Esther J. Cepeda: To fight child obesity, encourage kids to work their hearts

CHICAGO • Our children's hearts are in danger.

High rates of obesity are translating into rapidly growing numbers of children suffering from diseases that used to be seen only in middle age and beyond. According to a recent scientific statement from the American Heart Association (AHA), a large proportion of U.S. children fail to meet the standards set for ideal cardiovascular health.

"A primary reason for so few children having ideal cardiovascular health is poor nutrition — children are eating high-calorie, low-nutrition foods and not eating enough healthy foods, such as fruits, vegetables, whole-grains, fish and other foods strongly associated with good heart health and a healthy body weight," said Julia Steinberger, the lead author of the new statement and director of pediatric cardiology at the University of Minnesota in Minneapolis.

Yes, there have been some notable improvements in nationwide measures of childhood obesity — the Robert Wood Johnson Foundation (RWJF) reports that the national childhood obesity rate has leveled off and is actually declining in some school districts. But we still have a way to go.

Since 2003-2004, the obesity rate among U.S. youth ages 2 to 19 has held steady at 17 percent, according to the RWJF, with racial and ethnic minority groups — as well as low-income children — seeing fewer improvements.

The numbers reflect the divide between those on opposite ends of the wealth spectrum. More affluent Americans typically value and can afford fresh, locally sourced meals and prefer water as their main drink. Compare this to low-income communities in which fast-food dollar menus and sugary drinks are the norm. Among white youth, the national obesity rate was 14.7 percent between 2011 and 2014, compared to 19.5 percent among black youth, 21.9 percent among Hispanic youth and 20.2 percent among Asian-American youth during the same time period.

It's easy to simply blame junk food — the AHA's analysis of data from a 2007-2008 National Health and Nutrition Examination Survey found that children ages 2 to 19 get the bulk of their daily calories from simple carbs like sugary desserts and beverages.

And the scholarly research has been pretty clear on the things that work in fostering healthy eating and living habits for optimum weight: access to healthier foods, improved nutrition education, less sitting throughout the school day and more sleep at night.

But it's also important to note that kids simply aren't getting enough physical activity to protect their hearts.

Among children ages 6 to 11, only half of boys and just over a third of girls were active for the recommended 60 minutes or more per day. As children reached 16 to 19, the percentage meeting the recommended amount of physical activity decreased even further, to 10 percent in boys and 5 percent in girls.

It is especially noteworthy that minority and low-income children are additionally hampered by not having safe spaces in which to exercise and be active.

The Robert Wood Johnson Foundation Research Network to Prevent Obesity Among Latino Children recently published a brief that illustrated how under-resourced communities get left out of physical activity opportunities.

One study found that, compared with 38 percent of white neighborhoods, 81 percent of Latino neighborhoods did not have a recreational facility. Another study of a Latino-majority region found that unpleasant neighborhood conditions, such as trashed streets, gang activity, odors, dilapidated playgrounds, unleashed dogs and speeding cars prohibited children from being active.

These circumstances are hardly limited to Latinos — most low-income communities contend with crime, polluted air, crumbling play structures and a lack of green community space.

The solutions aren't simple, but some have been found to be achievable. For instance, in some Latino communities, formal contracts between a school and a city, county or sports league have outlined ways to share existing physical activity facilities, and have helped increase access to active spaces. Similarly, scheduling park programs to occur in the evening so that parks are occupied with positive activities and are accessible to the greatest number of attendees has made a difference in some places.

The battle against the childhood obesity epidemic started with nutrition awareness efforts. The subsequent education campaigns have largely succeeded in reaching those with the most resources for implementing good nutrition and physical activity habits.

The next push must be to reach the youngest, lowest-income among us — with not only tips for eating, but with real resources for getting the exercise needed for healthy living.

estherjcepeda@washpost.com

Twitter, @estherjcepeda