It seems that everywhere you look obesity is being discussed—TV, magazines, radio programs and books. The statistics are unsettling—in the year 2000, 15 percent of children were either overweight or obese. That percentage has nearly tripled since 1980.

The definition of overweight and obese is based on BMI (body mass index—see story below). The children’s BMI chart is age-based.

The health consequences of being overweight or obese are numerous, including:

• Diabetes mellitus.
• High cholesterol.
• High blood pressure.
• Heart disease.
• Premature arthritis of weight bearing joints.

These diseases were mostly seen in adults until now. The increasing rate of obesity in children has made many of these diseases a part of our everyday practice in pediatrics. Among the adult diseases seen more frequently in pediatrics is metabolic syndrome.

Metabolic syndrome is a combination of obesity, high blood pressure, high triglycerides/low HDL (good cholesterol), and pre-diabetes (fasting blood sugar is higher then normal range but less than diabetic level). Approximately 1 in 4 adults has this syndrome and 1 in 25 adolescents.

The underlying cause of the syndrome is being overweight or obese. The increased fat stores make your body relatively resistant to insulin. A person needs insulin to drive sugar into the body’s cells. You need it for energy. As a person’s body becomes increasingly resistant to insulin, the blood sugar increases until you reach diabetes.

Along the way though, your body sends you signals—increased blood pressure, decreased good cholesterol and elevated triglycerides. If you heed the warnings and change your lifestyle, metabolic syndrome can be avoided. If you develop metabolic syndrome, you have markedly increased risk of heart disease and possibly stroke.

Although this complication will not probably occur during childhood, the earlier you develop metabolic syndrome, the earlier you are at risk for heart disease and possibly stroke.

We can avoid metabolic syndrome with exercise and good nutrition. Making simple changes in diet and activity level is achievable with minimal effort. (Remember an extra 3500 calories equals a pound in weight).

• Add color to your plate. Increase fruits and vegetables in your diet.
• Walk 2000 extra steps (roughly a mile everyday).
• Skip the extra brownie, cookie, piece of cake, or sweet—you’ll save 100 to 300 calories.
• Have three servings of dairy everyday—milk, cheese, yogurt or cottage cheese.
• Drink eight glasses of water a day and increase fiber intake.
• Avoid all soda pop. Limit juice to four ounces per day.

When you have a check-up at PIP, we will let you know whether your child’s BMI is high. We will also offer help, including the services of our in-house dietician Jackie Uglow, if appropriate, to get that BMI to a healthy level.

—Bruce Cantor, MD