Who is to blame for childhood obesity?

Every first lady has taken on a "CAUSE" that is politically attractive, socially convincing, humanly desirable, and personally rewarding during the term of her husband's presidency. Whether the cause was to beautify the highway, promote fine arts, encourage literacy or attempt to curve the popped belly among the youth, they all mean to do "good" and to improve something or someone. But some of these causes touch my cynical side as I think of the bigger picture in a way my limited capacity attempts to see it. A cause that I consider ambitiously conscious of liberal national health care agenda has been revealed recently called, "Let's Move".

While paying attention to the recent "Let's move" campaign to fight against childhood obesity, I hoped to hear that first lady would be comprehensive in her effort enough to tactfully address the issue by focusing not only on fast food restaurants' menu, quality of school lunches or manufacturer's labels, but also on the influence of the maternal lifestyle before and during pregnancy and beyond. There is a documented association (based on multiple large epidemiological studies across the globe, animal studies and human studies ) between the childhood obesity and pre-pregnantly obese mothers, formula feeding or smoking mothers. These factors are known predictors of childhood obesity.

http://www.medscape.com/viewarticle/433309

This link below takes you to a systematic review article. Well, people have been studying about this issue far and wide for decades.

http://www.ncbi.nlm.nih.gov/pubmed/18278059?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed

One study from Germany reviewed 35,434 five to seven-year-old kids and found that smoking in the living place was associated with obesity or overweight. However, breast feeding more than 3 months and having increased educational level (of parents) had a decreased association with obesity. http://www.medscape.com/viewarticle/577744

Another study showed that maternal obesity and smoking during pregnancy were correlated with childhood obesity. http://informahealthcare.com/doi/abs/10.3109/17477160903060028?cookieSet=1&journalCode=jpo

Prenatal programming is a concept that is not new. Unhealthy mom translates into an unhealthy babies. Googling prenatal programming can be fun. My favorite book that is written in lay terms is "The prenatal prescription" by Peter Nathanielsz, M.D, Ph D. (2001) Harper Collins Publishers:New York. I highly recommend it to anyone who would like to begin parenting before you meet your baby.

A review done on 200,ooo birth records is titled, "Can prenatal care prevent childhood obesity?". The link is below and I think most of us would feel that common sense is simply reinforced by epidemiologists' thorough review. Smoking moms and obesity before pregnancy doubled the risk of childhood obesity in their off springs' lives.

(http://www.imakenews.com/cppa/e_article001081327.cfm?x=b11,0,w)

Of course, none of these studies prove that obese mom or smoking moms CAUSE children to become obese. The argument is made that fighting childhood obesity would reduce the health care cost and improve general health by potentially decreasing future diabetes, high blood pressure an cardiovascular diseases. Childhood obesity is ASSOCIATED with these conditions including premature deaths. But of course it does not prove that obesity causes any of the end results named above for certain. But national action is suggested based on the significant association of obesity and future illnesses hoping for a subsequent health care cost reduction. Why are they not also focusing on prevention of smoking and obesity among fertile young female? Why are they trying to challenge all the elements of society except for the very moms who carry the babies who have the potential to make the difference first hand? Is it because addressing obesity or smoking would be considered discriminatory? Is it because talking about young ladies' obesity is so wrong for self esteem reasons? I agree that it is a very touchy and tough discussion to bring up. I have done it, believe me. I have met many many moms who did not know that they were 6-7 months pregnant due to their obesity. It is also very tough for the food industries and especially tax payers to foot the bill and assume much of the responsibilities related to the childhood obesity. The government is already in the "RED" in a serious way and it is questionable to say the least to neglect preventable factors of the equation of the formula for childhood obesity.

