Content provided by: Tiffani Ghere, Clinical Pediatric Dietitian


It’s common sense:  a body nourished by good, healthy food is stronger and less susceptible to illness than one deprived of vitamins, minerals, and essential nutrients. A balanced diet helps kids maintain a healthy weight and gives children the foundation they need to withstand the challenges of chronic health conditions.

Childhood obesity has been described as the most prevalent nutritional disorder among kids and adolescents in the United States. According to the Surgeon General's Vision for a Healthy and Fit Nation 2010, the United States is at a crossroads. On one hand, we are seeing great progress in prolonging the quality of life and number of healthy years lived. On the other hand, we are seeing staggering statistics in the rise of pediatric obesity which threatens this very progress.  

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems (WHO, 2000). It can predispose kids to insulin resistance and type 2 diabetes. The National Health and Nutrition Examination Survey (NHANES) indicates that the prevalence of obesity has increased in all pediatric age groups, among both sexes, and various racial and ethnic groups. Childhood obesity is affected by many factors: genetics, environment, metabolism, lifestyle, and eating habits. 

The easiest way to determine the amount of body fat a person carries is by calculating the body mass index (BMI). Figured using a child's height and weight, the BMI is an accurate measure of excess fat in children and teens. An increased BMI in children has been associated with poor cardio-respiratory fitness, as well as sleep disturbances like sleep apnea.1  The following chart shows a comparison of BMI averages from around the world, based on ages of 15 and up. A normal BMI for a person of this age ranges from 18.5 to 24.9. A BMI of 25 through 29.9 is considered "overweight."  A BMI of >30 is considered "obese."

obesity per country

Unfortunately, as the chart shows, average American who is 15 or more is obese.

% of population with BMI>30 collected from 1996-2003; OECD Factbook 2005

In the last 30 years, childhood obesity has tripled.
In the last 15 years, 
the obesity rate in California increased by 78%.
In the last 10 years,
the rate of diabetes in California has doubled.
In the last 5 years, 
California had a combined obesity and overweight rate of  64%.
 more than one-third of kids and teens are overweight or obese.


Foods with little or no nutritional value are called "empty calories" which are comprised largely of refined sugars and solids fats. The sad irony is that a child may be starving for the essentials he or she needs to develop into a healthy, adult – and yet still be obese. The foods kids often eat are full of unnecessary things like sugars, fats, and preservatives that fill them up without supplying the nutrients their bodies need for healthy growth.  Worse, they’re then too full to eat things that ARE good for them.

A birthday party, Halloween, or too many pancakes with artificial syrup in the morning...whatever the reason, the sugar rush begins. What happens to a kid's body afterward?

TEETH- Sugar + bacteria in the mouth = acid formation which can erode dental enamel and promote tooth decay.
- After 15 minutes, the goodies pass from the stomach into the small intestine where sugar is split into glucose and fructose.
- After 30 minutes, glucose rushes into the bloodstream, increasing blood sugar; fructose goes to the liver.
- The pancreas responds to the increased blood sugar levels and cranks out insulin to help cells use the glucose for energy.
-  With the surge of blood sugar, kids feel more energy and alert. Neurotransmitters "reward" kids with a feeling of a "sugar high".
- After 2 hours, all available energy has been used up and the leftovers stored as fat. Insulin and blood sugars drop. Kids begin to feel tired and foggy leading to poor concentration and a lack of energy.
- The drive to increase blood sugar is strong so more sugar gets consumed, and the cycle starts over.

According to the Kaiser Family Foundation, children between the ages of 8 and 18 spend an average of 45 hours every week in front of the TV, on a computer, playing video games, or texting and instant messaging their friends.  This means that kids aren't spending nearly enough time engaging in physical activity.  If the excessive intake of empty calories is the insult, then the lack of physical activity to burn off those calories is the injury. Together, these two things constitute the primary cause of childhood obesity among kids, and contribute greatly to disease.

Type 2 diabetes begins when the body develops a resistance to insulin and no longer uses the insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce sufficient amounts of insulin to regulate blood sugar (2). Eating foods with a high glycemic index can contribute to pancreatic overload. The glycemic index (GI) is a measure of the power of foods (or specifically the carbohydrate in a food) to raise blood sugar (glucose) levels after being eaten. Children and adolescents diagnosed with type 2 diabetes are generally between 10 and 19 years old, obese, have a strong family history for type 2 diabetes, and have insulin resistance. Usually, children and adolescents with type 2 diabetes have poor blood sugar control. Obesity is strongly associated with insulin resistance and glucose intolerance (3). The American Diabetes Association estimates that 2 million children — 1 out of every 6 — have pre-diabetes, which is a collection of risk factors that often leads to type 2 diabetes.

Excess sugars and fat in the diet are stored, because they can't be used as energy by the body. This fat storage occurs in the bloodstream as well as the fat cells. Damage to the lining of the blood vessels starts with a slippery slope of inflammation leading down a road to arterial blockage and cardiovascular disease. In addition to its role in the formation of arterial plaque, elevated cholesterols also affect the liver, where they are produced and where excess cholesterol is metabolized. A continued intake of empty calories can eventually strain the capability of the liver, causing damage to this vital organ.

beating heart


Eating poorly for sustained periods leads to the  accumulation of fat deposits in the bloodstream, which interferes with circulation. Over time, this can result in significant heath issues, including heart disease. Myocardial infarction (or heart attack) is usually due to the formation of plaque in arteries, which puts extra demands on the heart simply in order to pump blood through the body. