Generation Extra Large: Rescuing Our Children from the Epidemic of Obesity

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9780465083916: Generation Extra Large: Rescuing Our Children from the Epidemic of Obesity
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A new epidemic is gripping the world. You can see it in San Antonio and London, in Beijing and Tashkent: Far too many kids are far too fat, putting them on track to becoming the first generation in history to have a shorter life expectancy than their parents. And it's not their fault. It's not their parents' fault, either. It's not even entirely Ronald McDonald's fault, although it's time for him to wipe that smile off his face. Obesity is the biggest threat to our children's health today, and it's up to us to get serious about defending kids against it. Generation Extra Large reveals the cultural and economic causes of childhood obesity. It's not only television, video games and junk food. Parents work long hours that disrupt family eating and exercise. Schools compound the problem by lining the halls with soda machines, serving fast food and cutting back physical education and recess. Poverty plays a key role, with kids growing up in neighborhoods where it's too dangerous to play and where unhealthy food is affordable and all too easy to get. But there is hope. Dedicated parents, educators, physicians, and community leaders are working to find creative, effective ways of helping our children slim down and stay healthy. The authors give voice to these crusaders, and provide checklists, interactive tests, and nutritional guides for concerned readers. Generation Extra Large explains why the epidemic has grown, reveals the consequences it has in store for our young people-and gives us tools to fight it.

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About the Author:

Lisa Tartamella is a nutritionist at Yale-New Haven Hospital's Centers of Nutrition, where she provides nutrition and wellness counseling to both adult and pediatric patients. In 1997, she was named Young Dietitian of the Year. She lives in New Haven, Connecticut. Elaine Herscher is a senior editor at Consumer Health Interactive, an online health and medical news organization in San Francisco. Her work on the San Francisco Chronicle AIDS reporting team resulted in a Pulitzer Prize nomination in 1989. She lives in San Francisco, California. Chris Woolston is a contributing editor at Consumer Health Interactive, where he writes about nutrition, children's health, and obesity. He lives in Billings, Montana.

From The Washington Post:

You don't have to commission a study to be convinced that American youngsters are fatter than they once were. Just get out your old yearbook -- or better still, one of your parents' yearbooks. Then compare the kids in those photos to those pouring out of schools these days. The once exceptional "chubbies" have been replaced by a small army of overweight youngsters, many of them struggling to do ordinary things -- like climbing on the school bus. The collective weight gain is not just a perception but a statistical reality.

Their excess baggage is not just making their lives socially miserable or simply putting them at risk for future health worries. Some already have high blood pressure. Type 2 diabetes, once called adult-onset diabetes, is increasing rampantly in obese children, say pediatricians. Between 1982 and 1994, a Cincinnati study found a tenfold increase in the disease in children. These youngsters are at risk for heart disease, blindness, kidney failure and amputations in early adulthood. Today's children, experts note grimly, may be the first generation to have shorter life spans than their parents.

What is behind this fat-cell explosion? Two new books, Generation Extra Large and Fed Up!, take on this complex question, looking at it from every angle. They cover remarkably similar ground, in slightly different styles. Generation Extra Large is science-based but uses a zingy prose style to enlighten, alarm and, the authors hope, activate. Fed Up! dwells longer on the science but concludes by offering thoroughly sound and detailed solutions to an exasperating problem. Either (or both) is a must-read for parents whose children are overweight -- or who hope to avoid the problem.

Both include frankly shocking revelations about what and how much children are eating -- a now-reformed Harlandale High School in San Antonio once allowed its students to spend their lunch money on full quarts of ice cream -- and how little they are moving. Both sets of authors optimistically suggest that the fattening of one generation could be reversed in the next.

The problem is actually international. In China the one-child policy has produced a generation of pampered and overstuffed children -- in the cities especially -- affectionately called "the Little Fatties." European children are suffering as well. The obesity rate for boys ages 4 to 11 in the United Kingdom nearly tripled between 1984 and 1994. Roughly 30 percent of 10-year-olds in Munich, Germany, are overweight; in a recent study of French 7-to-9-year-olds, 20 percent were overweight.

But, according to Lisa Tartamella, Elaine Herscher and Chris Woolston, the authors of Generation Extra Large, "In this as in so many global trends, the United States -- the country behind such innovations as chili dogs, cheese-stuffed pizza crusts, and sixty-four-ounce servings of soda -- is leading the way."

While genetics can certainly play a role in who gets fat, says Fed Up!'s author, Susan Okie, a former science writer for The Washington Post, that can't be the whole answer because the shift has taken place far too quickly. The unavoidable conclusion is that childhood obesity is a tragedy -- and tragically unnecessary -- because vulnerable children are being exposed to what Kelly Brownell of Yale University calls a "toxic environment." David L. Katz of the Yale School of Medicine puts it more bluntly: "Children growing up in the United States today will suffer more chronic disease and premature death because of the way they eat and their lack of physical activity than from exposure to tobacco, drugs, and alcohol combined."

The epidemic -- and it is an epidemic, even though not literally infectious -- can be blamed on a broad range of lifestyle and cultural shifts that both books devote the bulk of their pages to examining. Calling for "Personal Responsibility," the mantra of the moment, is asking a lot in the face of changes over which kids have little control. Biking or walking to school is becoming rare as automobile traffic increases and suburbs are built without sidewalks or bike paths. Schools work hard at keeping naturally active children quiet and in their seats. Many are cutting back on physical education and some have even eliminated recess. Safety concerns keep some kids indoors after school.

