Combat childhood obesity with one simple message: no sugary drinks

Sunday, July 24, 2011

(The Baltimore Sun) -- Click here to download a PDF of the article.

By Peter L. Beilenson and Rich Krieg

A recent Harvard School of Public Health study indicated that potatoes, especially chips or fries, but even boiled ones, contribute more to weight gain than other foods.

But rather than putting the question to rest, the finding prompted the U.S. Potato Board to provide the public with precisely the opposite advice: "There is no evidence that potatoes, when prepared in a healthful manner, contribute to weight gain. … In fact, they are one of the most naturally nutrient dense vegetables available."

While the multi-faceted Harvard study shed important light on both dietary and lifestyle contributors to weight gain, it had one unintended consequence: adding to the unrelenting barrage of approaches parents must consider in reducing obesity in their children.

It is arguable — in terms of both adverse health outcomes and aggregate economic impact — that childhood obesity stands as the central health challenge of our time. Since the 1970s, the rates of overweight and obese children (age 6-11 years) have quadrupled, and these rates have more than tripled for adolescents. One in three American children is currently overweight or obese. Research indicates that these 23 million children, who are likely to be overweight their entire lives, are increasingly susceptible to diseases previously confined to adults.

The annual health care costs of childhood obesity have been estimated to be $14.3 billion, including $237.6 million in inpatient costs. As they age, these obese children will inflate the impacts of treating adult obesity-related illness, now exceeding $147 billion annually. In 2008, obesity-related disease impacted Medicare ($19.7 billion), Medicaid ($8 billion), private health insurance plans ($49 billion), and the cost of obesity-related business absenteeism ($4.3 billion).

As the obesity epidemic has grown, Americans have been subjected to a torrent of advice about proper eating habits: eat meat servings the size of a pack of cards vs. don't eat meat at all; eat carbs vs. cut out carbs; caffeine is bad for you vs. modest caffeine intake has significant preventive properties; everything in moderation vs. some things should be avoided at all costs. This is in marked contrast to the singular prevention messages promoted for other health risks — don't smoke, wear sunscreen and use your seatbelt.

The cacophony of potential actions for parents and kids to take has made most Americans throw up their hands in frustration, leading to far too little improvement in our nation's diet despite the immense amount of attention being focused on the issue of weight.

The unintended consequence of this onslaught of advice is that it has blocked attention to the single most important action that parents can take in reducing their child's risk of obesity: keeping sugar-sweetened beverages out of the family refrigerator.

Here's why:

Kids get the largest chunk of their excess daily calories from sugary drinks (e.g., regular sodas, energy drinks, artificial "fruit juices" and sweetened teas). These drinks have little or no nutritional value and contribute greatly to yearly weight gain. There is a solid body of evidence that links increased sugar-sweetened beverage intake with childhood obesity and diabetes. Newer studies associate these drinks with increased cardiovascular disease risk. One can argue that potatoes prepared in a healthful way are good for you. That argument simply does not apply to sugary drinks.
Sugar-sweetened beverages are the greatest source of added sugar in a child's diet. At 9 teaspoons of sugar per 12-ounce can of regular soda, that's easy to see. Our adult eating patterns and food preferences are greatly influenced by exposure to food items in infancy and early childhood. Parents who allow their children to drink such beverages during this time period are exposing their children to high levels of sugar at a critical time in their development. This alone may make their children more prone to having a "sweet tooth" and to a lifetime of being overweight or obese.
There are readily available, low-cost, healthy alternatives to sugar-sweetened beverages that are free of calories. Water is the best example. Even sparkling water is a better choice. Making the switch is an easy way to help your child avoid 140+ excess calories a day. Over the course of a year, cutting out just one sugar-sweetened beverage serving per day could help your child shed 12 pounds or more.

With this in mind, it makes sense for health officials and health care providers to coalesce around one primary message regarding our children's diets: cut out sugar-sweetened beverages. If we are successful in just reducing intake of those drinks by 50 percent, more excess calories will be eliminated from the average child's diet than has resulted from the innumerable mixed messages promoted to date. That will make a true dent in the childhood obesity problem.

Dr. Peter L. Beilenson is the Howard County health officer. His email is pbeilenson@howardcountymd.gov. Rich Krieg is president of the Columbia-based Horizon Foundation. His email is rkireg@thehorizonfoundation.org.