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(6) Obesity in Children’s

 Tipping the Scales- A Documentary on Childhood Obesity


Maybe my son is just a bit short and is slow in developing? Do we have to worry now, or can we wait a bit?

It is certainly possible that your son is just in a slow patch of his growth and development and that he will sprout up at some point and drop to a normal weight for his height. You really cannot presume, however, that this will happen. Thus, you should act now if your son is overweight or obese.

A lot of work has been done on fat cells, and how they grow, develop, multiply, and turnover is very important in weight and obesity. Although the work is somewhat controversial and contradictory, the evidence on fat cells supports the notion that obesity as a child produces weight problems in later life. More fat cells are created in children who are obese than in those who are slim. Thus, a child who is fat will have more fat cells throughout life and will have more trouble maintaining a healthy weight.

The message is this: Don’t let your child become fat because he or she is more likely child’s weight becomes normal. Thus, it is not a good idea to wait to see whether your heavy child has a growth spurt and drops to a healthy weight. Instead, get his or her weight down to a good level now.

 My child is “big boned” (i.e., muscle not fat). Why would he be considered overweight or obese?

That may indeed be the case if your child is very muscular and works out, but some of that muscle may actually be fat. As noted, the BMI does not measure body fat, and your child might benefit from a measurement of body fat. Several techniques are available to measure actual body fat compared with the BMI. These include skin-fold thickness, underwater weight, bioelectrical impedance, and others. One common, easy, and noninvasive technique is the skin-fold measurement. In this technique, a special instrument is used to measure several sites (e.g., triceps, biceps, abdomen, thigh, and calf ) on the body. The skin is pinched into a double layer that includes fat (adipose) tissue but not muscle. The thickness is measured at each site. Because special calipers (that must be kept calibrated) and some training in their use are required for consistency, not all pediatricians will perform this test. They may refer you to a fitness or obesity specialist or clinic for measurement.

If, after this measurement, your son has a normal and acceptable level of body fat, there may be no issue with weight. If his BMI and body fat are elevated beyond healthy, however, then we cannot say that he is just “big boned.”

 LeVon’s father:

 LeVon is 12 years old and already weighs more than all of his friends. He’s very athletic and plays football at school. He’s young and still growing and wants to be an offensive guard on the high school football team when he’s old enough. He is serious and does well in his classes. I think he’ll do fine. He’s strong, big boned, and works out a lot. LeVon is not too tall or fast, and that’s why he wants to be a guard. He’s a great eater, is not picky, and will eat anything we put in front of him. He loves fried food and barbecue, which is very popular here, but he also eats fruits and vegetables. The school nurse told us at the beginning of the year that she was a bit concerned about his weight. We said that he’s just big boned, but she said that she was concerned that he is too heavy for his age and height and that not all of his weight is muscle but also fat. That is true, as he does have a “spare tire” around his waist, but for a football guard position, that’s good. We’re not sure what to do because he is a great kid and is doing fine.

Data suggest that only 10% of normal-weight kids become obese or overweight adults, whereas about 75% of fat children become or remain fat as adults. Being heavy can produce some physical problems that may disappear or lessen if your


 Bioelectrical impedance - A highly accurate way to measure a person’s body mass. A small electric current, which flows at different rates through fat and fat-free tissues, is sent through the body. When factors such as height, weight, and gender are analyzed with the results, a measure of a person’s body fat can be obtained.

Adipose - Fat cells. There are two types: white and brown.

 How much body fat should my child have, and what is normal?

Broadly speaking, two types of body fat exist: essential fat and storage fat. The body cannot be “fat free.” Fat is a normal, necessary component of cells. Cholesterol and triglycerides, for example, are lipids that are required for life but in excess can produce major problems in blood vessels, the heart, and elsewhere. This is essential fat and, in the normal, healthy adult female, makes up about 12% of body weight and in men about 3%. Although unfair, this is the way the body is made. Storage fat is a way the body stores or stockpiles energy for future use. It is under the skin and inside the body around many organs. Everyone needs a certain amount of storage fat, but an excess is unhealthy. Storage fat in the male is around 12% and in the female is around 15% (yes, still unfair). The ideal percentages of body fat for the population are as follows.

For women:

• Up to 30 years old: 14% to 21%

• 30 to 50 years old: 15% to 23%

• Over 50 years old: 16% to 26%

For men:

• Up to 30 years old: 9% to 15%

• 30 to 50 years old: 11% to 17%

• Over 50 years old: 12% to 29%

The American Council on Exercise has determined that acceptable “fitness” levels of body fat are 21% to 24% for women and 14% to 17% for men. Because this is a bit complicated, it is probably best to stick with the BMI and weight, age, and height when trying to determine what a healthy weight is.

 What is the difference between white and brown fat cells?

Two kinds of fat (also called adipose) cells exist: white and brown. Their function is to store fat for use by the body as energy but also to keep the body temperature constant and to cushion the organs of the body.

Each white fat cell contains a droplet of fat (lipid). Each cell also contains, on its surface, receptors for glucagon and insulin, two hormones that play a key role in the regulation of the release of fat into the bloodstream for use by muscle cells for energy. Brown fat cells are found primarily in newborns and are somewhat different, structurally containing many droplets of fat as well as many mitochondria. Their main function is to produce heat. They exist in small amounts in adults, but their role is very limited. Thus, the body needs a certain number of fat cells; however, too many are damaging to one’s health. Recently, findings were published in the New England Journal of Medicine on the link between brown fat and healthy body weight. Researchers in Boston, Finland, and the Netherlands studied brown fat in adults, which is found mainly in the neck and around the collarbone (unlike white fat, which is found around the waistline and hips). The researchers found that lean people have much more brown fat than obese and overweight people, that women are more likely to have brown fat than men are, and that brown fat burns many more calories and produces far more heat, especially in cooler environments. Perhaps now a medication could be developed to stimulate fat cells to burn fat and produce heat and energy rather than just store the fat. Another approach could be to induce the body to produce more brown fat. Finally, another interesting finding is that it seems to be easier to lose weight by staying in a cool environment rather than a warm one.


Glucagon - A hormone that the body uses to regulate blood sugar, helping raise it when it is low.

Hormones - Chemicals produced and secreted by glands, which then act at a distant site in the body.

Mitochondria - The organs within cells that contain genetic material and produce the cells’ energy. Mitochondria have been called the “powerhouse” of the cell.

Calories - Units of energy. Although there is a technical definition (the amount of heat needed to raise one kg of water one degree Celsius at sea level), it refers to the amount of  energy in a food or the amount of energy that a person used.




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