We've worked hard to make life easier, and that's part of the problem. The buses and cars, vacuum cleaners, drive-up windows, rechargeable screwdrivers, garbage disposals, dishwashers and power mowers have all taken a nibble at what was once everyday physical activity. And at the end of a power-driven day, too many children plop down in front of a television with a remote-control device in one hand and a bag of chips in the other. TV-watching is an established risk factor for being overweight, says Okie. Then they are barraged with ads for foods that aren't good for them.

From dawn to dusk, in fact, children run a gantlet of pushers urging them to consume high fat, high sugar, low-nutrient foods. Generation Extra Large's authors say that the food industry is not only "making a killing from kids' hardwiring" (to no one's surprise, kids like sugary, high fat foods), it is "trying to rewrite their programming."

Twelve billion dollars a year is spent on advertising directly aimed at children, much of it hoping to imprint vulnerable minds with early brand loyalties. Every year, the average child is exposed to 40,000 television ads: 32 percent of those are for candy, 31 percent for cereal and 9 percent for fast foods. McDonald's spent $572 million and Burger King $407 million on advertising in 1998; in 1999, the USDA, to encourage healthy choices, spent a mere $1 million.

"All told, kids see about eleven food commercials per hour of television," say Generation Extra Large's authors, "and not a single one of these ads heralds the hottest new apples or carrot sticks." Trying to get children to make healthy choices in the face of that onslaught is very tough indeed -- especially when they are so seldom offered healthy choices. School lunch offerings are generally heavy on pizza, burritos, French fries and cake, vending machines are often close at hand, and bake- and candy sales actively encourage consumption.

In fact, corporations are stunningly aided and abetted in the fattening of America's children by schools and parents, in whom these children have innocently placed their trust. The reasons for this extraordinary betrayal are various and complicated. Underfunded schools are frankly selling their kids to the food industry, negotiating exclusive and sometimes secret contracts with soda companies -- occasionally with enticing up-front payments. "Schools get band uniforms and Big Soda gets brand loyalty," write Tartamella, Herscher and Woolston. Many consider themselves dependent on the money from vending machines and fast-food purveyors. (One Florida county school board negotiated a contract with Pepsi-Cola in 2000 worth $13.5 million.) PRIMEDIA's Channel One, now beamed into 12,000 subscribing American schools, gives away "free" media equipment in exchange for requiring kids to watch a minimum 12 minutes daily of television programming laden with ads for candy, soft drinks and fast foods. (That adds up to a week out of every school year.) Corporate lobbying undermines attempts to regulate what happens in schools. Today, soft drinks are sold in vending machines in more than 76 percent of public schools in America. Classes in nutrition are futile when the environment sends a different message.

At home, busy families rely more often on fast food or takeout and less on home-cooked meals. "Aim-to-please parents" often stock fridges and cupboards with sodas and junk food. In supermarkets, food choices are increasingly shaped by advertising, and processed foods often contain surprising amounts of added sugar. Fascinatingly, some modern processes -- for oatmeal, for instance -- actually change the rate at which the foods will be turned into energy; the slow-cooking kind is better. And high-fructose corn syrup, which has replaced sucrose in soft drinks, reduces the production of leptin, a hormone that tells the body it's full. Super-sizing or "value marketing" hasn't helped matters either. Poverty can be especially conducive to obesity because low-income parents are intuitively stretching their food dollars by choosing high-density foods that tend to be fattening, and because fresh fruits and vegetables may not be available in low-income neighborhoods.

There is hope. The authors of Generation Extra Large cite Maria Golan, a nutritionist at the School of Nutritional Sciences at the Hebrew University of Jerusalem, who believes that "even in the face of all the unhealthy influences in the world, parents have an astonishing power to shape their kids' eating habits." Community pressures can awaken schools to their responsibility to provide nutritious foods and an environment in which healthy choices are possible. New York City banned soda, candy, salty chips and sweet snacks from school vending machines in 2003, and Los Angeles is in the midst of implementing a similar plan. Instead of soda, school vending machines will offer water, milk, sports drinks and fruit-based drinks with at least 50 percent juice and no added sweeteners. Attitudes can change quickly: Philadelphia was contemplating an exclusive soft-drink contract for its public schools in August 2003 but public criticism resulted in the city's proposing a soda ban instead.

In the end, however, it comes down to parents. Turning off the television can be a tough call. Rationing or just getting rid of cable may be the answer. In fact, experts say, kids are watching TV out of boredom, getting less exercise because the culture has made exercise unnecessary or difficult, and eating unhealthy foods because they are all too available. It's the environment that needs to change.

Both books urge parents to simply take charge. Setting a good example and supporting kids trying to lose weight is vital. But small changes in lifestyles -- like sitting down to family dinners with home-prepared food -- can make a big difference. Making life a little harder would help. One expert suggests not only getting rid of the TV but also buying a push lawnmower, having the children do more household chores, and occasionally leaving the car behind. Modern life should come with a black-box label: Warning -- may cause life-threatening obesity.

Reviewed by Nicols Fox
Copyright 2005, The Washington Post Co. All Rights Reserved.

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