Children around the world are eating more like Americans-- and getting dangerously
fat as a result
Monday, Aug. 18, 2003
By J. Madeleine Nash/Helsinki
Eight-year-old Hannah McGoey lives in an upstairs apartment on a busy thoroughfare in
London. She has no yard to play in, and her school holds physical-education classes just
two days a week. Her busy parents tried to be careful about nutrition, giving up their
Friday fish and chips, for example. But over the years, Hannah only became plumper. By
the time she turned 6, children's sizes no longer fit her. "I would have to buy jeans
for 12- and 14-year-olds," her mother Julia remembers, "and then cut a foot and a half
off the leg."
But things began to change when a school nurse told the McGoeys about a program
called MEND (mind, exercise, nutrition, diet), started by Paul Sacher, a dietitian at
London's Great Ormond Street Hospital for Children. Hannah enrolled last September, and
by the time the program ended 10 weeks later, she had shed nearly 5 lbs. and grown more
than an inch. That wasn't all. Once a shy, clingy child, Hannah, who is now 4 ft. 11 in.
tall and weighs 84 lbs., brims with confidence and loves physical activity. "I didn't
swim much before," she says. "Now I go swimming once a week."
Hannah McGoey, unfortunately, is a rare exception to what is rapidly becoming a
global epidemic of childhood obesity. More and more countries around the world — even
some that have been struggling to prevent starvation — are now wrestling with the
dangers of excessive nutrition. The U.S. continues to lead the way, with as many as 37%
of its children and adolescents carrying around too much fat. But other countries are
rapidly catching up. According to statistics presented recently at the European Congress
on Obesity in Helsinki, Finland, more than 20% of European youngsters between the ages
of 5 and 17 are either overweight or obese. Children in North Africa and the Middle East
aren't far behind. Across Asia too, childhood obesity is on the rise, and the trend has
been documented even in urbanized areas of sub-Saharan Africa.
"These figures should set alarm bells ringing in ministries of health across the
developed and developing world," says Tim Lobstein, co-editor of a forthcoming report to
the World Health Organization on childhood obesity. And with good reason: people who are
obese as children have a high risk of becoming obese adults — meaning they will have a
much higher risk than their slender counterparts of contracting a broad range of
debilitating diseases, including heart disease, hypertension, diabetes and cancer. The
surge of obesity among children, in short, presages a global explosion of illnesses that
will drain economies, create enormous suffering and cause millions of premature deaths.
"This is a true health-care crisis," says Robert Lustig, a pediatric endocrinologist at
the University of California, San Francisco, far bigger than severe acute respiratory
syndrome (SARS) and ultimately, he thinks, even bigger than AIDS.
According to Hungarian pediatrician Dr. Denes Molnar, fully 9% of obese children and
adolescents already suffer from a premorbid condition known as metabolic syndrome. Among
the most worrisome symptoms are changes in blood chemistry that can trigger future
health problems. A substantial fraction of chubby kids, for example, have elevated
levels of LDL cholesterol, putting them at risk for atherosclerosis. Many also have
elevated blood-sugar levels, a precursor of Type 2 diabetes. Around the world, the
prevalence of Type 2 diabetes, formerly known as adult-onset diabetes, is soaring in the
under-18 crowd. As a result, complications like nerve and eye damage, which typically
take years to develop, are suddenly popping up among people in their 20s.
Why do children become obese? One important factor is insulin, which enables the body
to store extra calories as fat. Physical exercise helps control insulin levels, while
certain foods elicit its massive release. For example, ingesting fat alone doesn't
prompt a big surge in insulin, but fat combined with starches and sugar does. A child
who sits in front of the TV for hours on end, eating potato chips and doughnuts, is an
ideal fat-storage machine.
Genetics can make a difference as well. Those who are most susceptible to gaining
weight on high-fat, carbohydrate-rich diets are those who are primed to produce high
levels of circulating insulin in the first place. Among them are the inhabitants of the
South Pacific island of Nauru, who — thanks to a surfeit of cheap, calorie-dense foods,
along with a shift away from jobs requiring physical activity — have the unwelcome
distinction of being some of the fattest, most diabetes-prone people on the planet.
Alas, the Nauruan experience, while extreme, is not unique. Asia, for instance, lags
behind the U.S. and Europe in its obesity statistics, but Thailand, Malaysia, Japan and
the Philippines have all reported troubling increases in recent years. In China, where a
one-child-per-family policy has created millions of spoiled and overnourished children
(feeding a phenomenon known as little-emperor syndrome), the rise in childhood obesity
is particularly alarming. Up to 10% of China's 290 million children are believed to be
overweight or obese, and that percentage is expected to have doubled a decade from now.
Hannah McGoey is an example of the positive things that can happen when schools,
health professionals, parents and children work together. Encouragingly, changing a
family's lifestyle in healthy ways does not appear to be all that difficult. "It was a
bit of this, a bit of that, more exercise, slightly smaller portions, slightly different
foods," Hannah's mother recalls. And this, say health officials, is a message that badly
needs to get out. Parental involvement is critical since so much of modern life —
streets without sidewalks, housing developments without parks, schools without exercise
programs — conspires with TV, computer games, soft-drink machines and fast-food outlets
to make it hard for children on their own to avoid gaining weight.
That adults are finally becoming aware of the problem and are willing to do something
about it, says Dr. Philip James, chairman of the London-based International Obesity
TaskForce, is extremely positive. But unless they do so in much greater numbers, the
steady increase in life expectancy that has marked the 20th century may reverse itself
in the 21st, and far too many members of the next generation could end up dying before
their parents.
With reporting by Helen Gibson/London
Copyright © 2003 Time Inc. All rights reserved.
Reproduction in whole or in part without permission is prohibited.
