It's little more than a glimmer of hope, but a comprehensive new report suggests that a trend toward healthier habits may have halted the rise of obesity among the nation's teens.
In 2009 and 2010, American adolescents exercised more, watched less TV, ate more fruits and vegetables and drank fewer sugar-sweetened beverages than did children of the same age in 2001 and 2002, the national study found. The research was published online Monday in the journal Pediatrics.
Despite steady improvements in behaviors linked to excess weight, rates of overweight and obesity among children in grades six through 10 continued to rise until 2005.
But against a backdrop of urgent efforts to get children off the couch, improve schools' nutritional offerings and drive down soda consumption, something happened between 2005 and 2010 that's scarcely been seen for more than 30 years among the nation's young teens: Obesity rates held steady at 12.7% for this age group nationally. And the proportion of teens in grades six through 10 who were overweight ticked downward slightly from 17% in 2005 to 16.6% in 2010.
The report falls in line with a wide range of indicators suggesting that rates of obesity among the nation's children may at least have stabilized and could, with continued efforts, be poised for a reversal.
In California, the proportion of children in grades five, seven and nine who were overweight or obese dropped a modest 1.1% between 2005 and 2010. In Mississippi, obese and overweight children went from 43% of the state's pediatric population in 2005 to 37.3% in 2011. Major cities such as Philadelphia and New York reported significant declines in excess weight among schoolchildren.
"It may be that current public health efforts are succeeding," wrote Ronald J. Iannotti and Jing Wang, coauthors of the analysis, which gauged the health habits and weight status of close to 35,000 American teens between 2001 and 2010. "The trends from 2001 to 2009 are encouraging."
But, the authors added, "this leveling of the obesity trend may be somewhat unique to the United States, and continued improvements in physical activity, sedentary behaviors and dietary behavior may be necessary before the trend begins to turn downward."
Experts in child obesity hailed the report as encouraging, but cautioned that there was little cause for celebration.
"This is a nice finding that suggests that what we've seen in children of younger ages might be starting to have an effect in adolescents, who can assert more control over their choices than younger children can," said Dr. James Marks, senior vice president of the Robert Wood Johnson Foundation Health Group. That the study finds the trend toward healthier behaviors nationally, and not just in subgroups of American kids, "is what is most exciting," Marks said.
At the same time, he added, "we do have a long way to go."
Indeed, the authors of the study cautioned that "there is considerable need for improvement." Most adolescents failed to get the daily 60 minutes of physical activity recommended for their age group, and watched more than the maximum two hours of television recommended for good health. A small minority consumed five-plus servings of fruits and vegetables that are considered the standard for a nutritious diet, and few could be said to "minimize" their intake of sweets or sugar sweetened beverages.
Moreover, the averaged indicators of better habits hid some significant holdouts: African American youth continued to report the highest consumption of sweets and sugar-sweetened soft drinks; Latino children were less likely to report increased levels of physical activity than were non-Latino white adolescents, and they spent more time in front of a screen.
Girls were more likely to eat fruits and vegetables than boys, but they also were less likely to get an hour of physical activity daily. And while TV viewing fell overall, children appear to have compensated by spending more time in front of video games or on social media.
The study also comes amid evidence that the number of children with severe obesity is growing at a steady clip. "I don't think we have any evidence of a similar trend - an adoption of healthy behaviors - occurring among severely obese children and adolescents," said Aaron S. Kelly, professor of pediatrics at the University of Minnesota Medical School and author of a recent study on such children.
The ideal would be if the trend of healthier behaviors expanded into populations that may be difficult to treat, Kelly said. "Perhaps fewer of them will reach the level of severe obesity in the first place," he added.
The Pediatrics study suggests the pediatricians, who should already be urging children to move more and eat better, might tailor their messages differently so that kids' healthy behaviors improve across the board. For boys, whose gains in physical activity have come with an increase in video gaming, physicians might praise the exercise and caution against screen time. For girls, who are eating more fruits and vegetables but acknowledge they still eat lots of sweets, they might focus on the health costs of added sugar.
But having pediatricians step up their advice to children and their families "is not sufficient," said Rand Corp. analyst Dr. Deborah Cohen, author of the forthcoming book "A Big Fat Crisis: The Hidden Influences Behind the Obesity Epidemic - and How We Can End It." If we want children to get more exercise, school districts and states should "create more opportunities for physical activity," Cohen said.Copyright © 2014, Los Angeles Times