Study urges starting child obesity battle before birth
3-year-old Hispanics found to be far heavier than black, white counterparts
By ERIC BERGER
Copyright 2006 Houston Chronicle
As evidence documenting the increasing heft of school-age children mounted during the past decade, Texas passed laws requiring more physical activity and less junk food in schools, especially for the youngest students.
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But what if such interventions, even those beginning as early as first grade, still come too late?
That's one possibility raised by a new, national review of 3-year-old children that found nearly 1-in-5 were obese.
Perhaps more disconcerting for Texas and its rapidly growing population of Latinos, the study found that Hispanic children were, by far, the heaviest group.
Of Hispanic children, 25.8 percent were labeled obese, compared with 14.8 percent of whites, and 16.2 percent of blacks.
The study, published in this month's Archives of Pediatrics & Adolescent Medicine, is the largest-ever snapshot of the weights of very young children.
"I, frankly, think that getting children engaged in healthy activities in school, while important and reasonable for many children, is too late to intervene," said Dr. Robert Whitaker, a researcher with Mathematica Policy Review, a Princeton, N.J.-based private research firm that studies socioeconomic issues.
Diet, exercise emphasized
Whitaker said the prevailing wisdom among policy-makers is that the best way to stem childhood obesity is by encouraging children to be more active and eat nutritious foods in hopes of establishing lifelong, healthy habits.
In 2001, the Texas Legislature passed a bill, which takes full effect next year, requiring every school district to implement health programs in which students exercise more, eat better and learn healthy habits in all elementary schools.
But the new study, Whitaker said, suggests that efforts to curb obesity must begin earlier, possibly even during prenatal care.
Pregnant women who gain more weight than average tend to have larger infants, said Dr. Audra Timmins, an assistant professor of Obstetrics & Gynecology at Baylor College of Medicine. Larger infants — short and stocky — are more likely to become overweight and obese adults, she said.
Timmins said there are no formal guidelines for educating mothers-to-be about how their diets might affect their child's future weight, but said there is an ongoing discussion about the problem in the OB/GYN community.
"Obesity is an issue that is everyone's responsibility to try and combat," Timmins said.
The study's authors could not explain why Hispanic children were more obese than their black or white counterparts.
Among Texas children under the age of 10, Hispanics already slightly outnumber Anglos. By 2040, State Demographer Steve H. Murdock has estimated, more than two-thirds of the Texas population under the age of 18 will be Hispanic.
The health costs of treating heavier children, who develop diabetes and heart problems at an earlier age, are higher than those for children of normal weights.
"This is a very worrisome problem for Texas," said Dr. Jane Lynch, an associate professor of pediatrics at the University of Texas Health Science Center at San Antonio. "There appears to be a real correlation here between Hispanic children and obesity."
The cause, however, is more elusive.
Socioeconomic factors — such as access to healthy foods and safe playgrounds — didn't make much of a difference in the prevalence of obesity in children, said Whitaker, the study's author. The Hispanic and black children in the study had similar economic backgrounds, he said.
Image of health varies
In an editorial published alongside the new study, Dr. Elena Fuentes-Afflick, of San Francisco General Hospital, suggests one reason may be that Hispanic parents value chubby babies.
"For Latino immigrants, who may have experienced hunger as children or witnessed the adverse effects of malnutrition, the ideal image of a healthy baby or child may be an overweight image by current body mass standards," Fuentes-Afflick wrote.
Norma Olvera, an associate professor in the University of Houston's Department of Health and Human Performance, agreed. Olvera said Hispanic parents tell her they routinely ignore advice from their pediatricians to put their young children on diets.
One solution, she said, is educating mothers early: Don't stop breastfeeding too soon, don't put babies on solid food too early, and — Olvera has witnessed this many times — don't put soft drinks into a baby's bottle.
"There's a limited knowledge among some parents of what is appropriate for babies," said Olvera, who teaches immigrant mothers and their children healthier habits.
"We need to attack this problem through better education."
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