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Medical management of obesity, children to adults

Growth Spurt

How does Virginia stack up in the childhood obesity epidemic?

By Carmine Grieco, Hampton Roads Magazine - Sep/Oct 2007

Ask any parent about their fears of the well-being of their children, and you will likely hear a laundry list of answers, including such things as drugs, pedophiles, alcohol or teen pregnancy. What you will likely not hear, however, are the words "donut," soda" or "candy bar," even though these may actually pose the biggest threat to a child's health.

The plain truth is that children, like adults, are literally eating themselves into poor health. The American Academy of Pediatrics states that childhood obesity is the most common medical condition among children, and overweight adolescents have a 70 percent chance of becoming overweight or obese adults. One study that investigated the nutritional intake of children and adolescents found that only two percent met the USDA's guidelines for a healthy diet. Combine that with the fact that children are now considered a prime marketing demographic for food companies (the average child watches nearly 51 hours of food ads on television per year), and it becomes easier to see that this problem could get worse before it gets better.

Alarming statistics were revealed in a state-by-state comparison of childhood obesity conducted by the Annie E. Casey Foundation. Utah had the least amount of overweight/obesity among children, with 21 percent among its 10-17-year-olds. Kentucky occupies the bottom slot, with 38 percent. Virginia, with an estimated 1.2 million students, was smack in the middle of the ranks at 30 percent (25th in a seven-way tie with Maine, Maryland, Arizona, Ohio, California and Kansas).

But overweight/obesity in children is not the end of the story; actually, it is just the beginning. We can consider overweight/obesity to be the first "domino" to fall in a series of health-related issues, each one leading to progressively greater threats to health and well-being. For instance, the Centers for Disease Control and Prevention (CDC) predicts that one out of every three children born in 2000 will become diabetic at some point in their lifetime. Recent research even suggests that this could be the first generation of children to live shorter lives than their parents.

Dr. Margaret Gaglione, the founder and medical director of Tidewater Bariatrics in Chesapeake, views good nutritional habits as a matter of parental obligation. "We've got to protect our kids," she says. "This is as important as anything for protecting our children. It's a parental duty, and it is as important as homework, wearing a seatbelt or prescription medication."

Dr. Gaglione, who specializes in the medical management of obesity, adds that "Parents should choose reward systems that are not based on food; food is nourishment. If you start young you can change those behaviors."

Since children spend such a large portion of their day at school and typically consume 35-50 percent of their calories "on campus," this leaves one wondering if school systems are part of the problem or the solution. A survey conducted in 2006 by the nutrition watch-dog group Center for Science in the Public Interest investigated that very topic in the aptly named School Food Report Card. CSPI, which has earned the nickname the "food police" for its lobbying of food/nutrition reform, gave only nine states a grade of "B" or higher. Pointing out that children have easy access to what the USDA terms "food of minimal nutritional value," CSPI estimates that on a nation level, 83 percent of elementary schools, 97 percent of junior high schools, and 99 percent of senior high schools sell foods and beverages out of vending machines, school stores or in the cafeteria.

In a state-by-state breakdown, CSPI graded each based on five policy criteria that focuses on food and beverages sold outside of the school meals program. The good news is that Virginia was not one of the 23 states to receive a failing grade ("F") on this report card. The bad news, however, is that a grade of "D" indicates plenty of room for improvement.

On a more local level, Virginia Beach City Public Schools, the second largest school system in Virginia, is attempting to improve foods at school. "We have been talking to the vendors, asking what items are healthier and contain reduced sugar," says Valerie Lewis, a registered dietician and the nutrition and training coordinator for the Virginia Beach City Public Schools. "We offer salads with all student lunches with fat-free and reduced-fat salad dressings. We have whole grain items to choose from lik pretzels."

Improvements like these are a start, but nutrition experts agree that parents and school administrators alike need to make major changes if they want to prevent children from fighting an uphill battle against t obesity for the rest of their lives.

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This is the first step in improving your health and lifestyle.

At Tidewater Bariatrics, my staff and I are committed to helping you achieve your weight loss goals.

I am a board certified Bariatrician and Internal Medicine physician. I will tailor a program specific to your needs, time constraints and abilities.

Our program is modeled after successful academic university medical center programs, and is dedicated to decreasing your health risk, improving nutrition, providing health education, and increasing your overall wellness. You can expect to lose weight, improve your cardio-vascular health, and reduce your risk of developing long-term obesity complications.

Even if you already have the complications of obesity, weight loss can decrease or eliminate their effects.

Dr. Margaret Gaglione

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