Lack of access to exercise facilities, particularly
in low-income areas, is one force that's driving the obesity
epidemic that's endangering children.
But "food insecurity," a term used to describe
the feeling generated by not having a guaranteed food
supply, doesn't seem to be a factor in the trend.
Those are the conclusions of two studies that appear
in the February issue of Pediatrics.
"Our country faces a serious obesity problem --
one that disproportionately impacts poor, minority individuals
and communities," said Penny Gordon-Larsen, an assistant
professor of nutrition at the University of North Carolina's
School of Public Health and Medicine, and the author of
the physical activity study. "Our research suggests
that perhaps one way to address this would be to argue
for greater opportunities for exercise in disadvantaged
communities."
The number of overweight American children has more than
doubled in the past 20 years. In 1980, about 7 percent
of kids were overweight; by 2002, that number had climbed
to 16 percent, according to the U.S. Centers for Disease
Control and Prevention.
The reason for the increase is both simple and complex.
The simple reason is that today's children are consuming
more calories than they are expending. But there are many
factors driving this change in behavior, and the two new
studies sought to define or discredit some of the suspected
forces behind childhood obesity.
The first study included geographic and socioeconomic
information from across the country. The researchers also
gathered statistics on the number of physical-activity
facilities and the rate of overweight and average physical
activity levels for each area. Physical-activity facilities
included schools, public recreation facilities, parks
and YMCAs, as well as dance studios and private gyms.
"We found that more disadvantaged communities have
a great deficiency in terms of the number and types of
exercise facilities available. Working class, minority
communities get a double whammy -- they are at greatest
disadvantage in terms of exercise facilities and opportunities,"
Gordon-Larsen said.
Not surprisingly, the lack of places to exercise had
on effect on both activity levels and the prevalence of
overweight.
The second study, by researchers at Tulane University,
included a national sample of nearly 17,000 kindergarten
children. Height and weight measurements were taken so
the researchers could calculate the body mass index (BMI,
a ratio of height to weight) for each child. "Food-insecurity
status" was measured using an 18-question test developed
by the U.S Department of Agriculture.
Prior studies done with women in "food-insecure"
homes had suggested a link between overweight and food
insecurity. The suspicion was that people who weren't
sure where their next meal was coming from might overeat
when food was available, or eat less-nutritious foods
that weare higher in calories.
The researchers found that about 11 percent of the children
were overweight. However, children from "food-insecure
households" were actually 20 percent less
likely to be overweight. The risk factors the researchers
found that did contribute to overweight were low physical
activity, watching more than two hours of TV a day, having
a high birth weight, being from a low-income family, and
being either black or Latino.
"There are strong arguments for reducing food insecurity
among households with young children. This research suggests
that these arguments would be based on reasons other than
a potential link to obesity," the authors wrote.
Dr. Adam Aponte is a pediatrician and medical director
at North General Diagnostic and Treatment Center in New
York City who said he wasn't surprised by either finding.
Childhood obesity is a problem that needs to be dealt
with on many levels -- at home, in school and around the
community, he said.
In the area he serves in New York City, safety and access
to physical-activity facilities are often issues. He said
he advises his patients on ways to get exercise at home,
with something as simple as stretch bands. Or, he said,
for people who live in apartment buildings, if stairwells
are safe, people can walk at least part way up rather
than taking the elevator. He said health-care providers
can often recommend places, such as a YMCA, that will
let children come in and participate, regardless of their
income.
"The key is prevention. With children, the younger
you start developing healthy lifestyle habits, the easier
it is to keep them in good shape," Aponte said.
