ACADEMY PUBLIC POLICIES

Childhood Obesity: Quality Physical Education as a Solution

I heard that waist circumference is important. What does it mean if my child has a large waist size?

Excessive abdominal (stomach, belly) fat has a worse health prognosis than fat distributed elsewhere on the body. A male with a waistline over 40 inches or a no pregnant female with a waist of more than 35 inches is at a higher risk of developing such medical conditions as diabetes mellitus, elevated cholesterol and triglycerides, hypertension, and coronary artery (heart) disease.

Thus, it is not just the weight that matters, but also the weight distribution. Weight around the waist is worse than excess pounds in, say, the legs.

Metabolic syndrome is a condition that is sometimes seen in adults. This is cluster of risk factors for heart disease and stroke and includes the following:

• Excess abdominal fat

• Abnormal blood lipids (fats), including high triglycerides, decreased high-density lipoprotein (HDL) cholesterol, and elevated low-density lipoprotein (LDL) cholesterol

• Insulin resistance/high blood sugar

• High blood pressure

• Elevated markers of inflammation such as blood C-reactive protein

The key problems with the metabolic syndrome are obesity and insulin resistance. It is estimated that 50 million people in the United States have this syndrome, which the American Heart Association defines as follows:

• Waistline: men ≥ 40 inches (102 cm) and women ≥ 35 inches (88 cm)

• Elevated triglycerides ≥ 150 mg/dL

• Reduced HDL (“good”) cholesterol: men < 40 mg/dL and women < 50 mg/dL

• High blood pressure ≥ 130/85 mm Hg

• Elevated fasting blood glucose ≥ 100 mg/dL

Key to treating this is prevention of obesity in children. After a person has this syndrome, the goals are to lose weight, treat the elevated blood pressure and sugar, increase exercise, and go on a diet low in saturated and trans fats and cholesterol.

 Terms:

Diabetes mellitus - A complex disease of small blood vessels and glucose metabolism. It is manifested by elevated levels of sugar (glucose) in the blood. Long-term adverse consequences include kidney failure, cataracts, poor circulation leading to heart attacks, strokes, leg ulcers, and other serious problems.

Cholesterol - A fat (lipid) that is an essential part of the membranes of cells. It is made by the body as well as ingested with food. It is a steroid and is necessary for life, but an excess can produce atherosclerosis leading to vascular and other diseases including heart attacks and strokes.

Triglycerides - Lipids or fats composed of three molecules of fatty acid attached to one molecule of glycerol. Elevated levels have been associated with the development of serious medical diseases.

Hypertension - An elevation of the pressures in the heart and arteries, which can lead to severe disease including heart attacks and strokes. Also called high blood pressure.

Coronary artery (heart) disease - A disease of the arteries of the heart in which the deposition of plaque (cholesterol, calcium, and other compounds) progressively blocks the flow of blood to the heart, which can lead to chest pain (angina pectoris) and myocardial infarction (heart attack).