girl-with-melon1When was the last time you saw a child walk into a fast food restaurant with their parents and insist on wanting the salad and a glass of water or milk rather than the burger, fries, and soda? If that is your child, please share with all of us how you have made that happen. The norm is for children — and often parents — to go with the immediate gratification of foods that may taste great, but that come with a caloric “after burn” when foods and beverages high in saturated fat and added sugars enter our bodies and start to cause unhealthy weigh gain. This weight gain can and will lead to fat deposits that increase the risk of that child becoming overweight or obese as they get older—and with that unhealthy increased weight gain comes increased risk of associated complications such as diabetes, high blood pressure, heart disease and stroke.

Sadly, while no one can tell you precisely what is causing the epidemic of obesity in children today, we know from well-done studies that there are multiple risk factors that can all contribute to this problem and they all can start during childhood. What are these risk factors—more sedentary behavior as children spend on average 7 hours a day watching television, or looking into computer screens to do homework, watch movies, or play video games. Then there’s the lack of exercise that seems to be more and more a risk factor, especially as schools cut back on their physical education programs. And there’s “portion distortion” involving increased serving sizes of high calorie unhealthy foods rich in added sugars and saturated fats that are certainly playing a role in the epidemic of obesity we are seeing in children and adults.

The portion distortion is not just in foods, but beverages as well–especially the sugary beverages such as soft drinks, fruit drinks, sport and energy drinks, and even vitamin waters that contain added sugars like sucrose and high fructose corn syrup. Did you know that to burn off the calories from a 12 ounce can of soda, a child weighing 75 pounds would need to bicycle briskly for 30 minutes? Even worse, that 12 ounce can of soda if drunk daily can increase the odds of a child becoming obese by 60 percent, given that 11 percent of the calories consumed by kids and teens daily come from the large servings of sugary drinks available to them. In fact, a person who reduces sugary drink consumption by one drink a day has been shown to lose as many as 15 pounds per year if they otherwise maintain their routine diet and exercise regimen.

So, what can be done to curb the obesity epidemic? We are reading in the news about the possibility of adding a tax on sugary drinks to curb purchasing of these drinks. Such a tax would certainly generate added revenues for the state that can then be invested in funding for obesity prevention and education programs as well as to improve access to health care for low income Vermonters. The tax might also help subsidize the purchase of healthy foods for families who have difficulty affording them, families who instead currently buy cheaper, non-nutritious foods and beverages in bulk that are contributing to the obesity epidemic today. Yet, while a sugary beverage tax if passed could help reduce the obesity risk in our state, it is far from a legislative done deal—so there are other things that can be done now and at the family level to reduce the chances that our children will grow up to be overweight and obese.

For example, as a parent, and although you do not have a medical license, you can write your child a “5-2-1-0” prescription. What is that? It calls for 5 servings of fruits and/or vegetables 2 hours or less of screen time, 1 hour of exercise, and 0 sugar sweetened beverages each and every day (or at least minimize those beverages for special occasions rather than make them a regular daily addition to your child’s diet). Another idea is to work in partnership with your child’s health care professional or a dietitian to help you create a healthier diet and exercise regimen that will be acceptable to your child—but it also needs to be acceptable to your entire family so everyone role-models the importance of eating healthy foods at recommended serving sizes, drinking non-sugary beverages (like water and low-fat milk), and daily exercising.

And who knows—maybe if we all work together to help lower the chances of our children becoming overweight and obese, having your child ask for the salad and no sugary beverage in a fast-food restaurant will be commonplace and no longer a rarity. When that happens, we will certainly drink (water) to that!

Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital. He is also Professor and Chair of the Department of Pediatrics at the Larner College of Medicine at UVM.

Jerry Larrabee, MD, is Chief of the Division of Academic General Pediatrics at The University of Vermont Children’s Hospital. 

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