Kentucky ranks 3rd in child obesity, a disease tied to a long list of other health issues; treatment requires changes in family lifestyle

Robert Wood Johnson Foundation graphic; click it to enlarge

By Melissa Patrick
Kentucky Health News

More than one out of five Kentucky children between 10 and 17 are obese, ranking the state third in the nation, says a new report from the Robert Wood Johnson Foundation.

The state’s obesity rate rose to 20.8 percent in 2017-18 from 19.3% in 2016-17, though the report notes that this uptick is not significantly significant. Mississippi had the highest rate at 24.5% and Utah had the lowest at 8.7%. The national rate was 15.3%. The data is from the National Survey of Children’s Health.

The report also shows that when it comes to childhood obesity, disparities persist along geographic, racial, ethnic and socioeconomic lines.

Dr. Aurelia Radulescu, medical director of the Pediatric High BMI Clinic at UK Healthcare, told Kentucky Health News that this high obesity rate matters because obesity in children is associated with a long list of health conditions that children and their families are often unaware that they have, such as pre-diabetes, diabetes, high blood pressure, non-alcoholic fatty liver disease, high cholesterol and sleep apnea.

“Obesity is a disease,”said Radulescu. “It is not a cosmetic problem.”

According to the report, childhood obesity costs the United States about $14 billion per year in direct health expenses.

Childhood obesity also matters because children and teens who are obese will likely grow up to be obese as adults, according to the Centers for Disease Control and Prevention. Kentucky ranks fifth for adult obesity, with 36.6% of its adults obese.

Obesity is calculated through body mass index, essentially a ratio of height to weight. A child is considered obese if the BMI is at or above the 95th percentile for children of the same age and sex; children are considered overweight at or above the 85th percentile. About 40% of the state’s school-aged children are either overweight or obese, according to the Kaiser Family Foundation.

It’s about health, not weight

Radulescu, who is also a pediatrician and an associate professor at the University of Kentucky College of Medicine, stressed that childhood obesity is about health, not weight: “The cornerstone of treating pediatric obesity and also adult obesity and all these medical complications associated with or resulting from excessive weight gain is healthy lifestyle changes.”

Lifestyle changes include improving eating habits, getting more physically active and having good sleep habits, she said. She said children’s health improves much faster with lifestyle changes than it does in adults, but to be successful, these changes must involve the whole family.

“When a family is dealing with a child who suffers from obesity, those changes have to be implemented as a family,” she said. “It cannot be just an individual.”

Other options to treat obesity in older children include taking approved weight-loss medications and bariatric surgery, but both of these options require a commitment to lifestyle changes, she said.

Radulescu encouraged parents to take charge by becoming aware of the weight status of everyone in their home and to talk to their pediatrician or primary-care provider about it if they are concerned.

“Providers often take the lead of the family on this issue,” she said.

She acknowledged that the causes of obesity are complex; beyond genetics and lifestyle choices, other contributing factors are policies that don’t support health and a general lack of resources. She said everyone must play a part in tackling this issue: the medical community, community leaders, schools and families.

Actions taken and recommended

The Foundation for a Healthy Kentucky has long considered child obesity as one of its core issues. Six of the seven grants it made to address children’s health, totaling $3 million, focused on the problem. It has also worked with the Appalachian Regional Commission and the Robert Wood Johnson Foundation on a study of child obesity in Appalachia.

Most recently, along with Kentucky Voices for Health and Cairn Guidance, an education and school-health consulting company, the Kentucky foundation has established a new, statewide coalition to work on policy initiatives to improve children’s health in school settings.

“The foundation is committed to bringing to bear this cross-sector coalition approach to address this issue through policy advocacy in the same way that we are working to reduce tobacco use in the commonwealth,” said Bonnie Hackbarth, the foundation’s vice president for external affairs.

To ensure more children grow up with a healthy weight, the report offers a long list of policy suggestions.  One is that the U.S. Department of Agriculture rescind its proposed changes to the Supplemental Nutrition Assistance Program, previously known as food stamps. If allowed to proceed, the changes will result in millions of participants losing their benefits, says the report. According to Center on Budget and Policy Priorities, more than 68% of Kentucky’s 655,000 SNAP participants in 2017 were families with children.

Among other recommendations, the report also calls on the USDA to maintain the nutritional standards for school meals that were in effect before December 2018; and that the Centers for Disease Control have adequate funding to provide obesity campaign grants to all 50 states.

Kentucky is one of 16 states that got such a grant. It received $856,326 to use for evidence-based strategies at the local level to improve nutrition and physical activity. It will be allocated to 11 community health departments in Eastern and Western Kentucky.

The state Department for Public Health suggests the “5-2-1-0” prescription to significantly reduce childhood obesity: five or more servings of fruits and vegetables each day; limit screen time to no more than two hours a day; be physically active for at least one hour a day; and drink zero sweetened beverages. The website offers free resources to help meet these goals.

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