in Chicago,” Becker says. The report will include research regarding what we’ve learned about Chicago’s childhood obesity epidemic in the past decade, and what we have been doing this year and can do in the future to combat childhood obesity in the next decade.

What Can You Do?

Although an epidemic as large as childhood obesity can be overwhelming, taking small steps to begin living a healthier lifestyle can make it seem more approachable.

When it comes to how many calories a day a child should consume, Dr. Westerholm says that there is no straight answer; that it is different for every child, depending on the child’s current body size, activity level, metabolic rate, and where each child is at in the growth spurt. Instead of limiting calories, allow healthy snacks, avoid sugary sodas and juices, practice portion control, and cut out the oil and butter when cooking, keep screen time (which includes television, video games and the computer) to a minimum—it’s not only easy to eat more while sitting in front of a screen, but watching aggressive and tantalizing marketing ads for foods on TV can also be a problem. Simple steps to childhood obesity prevention include:

Rethink drinks. Nix sugary beverages, such as soda and juice, from your child’s diet—it’s an easy way to carve 400–500 calories off the daily caloric intake. According to a 2012 CDC Illinois State profile survey, 31 percent of Illinois residents drank a can, bottle or glass of soda or pop (not including diet soda or diet pop) at least one time per day during the seven days before the survey. That adds up to an additional 240 calories for each 20-ounce bottle. Add a 16-ounce Snapple Lemon Iced Tea from the vending machine for an afternoon thirst quench, and you’re up to 440 calories in one day, with just two drinks. And while most of us know that soda is chock-full of calories, many of us are unaware of the calories in juice. A 20-ounce glass of 100 percent orange juice contains 280 calories, and a 20-ounce glass of 100 percent apple juice contains 300 calories, although numbers vary brand to brand. According to Westerholm, if you cut out 500 calories from your diet a day, you could lose a pound a week—one pound is the equivalent of 3,500 calories. If a child is suffering from obesity, rethinking ­­­juice and soda every day could save at least a pound a week.

Practice portion control. The average restaurant meal is about four times the size that it was back in the 1950s, according to the CDC. “You have to retrain your brain about the correct portion size,” Westerholm says. The CDC recommends splitting meals when you eat out or taking some home with you for another meal. To keep kids from overeating at mealtime, let them eat a healthy snack, like a piece of fruit or small salad, before dinner. The CDC also recommends dividing up the contents of one large package, like a bag of pretzels or crackers, into several smaller bags to help avoid overeating.

Get physical. “Play for 60 minutes a day,” Westerholm says. “And if you can’t go outside, reserve an area of the house for activities.” According to the 2012 CDC Illinois State profile survey, 24 percent of kids were physically active for a total of at least 60 minutes per day. That means 76 percent were not. Get kids to play, and get their adrenaline pumping for an hour each day. Whether it’s inside or around your home, be active with your kids.

According to the Illinois State Nutrition, Physical Activity and Obesity Profile, active parents lead to active kids. And it could be as simple as an evening walk. Also, minimize television-viewing time. According to the CDC, about 36 percent of kids watched television three or more hours per day on an average school day. CLOCC recommends two hours or less of screen time a day, which includes TV, playing on a computer and video games.

Published in Chicago Health Winter/Spring 2013

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