Posted on: Tuesday, August 5, 2003

Experts urge keiki weight checks

By Robbie Dingeman
Advertiser Health Writer

With recent studies showing the rate of childhood obesity in Hawai'i at twice the national average, local experts are urging families to focus on more exercise and healthy eating to prevent an epidemic of overweight children.

The American Academy of Pediatrics has just issued a new policy calling for all children to have their body-mass index, or BMI, measures checked annually to identify weight problems early.

Hawai'i children face some of the same pressures as children on the Mainland: sitting in front of televisions, computer screens and video games, as well as the constant availability of cheap, tasty high-fat foods, said Dr. Jeff Okamoto, developmental behavioral pediatrician at Kapi'olani Women's and Children's Medical Center. In addition, there's a cultural blend that practically requires the sharing of food for gatherings, he said.

"Our culture is so based on food," said Okamoto, who is among those alarmed by the weight gains in Hawai'i keiki.

Okamoto said the trend had been edging upward since the 1970s but changed dramatically recently. "We've really seen a big spike over the last decade."

Until 1994, the national average was 10 to 11 percent of children (ages 6 to 19) considered obese — defined as above the 95th percentile for weight in the growth charts. But by 1999 that rose to 13 percent for children and 14 percent for adolescents. A study by professors from the University of Hawai'i and Brigham Young University-Hawai'i studied obesity rates among 1,437 Hawai'i students in one school district and found double those rates for the period from 1992 to 1996.

Dennis Chai, associate professor of kinesiology — the study of muscles — and leisure science at UH, is one of the study authors and has been working to gauge the problem and prevent obesity.

In a study published in February in the American Journal of Human Biology, Chai and other researchers noted the sharp increase, especially in those of Hawaiian ancestry. The average obesity rates ranging from 20 to 26 percent for ages 6 to 11; and from 22 to 25 percent for12- to 19-year-olds.

Okamoto said no ethnic group is immune. "There's a stereotype that it's not affecting Asians," he said. "It's hitting everyone."

He said families need to work together to improve the health of future generations. Get children involved in sports, martial arts and being more active. Have everyone eat more fruits and vegetables.

Okamoto and his colleagues have been talking about BMI measurements for children and teens for years. He worked with Susan LaFountaine, manager of rehabilitation services for Kapi'olani, and others to develop a handy tool to take the height, weight and age of a child and use it to calculate a child's BMI.

The result is a paper wheel that doctors or health aides will be able to use in their office to flag the concerns about weight. The wheels are expected to be ready later this year and are being produced with the help of a $4,000 grant from the Healthy Hawai'i Initiative, which uses tobacco settlement money to help encourage healthy habits.

LaFountaine noted that a recent survey found 70 percent of today's parents rode bicycles or walked to school when they were kids, but only 18 percent of their children walk or bike to school. People are worried about safety and unwilling to let their children play outside the way previous generations did.

Some find that if they get more exercise, turn off the TV and eat more fruits and vegetables, they slim down as they grow taller. "The height will sort of a catch up with the weight," she said.

"More activity and better nutrition are just the bottom line," LaFountaine said. Because children keep growing taller, it's possible for doctors to counsel families to make changes that prevent the children from gaining more weight without forcing them to lose weight.

LaFountaine said health educators walk the line between wanting people to be aware chubby children face big health risks without stressing people about weight so much that they develop eating disorders.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.