Too Much and Not Enough

There’s an epidemic of heaviness in our nation’s children, the Centers for Disease Control warn. Orange County surpasses the national rates--more than 14% of our children exceed the norms for childhood chubbiness enough to be termed obese.

Being overweight places children--and the adults they will become--at greater risk of a host of diseases, including hypertension, diabetes and various heart conditions. An alarming corollary is that Type II diabetes, once a disease of the middle-aged, is on the rise in teens and young adults.

A 1998 phone survey of California teens found that just 2% met daily nutrition guidelines; they spent twice the time on TV or video games as being physically active; 27% had eaten at a fast-food restaurant the day before.

Yes, the nation’s children are overweight. But how did health-conscious California come to exceed national rates, and Orange County to surpass California’s? With 20-20 hindsight, we can see that a series of solutions to other problems created the one at hand:

Faster food. When did fast foods, replete with calories and carbohydrates, go from a once-a-month treat on a family outing to a daily food source? With most parents in the work force, it’s an easy jump for kids who grew up on TV dinners and skillet meals to become pizza, burger and carry-out parents.

For those lower-income families who may have limited access to cooking facilities, or to markets that stock a full range of nutritious foods, franchise fast food seems an attractive and affordable option.

Bigger portions. As labor costs in the food business have grown, many restaurants have made higher prices palatable by increasing portion sizes--a trend in family restaurants and fast-food outlets alike.

Early branding. Many school districts have turned food service from a cost center to a revenue center by signing agreements with Coca-Cola, Pepsi, McDonald’s, Taco Bell, Pizza Hut or others to offer these brand-name products in their cafeterias and sodas in vending machines on campus. The Public Health Institute reported that 53% of California schools had such agreements in 1999, compared with 13% nationwide three years earlier. Some schools have used these agreements to require more nutritious variants of the franchises’ famous products; many have not.

Alarmed at recent trends, Coca-Cola recently announced it would offer juice and water, along with cola, in campus vending machines. State Sen. Martha Escutia (D-Whittier) has introduced a bill that is now in committee to ban sales of sodas and high-fat snacks on campus.

Chained schoolyards, frightening parks. While we may decry the lack of exercise among California youth, “solutions” of concerned school officials and parents again have contributed to current behavior. How many schools now chain off the schoolyard when the staff leave, to avoid the liability of unsupervised play? In some neighborhoods that schoolyard is the only parklike setting within walking or biking distance. What would it take to reopen the yard, with volunteer supervision?

Parks, where they do exist, may also evoke fears for a child’s safety where there is no parental supervision.

Do you know where your children are? For latch-key children, supervised by phone by a working parent, “play” on the computer, or in front of the television, seemed to provide a safe, even mind-broadening, option. Physical exercise suffered in the balance.

“We must never take for granted the precious gift of hindsight,” as Drew Altman of the Henry J. Kaiser Foundation has said. With today’s understanding, we can forge new solutions that avoid the pitfalls. Busy parents are no less concerned about keeping their children safe and well-fed; schools are no less strapped than before; restaurants still struggle with labor costs.

But armed with today’s knowledge, we can look for new answers on diet and exercise that do not risk the health of those we love. One project that has begun this important effort is a collaboration of Hoag Memorial Hospital Presbyterian, Latino Health Access, and staff, parents and students at four Santa Ana elementary schools.

With funding from The HealthCare Foundation for Orange County, their task will be to reshape school policies and after-school opportunities so that our kids can exercise more and eat better while parents still hold down jobs, and schools stay safe and solvent.

We wish them well, and hope what they learn will provide a blueprint for schools around the county and across the nation.