September is National Childhood Obesity Awareness Month

By Parul Kharod

According to the Center for Disease Control, almost 20 percent of children in the USA are obese. Childhood obesity is a major public health problem, not just in the US, but across the world. The prevalence has increased at an alarming rate. According to the World Health Organization, in 2016 the number of overweight children under the age of five was estimated to be over 41 million. Almost half of all overweight children under five lived in Asia and one quarter lived in Africa.

Measuring Childhood obesity

A child is defined as “affected by obesity" if their body mass index-for-age (or BMI-for-age) percentile is greater than 95 percent. A child is defined as “overweight" if their BMI-for-age percentile is greater than 85 percent and less than 95 percent.

Risk Factors of Childhood Obesity

Children with obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and Type 2 diabetes. They also have more risk factors for heart disease like high blood pressure and high cholesterol than their normal weight peers.

Children with obesity can be bullied and teased more than their normal weight peers. They are also more likely to suffer from social isolation, depression, and lower self-esteem.

Children with obesity are more likely to have obesity as adults. This can lead to lifelong physical and mental health problems. Adult obesity is associated with a higher risk of Type 2 diabetes, heart disease, and many types of cancers.

Obese children are also prone to a skin condition called Acanthosis nigricans, which has been linked to insulin resistance. It causes thick dark skin patches in various joints and folds of the body, most commonly seen on the back of the neck.

Causes of Childhood Obesity

Many factors can have an impact on childhood obesity, including eating and physical activity behaviors, genetics, metabolism, family and home environment, and community and social factors.

There are some common causes which are related to increased obesity.

• Too much time spent sitting and being inactive
• Lack of adequate sleep
• Lack of places to go in the community to get physical activity
• Easy access to cheap high calorie foods and sugary beverages
• Lack of exposure to healthy foods
• Lack of parents' ability or knowledge to cook healthy foods at home

What can be done?

The good news is that childhood obesity can be prevented. There are several ways parents and communities can come together to make positive changes.

Help Kids Develop Healthy Eating Habits

Serve and eat a variety of colorful fruits and vegetables
Serve reasonably-sized portions of all foods
Encourage your family to drink lots of water
Limit or avoid sugary beverages, including soda, sweet tea, juice, Gatorade, fruit punch, etc.
Limit consumption of sugar and saturated fat
Limit pantry snacks - processed packaged foods
Keep healthy snacks in the refrigerator – fruits, yogurt, hummus, salsa, cut up veggies, bean dip
Limit eating out- limit or avoid fast food
Cook healthy family meals
Look for ways to make favorite dishes healthier
Eat dinner together as a family
Make meal times fun by talking to each other
Practice mindful eating – no TV or devices on the dinner table!
Visit the farmer's market to try new seasonal vegetables.

Regular Physical Activity

It is important to get a consistent of physical activity and avoid too much sedentary time. In addition to being fun for children, regular physical activity has many health benefits, including:

Strengthening bones
Decreasing blood pressure
Reducing stress and anxiety
Increasing self-esteem
Helping with weight management

Children should participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily. Remember that children imitate adults. Start adding physical activity to your own daily routine and encourage your child to join you.

According to CDC, children ages 8-10 spend six hours of screen time, whereas children ages 11-14 spend about nine hours of the day in front of a screen. In addition to encouraging physical activity, help children avoid too much sedentary time. Although quiet time for reading and homework is fine, limit the time your children watch television, play video games, or surf the web to no more than two hours per day. Additionally, the American Academy of Pediatrics (AAP) does not recommend television viewing for children aged two years or younger. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity.

How can Parents help?

• Be a role model – kids do what they see!
• Limit total screen time to no more than two hours per day
• Ensure at least one hour of outside activity
• Remove TV sets and game consoles from the child's bedroom
• Encourage activities that involve movement such as dancing, joining a team sports, walking the dog, bike ride, playing tag, jumping rope, dancing, help with chores such as yard work
• Make lifestyle changes to help the whole family develop healthy eating habits

Remember that small changes every day can lead to success!


Parul Kharod, MS, RD, LDN is a registered dietitian and licensed nutritionist and works as a Clinical Dietitian with Outpatient Nutrition Services at WakeMed Hospital in Cary and Raleigh. She can be reached at