For nearly 20 years, childhood obesity has been considered a public health crisis in the U.S. And yet, more children than ever before are struggling with weight management. Nearly 42 percent of teens between 16 and 19 are overweight or obese, and the repercussions are determining their future right now.
Obese children are at nearly twice the risk of having three or more co-morbidities, when compared to children who are not overweight, according to research led by Dr. Neal Halfon, Professor at the Fielding School of Public Health (FSPH), the David Geffen School of Medicine at UCLA and the Luskin School of Public Affairs. These kids don’t just bring the potential for depression, ADHD or a learning disability to school with them; they could bring all three or a number of other associated conditions. Any one of these co-morbidities on its own can seriously limit a child’s academic progress and transition into adulthood. But for some of these children, the idea of moving into a career is the last thing on their mind. They’re far more concerned with other pressing realities, like bullying and thoughts of suicide.
While the scourge of childhood obesity has become entrenched in our society, progress has been made to untangle its complexities and root it out. Through a combination of research and hands-on community involvement, UCLA and partners are helping our children find the solutions that fit their unique challenges.
Make the Healthy Choice the Easy Choice
A healthy appetite for water-rich, fiber-rich produce plays a crucial role in curbing food cravings and reducing obesity in children. But these choices have become harder to find in many day-to-day environments, especially for those who need healthy options the most.
More than 42 million people in the U.S. are food insecure. They lack reliable access to food that is both affordable and nutritious, like fresh produce. Instead, when they walk to and from school or go out for lunch on the weekend, they find themselves choosing from an abundance of fast food and convenience store snacks.
“The gut microbiome research suggests that the quality of what one eats is an important influence on satiety. People who need to economize when it comes to food choices buy low-cost foods that are fiber-poor and calorie-rich, and because the lack of fiber reaching the gut microbiota depresses satiety signaling, it also means they need more calories to feel satisfied than people with diets high in fruits and vegetables,” explains Dr. William McCarthy, Adjunct Professor in the FSPH Department of Health Policy and Management.
While the food insecurity situation can be dismaying, Dr. McCarthy knows there is hope. His research has shown that even if children don’t make the healthy choice right away, just giving them the option will develop their appetite. "Schools need to be patient and tolerate some plate waste … but students will not expand their liking for fruits and vegetables if they don't at least taste the food."
One way UCLA is making the healthy choice the easy choice is through Good Food for Local Schools (GFFLS). The national school lunch program feeds almost half of all kids in the U.S. That’s 31 million hungry bellies every day. GFFLS provides school districts with a comprehensive tool kit of resources for supporting healthy, sustainable food in pre-K–12 schools. This includes curriculum, operational resources, policy, research, and services that help our school districts make informed, systemic change.
Break a Sweat to Change a Life
Children also need to balance the calories they consume with enough physical activity. But it’s no secret that they are living increasingly sedentary lives, attached to digital devices. Activities that could be fun and full of exercise are greeted with moans of aversion.
For generations, Physical Education (P.E.) was the front line of defense against inactivity. This was especially true for inner-city youth. However, funding cuts and pressure to perform well on standardized tests have made P.E. an afterthought for many districts. The situation is currently so bad that the median P.E. budget is only $1.50 per student a year, in a school of 500 students. The result is that many students in this generation are growing up without adequate fitness equipment, a motivational fitness curriculum, and professional development for their teachers.
UCLA has an active presence in thousands of schools across the nation. The Sound Body Sound Mind (SBSM) program is one example of how our research can combine with action to create change. The program, which serves more than 185,000 students a year, is unique in that it develops both the body and the mind to enjoy physical activity. Most of the children in the program don’t start off thinking of themselves as athletic. But after they’ve been in the program for a while, they report higher levels of confidence and perform better on fitness tests. As the SBSM cofounder Professor William E. Simon likes to say, “exercise is preventive medicine.”
One Size Does Not Fit All
While it’s clear that programs targeting nutrition and exercise help, it isn’t clear why results aren’t easy to replicate from one zip code to another ... yet.
“Looking at our data it became very clear that we have families in census tracts right next to each other with very different obesity rates—one community where the trajectory was going up right next to another where it was going down, for reasons that weren’t clear,” says Dr. Shannon Whaley, Director of Research and Evaluation at Public Health Foundation Enterprises WIC (PHFE WIC). “Up to now, no study that I’m aware of has looked at the interplay between community-level environmental issues and early childhood obesity rates.”
What the public health community and concerned agencies have been lacking is a tool that can help them understand the myriad of cultural factors at play. And that’s exactly what a team of researchers at the FSPH is creating.
“We want to understand which strategies are most effective within the context of a specific neighborhood,” says Dr. May C. Wang, Professor, Department of Community Health Sciences at the FSPH. The result is an NIH-funded interdisciplinary project led by Wang and Dr. Michael Prelip of UCLA, in partnership with Whaley of PHFE WIC and others, called the Early Childhood Obesity Systems Science Study (ECOSyS).
ECOSyS innovatively applies methods from the field of systems science, to better understand the impact of various intervention strategies on childhood obesity in diverse neighborhood or community settings, and has the potential to advance knowledge about replicating and scaling-up interventions. For instance, preliminary findings suggest that interventions that promote breast-feeding may influence the effectiveness of child nutrition and physical activity programs on child growth.
“Rather than examine one program or policy at a time to see its impact, with systems science we can examine a collection of programs and policies all at once to determine their impact on obesity among the 2- to 5-year-old population,” says Dr. Prelip, Professor and Chair of Community Health Sciences at FSPH. It’s a breakthrough that promises to help agencies across the nation coordinate their efforts and utilize their finite resources on well-informed, comprehensive change.
The Choice is Ours
In less than a single lifetime, childhood obesity has become one of the greatest threats to our children. The causes are numerous, but more than ever before, our understanding of them is clear. With the knowledge gained through research and civic action, we can fight back together. It will take community-wide support as well as individual determination to create the systemic change our children need. But it is possible, and within our power, to help them make their next choice their best choice.