American way of life is hazardous to our kids' health. welcome to the party.

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By Springen

Newsweek

Updated: 5:48 p.m. CT June 26, 2007

June 26, 2007 - The American way of life is hazardous to our kids' health. In a commentary published this week in the Journal of the American Medical Association, Harvard researchers say the number of kids with chronic health conditions has "increased dramatically in the past four decades." Today 15 to 18 percent of kids suffer from chronic health problems, many of them severe. Seven percent of U.S. kids suffer from a condition that limits their usual daily activities for a period of more than three months, up from only 1.8 percent in 1960. Nearly 9 percent have asthma (twice as many as in the 1980s), which will follow at least 25 percent of them into adulthood. Six percent of kids are diagnosed with attention-deficit hyperactivity disorder; about half of them are expected to still suffer from it as adults. And at least 18 percent of kids and adolescents are obese, up from just 5 percent in the early 1970s. Childhood obesity increases the risk of adult obesity, which increases the likelihood of heart disease and associated type-2 diabetes. NEWSWEEK's Springen spoke with coauthor Gortmaker, professor of health sociology at the Harvard School of Public Health. Excerpts:

NEWSWEEK: Your findings are depressing! What are the long-term implications of the increase in chronic conditions among U.S. kids? Gortmaker: Because these conditions tend to track into adulthood, the number of adults with these conditions is going to increase. We have increased costs related to medical care and associated disability.

Will this be the first generation with a shorter life expectancy than its parents?We don't know for sure. You have these substantial increases in chronic conditions like obesity. One of the consequences of higher rates of obesity is going to be increased incidence of subsequent diabetes. Along with diabetes come complications like heart disease. At the same time, there are lots of new technologies coming to reduce the risk of heart disease—for example, improved medication for high blood pressure or improved treatment for diabetes. If nothing were to change, we certainly would expect life expectancy to increase.

What can we do to reverse the increase in childhood chronic conditions?The most important thing is to look at possibilities for prevention. A lot of the focus in the world of asthma, for example, has been on treatment. What we haven't done successfully is really understand why we've seen the increase in asthma in children, and work on primary prevention. A lot of people talk about obesity. The media environment in kids' lives has changed dramatically. Kids spend hours and hours on screens. That means they're less active. And opportunities for school-based physical activity have really declined.

Genetics contributes to diseases like obesity, asthma and ADHD. But it can't explain the recent dramatic growth in these conditions. Your report notes changes in families and communities, including increased TV watching, indoor time and consumption of fast foods. How can we get U.S. kids to eat better and exercise more?The first thing is to identify the foods we want our kids to be consuming a lot of and which ones we don't want them consuming much of. Right now, by the time kids are in high school, they're consuming about 300 calories a day of sugar-sweetened beverages. It comes in sodas. It comes in sports drinks. It seems like just about every parent in the United States thinks that if their kids play sports, they need to consume sugar water. I see coaches and parents bringing in tons of these sports drinks that kids don't need.

What about getting kids active and outdoors?Think about how kids really get interested in being physically active. As they get older, they need games and sports to provide an interest in physical activity. Kids are not going to be participating in games and sports when they're older unless they get a chance to learn how to do them when they're younger. It's important that kids get an opportunity to have fun physical education so they learn the skills to participate in a variety of sports that will keep them interested when they're older. You can't take a kid in high school who hasn't participated in sports for five years and say, "go play." The second thing is to provide structured opportunities for play during the after-school periods and the weekend.

Should kids have recess every day? Absolutely. Those kinds of changes really need parents getting involved with school districts, saying, "We want our kids to do more than study for standardized tests."

In your report, you say that breast-feeding is "indicated to be protective" for obesity and potentially for asthma. Yet about three in 10 new moms never even try to nurse. How can we increase breast-feeding rates?Hospitals can make a big difference by providing packages of material in support of moms right away. Start early during the prenatal period, during the hospital period right after birth and when the mom goes home. With so many moms working nowadays and with so many work environments not being supportive of breast-feeding, it really makes it difficult. All that can be changed, but it takes a while.

Your report notes that kids' physical activity decreases markedly between the ages of 10 and 16. Why?As kids move into the teenage years, they're being pulled indoors by lots of other things. For a lot of kids in the United States, they're spending four hours a day in front of the screen—the computer screen, TVs. If you look back to 30 years ago, there weren't many screens available in homes. Now I think the average household has three—TVs, a couple of computer screens. Then there are 120 channels of shows, YouTube, multiple things to watch, computer games. And then they get pulled away to hanging out with their friends, they get interested in the opposite sex.

In May, researchers reported in the journal Pediatrics that one fifth of U.S. kids from 6 months through 2 years old (and more than a third of kids 3 to 6 years old) have TVs in their bedrooms. And yet, the American Academy of Pediatrics recommends that kids under 2 watch no TV and that older kids get no more than two hours a day of screen time. Why do so many parents ignore advice from health professionals?Parents are a little confused about the role of TV in their kids' lives. They see these Baby Einstein videos. They don't realize there's no evidence these things work. There's no evidence that TV does anything good for your kids. One of the issues for parents about not wanting to do anything about TV is they don't want to get into a daily argument about how much.

Your report says that the rapid increase in childhood and adult obesity and associated type-2 diabetes will probably lead to higher rates of cardiovascular disease. The health risks linked to obesity are hardly a secret. Why do parents let their kids eat too much?For one thing, the overall price of food has dropped. There's food available everywhere, all during the day. People haven't really successfully coped with that growth in access to food and the decline in price. It's easier to overeat. We published a paper in Pediatrics last December where we quantified the energy imbalance on a day-to-day basis that was driving the growth in obesity among kids. It's being driven by an excess of only about 160 calories a day. It could be an extra sugar-sweetened beverage or two that over time can lead to the excess weight. The same thing is happening among adults.

About 6 percent of school-age kids are diagnosed with ADHD, which is associated with increased car crashes, decreased educational attainment and an increase in anxiety and depression. Employees with mental-health conditions generate three times the healt-hcare costs of other employees. What can be done to reduce the growth in ADHD cases?We have a very limited sense of what we can do to prevent ADHD. Research is pretty critical. There's been a lot of emphasis on drug treatment. The fact that we haven't done a good job of identifying primary causes to help us with primary prevention really indicates that we're not necessarily spending the research dollars where we should be.

Hispanic, African-American and Native American children are at greater risk of chronic health problems. Should the U.S. government be targeting them more aggressively?If you focus on prevention and try to identify factors that are causing these increases, then we will find things that will be most helpful to the most disadvantaged groups. For a lot of these conditions, what we're doing is just trying to treat them after they've emerged. We need to focus more on primary causes.

Of all the chronic health conditions plaguing our children, which one worries you the most? Obesity?I think so. It doesn't show much sign of abating. There are very powerful forces, both in the food industry and the media industry, which seem to be pushing it along. It seems to be a growing epidemic that doesn't seem to be going away. It's going to be difficult to change.