Fighting Obesity at the Table

Despite healthier offerings at fast food restaurants and school lunch programs that introduce children to more nutritious foods, the rate of childhood obesity continues to rise.

Roughly a third of children between the ages of two and 19 are overweight and, of those, 17 percent are obese, according to a study just published in Obesity. The statistics haven’t changed much, but the number of severely obese children and teens has increased.

Possibly, we’re going about it all wrong. Maybe it’s not just the calories kids are eating or the lack of exercise that’s the problem. There is only so much more parks or nutrition education in school can do. Perhaps real change needs to start at home — with the family.

That's the idea put forward by two researchers at the University of Illinois. They came to the conclusion that improving family communication and helping children handle their emotions and recognize when they have eaten enough could reduce the risk of obesity, even in children with a genetic predisposition to being overweight.

They began by reviewing the research on biology and genetics, family systems, and food marketing and composition as they relate to childhood obesity. “The family system plays an important role in understanding childhood obesity — not as a source of blame but as part of a larger ecology that may support or derail children's health,” write Barbara H. Fiese and Kelly K. Bost, both on the faculty of the University of Illinois’s Family Resiliency Center.

Roughly 20 genes have been identified that increase a person’s risk for obesity, but in a study of 10-year-olds, when children who carried an “obesity gene” were aware of and responded to feelings of fullness or hunger, it reduced their chances of becoming obese in spite of their genetics, according to the authors.

Children in families that spent at least 20 minutes eating together a minimum of four times a week weighed significantly less than children who spent just three or four minutes less time eating with their families

They also found that parenting styles and family communication patterns have an effect on children's eating behaviors, as well as how much food they eat and, consequently, their risk for obesity. Children of indulgent parents, for example — those who expect little of their children but grant them their every wish — tend to eat fewer fruits and vegetables and more fat and sugar.

The road to obesity is paved with often-overlooked influences like these, and the study helps draw those out. “…[T]his study highlights that we may need to be more disruptive in our thinking about how we change the environment around children if we really want to see that [obesity] statistic move on a national scale,” commented Sarah Armstrong, a pediatrician and obesity researcher not involved in the study.

For example, the way parents respond to a young child’s distress, including their early hunger cues; how they help children cope with stress and regulate their emotions are two of the areas of the family environment that can affect how kids eat and their relationship with food. “Disrupting” that environment might mean finding ways to keep things quieter and calmer at home, carrying healthy snacks when the family is out so there is something to offer quickly when hunger hits, or maybe preparing food for the week on the weekend, so family meals on weeknights aren't so hectic.

Family mealtime is an important opportunity for parents to model healthy eating behaviors, and children who eat with their families have less risk of developing an eating disorder or weight problem. In fact, Fiese had found in earlier research that children in families that spent at least 20 minutes eating together a minimum of four times a week weighed significantly less than children who spent just three or four minutes less time eating with their families.

“Family communication is key to the developmental processes that promote — or disrupt — healthy eating habits, physical activity and internal cues to satiety,” said Fiese in a statement. “Families who routinely engage in positive forms of direct communication and show genuine concern about each other's activities also have children who are less likely to be overweight or obese, or engage in unhealthy eating habits.”

In contrast, the communication and social interaction that take place during family meals that promote healthy eating are disrupted when children’s focus is on television, texting, or some other form of electronic media during mealtimes. And adults who are engaged with media rather than their children lose opportunities to be role models for healthy eating, and tend to be less mindful of what their children are eating.

Studies have clearly shown that children who use electronic media while eating are at greater risk for obesity. The mindless eating, typically of unhealthy snack foods, that occurs when people are engrossed in television or an electronic device, often leads them to overlook how much they are eating and ignore signs they have had enough.

The Institute of Medicine and the World Health Organization have identified the marketing of unhealthy foods as an important factor in childhood obesity. Electronic media exposes children to food commercials and video games that frequently market foods that are high in sugar, salt and fat. Not only do kids tend to remember the names of those foods more often, the more a child sees a food advertised, whether on television, billboards or the internet, the more likely he or she is to believe it is nutritious.

The mindless eating, often of unhealthy snack foods, that occurs when people are engrossed in television or an electronic device, leads them to overlook how much they are eating and ignore signs they have had enough.

Parents may feel they need some educating themselves so they can teach kids about healthy eating and model good eating and exercise habits. If you think you could use some tools to put the concepts of healthy eating into action, take heart: the authors have developed a series of 30-second videos, called Mealtime Minutes, that address common problems parents face in establishing an environment that promotes healthy eating. The videos are available on YouTube and Vimeo.