Author: Ilaria St. Florian, MS, RD

It is one of this century’s most serious public health challenges. No, it’s not COVID-19. It’s childhood obesity.

Here are some troubling statistics: During the past four decades, childhood obesity in the U.S. has skyrocketed, from 5% in 1978 to 18.5% in 2016. Its prevalence has continued climbing since the pandemic. Last August, approximately 22% of U.S. children and teens were obese, up from 19% just one year before. Today, 1 in 5 children and adolescents lives with this potentially disabling and deadly condition.

As a registered dietitian, I treat many youngsters, whose excess weight puts them at risk for hypertension, hyperlipidemia, diabetes, sleep apnea, poor self-esteem, and depression. Even before the pandemic I saw kids — some as young as middle school-age — who were prediabetic or had fatty liver disease, hypertension, or high cholesterol. These young people are more likely than others to develop cardiovascular and digestive diseases as adults, as well as breast, colon, esophageal, kidney, and pancreatic cancers. Because their obesity started during childhood, it will be tougher to treat in adulthood.

To minimize obesity risk factors, you have to recognize them. The new school year is a perfect time to start.

First, let’s distinguish overweight from obesity. Both conditions indicate an unhealthy amount of body fat. Overweight children and adolescents have a body mass index above the 85th but less than the 95th percentile for age and gender. Those with obesity have a BMI greater than the 95th percentile. A BMI that exceeds the 99th percentile indicates severe obesity.

Numerous factors can influence children’s eating and exercise habits. Some are inherited, like genetics. Others are environmental, such as family stress, cultural attitudes toward food, low socioeconomic status, and limited access to safe recreation or affordable healthy food options.

At the height of the COVID-19 pandemic, some of the families I work with didn’t want their kids to go outside, either for fear of getting sick or unsafe neighborhoods. When learning went online, many of my patients lost their daily walks to and from school, not to mention recess, gym time, and sports programs. More kids spent time indoors glued to their screens. They even did schoolwork in bed. Parents were working from home, too. The fatigue of being inside made everybody sedentary. Many kids handled the stress and boredom of being home by grazing all day. So did parents.

The good news is that there are really simple steps everyone can take to combat this issue. Since children typically follow the models that their parents set, I educate everyone to follow this simple advice:

1. Choose healthy snacks. Skip refined carbohydrates like chips, pretzels, and cookies. They’re cheap and taste good but have no fiber or protein, so they don’t fill you up. Let your children enjoy a small bag of chips as long as they also have some cheese and carrot sticks.

2. Serve snacks on a plate. This allows your children to see what — and how much — they’re eating.

3. Buy healthy school lunches. Kids have the power to choose what they eat. They can either have pizza or a sandwich, piece of fruit, and milk. Help them make the best choices. If they don’t want fruit during lunch, encourage them to take a piece with them for later.

4. Eliminate soda and juice. Drinking juice is not the same as eating fruit. If your children must drink juice, then limit them to no more than 4-8 oz. daily and make sure it’s 100% fruit juice without any added sugar.

5. Set mealtimes to prevent all-day grazing and late-night eating.

6. Discourage long naps for older kids. They tend to sleep when they come home from school, stay up late, and eat at odd hours, which can cause weight gain.

7. Limit screen time. Research suggests that U.S. children engage in more than six hours per day of television watching, video gaming, blogging, or other social media. If they’re in front of a screen, they’re not exercising.

8. Remove phones from children’s room at night so they sleep. One study found that 3-year-olds who got fewer than 10.5 hours of sleep nightly were 45% more likely than those who got more than 12 hours of sleep to develop obesity by age 7.

9. Stock up on healthy staples — like beans, fresh fruits, and vegetables.

10. Model mindful eating. Eat sitting down at a table and be aware and appreciate your food. Scarfing meals leads to overeating.

Parents are their kids’ best teachers. The sooner you expose your children to healthy foods and eating habits, the more equipped they’ll be to avoid unhealthy weight gain and the problems it can bring.