The current administration is requesting 10 billion over next 10 years toward making school lunches (and breakfast) healthier. Congress would look like a villian if they do not pass that, right? Words are spread by FDA to enhance the food labeling so that parents can see how good or bad the food items are and to make choices that promote healthy life style. Enticement of food is less related to the words they read but more associated with the visual effect of the yumminess of the food. Am I wrong? I wonder if it would further increase the effectiveness of the food label if the label included an illustration of an obese child with an insulin syringe in his or her hand or having a blood pressure cuff wrapped around?

http://www.cnn.com/2010/POLITICS/02/09/obama.child.obesity/index.html

When we look at the first lady's attempts to resolve childhood obesity, it appears that none of the preventable personal responsibility elements of prenatal factors are addressed with the same rigor that she approaches the fast food establishment or school lunches with. I wish she would say, "ladies, watch your life-style and quit smoking during pregnancy, since smoking during pregnancy doubles the risk of childhood obesity", or "Moms, get off the assistance and consider breast feeding for your health and your babies'." I consider childhood obesity as one of the symptoms of poor prenatal/perinatal health that must be addressed not after birth but before.

Her agenda is closely tied to the current push for the national health care. I don't think it is a coincident that she picked this issue...... I am not articulate enough to make a sound argument here. I hope someone you get it.

Even though, I completely agree that we must prevent childhood obesity, making this a national campaign now in the way this initiative is presented can potentially lead to more cost than reduction of the cost.

I am a pain in a the "XXX" to all the moms I come in contact with at work, especially when they request WIC form and show no interest in breast feeding or cutting back smoking. I hate to say this, but recent efforts I made while at work to encourage breast feeding on moms on public assistance (WIC, medicaid, food stamps) all failed. I explained that breast feeding assist them to use extra calories a day (meaning, many women lose weight faster), there are other hormonal factors to enhance recovery from delivery of the baby, protects the babies from infection by passing mom's immune molecules,,,, etc etc... Moms often said, 'Well, formula is much easier and its free". Free to these moms' pocket but not to the state or the nation. Something does not sit well when more money is invested into the subgroup who contribute very little to their nation except breathing back CO2 out when we omit too much out of our environment. So, by helping them in a way we do now, we are discouraging them from breast feeding. During the days when moms were malnourished, formula assistance meant survival to the infants. Situation here is slightly different. We are also likely helping them to afford the cigarette habit easier. I am not convinced that more investment to help improve the school breakfast and lunches an making "good food" affordable would have an impact worth 10 billion dollars. Even if the schools have better food selection, what if the kids just ate more of it, therefore ingesting not much less calories with little curving effect on the obesity.

If I can add one more correlation with maternal obesity, I would mention that no docs, NICU nurses, NPs would deny that incidences of toxemia or premature births among obese moms are rather frequent occurrences in NICU. We see many of those babies who end up coming way too early,,,,, the cost is enormous. It is not rare that I have to type under the maternal health record section with the diagnosis of, "Maternal Obesity".

The society is saying that the children are obese because fast food places sell fattening foods, or because foods at grocery stores are not labeled with screaming messages to say "don't buy me" /"I will add a pound on you!", and because school lunches and breakfast do not consist of low fat foods. Probably, there is also a suggestion of the need to widen the food selection on the public assistance food program so qualified food items will include more expensive items (high fiber, low fat items are often priced higher, we all know that). The grocery stores may increase sales at the cost of the state but I bet my money, the prices for regular customers would increase in the future. Someone will have to pay. If you work, that would be you and I.

I wish the first lady had the courage to address irresponsible fertile women and men. My view is that preventable issues that can be addressed without squeezing the national budget are completely overlooked, probably on purpose. The population who will benefit from such agenda of hers likely overlap with the population who would love to push for the national health care.

Nothing is wrong with helping, but what about meeting half-way on at least on one of these issues?

I cannot help but opening my mouth every time I see an overweight mom with cigarette pack at her bedside declaring the need for the public assistance form for me to sign. They are not entitled to the provision, but the babies are entitled to a bit more effort from their moms.

I am unfortunately afraid to make some of these young moms upset. One mom told me that, smoking was her right. Well, maybe it is. Babies can not assert their rights to avoid immersion in nicotine flooded environment for montsh.

This is simply my personal view and please read it as such. I welcome any opinion.

So, "Let's Move" away from the "entitlement" philosophy. Oh, but that is not what She meant.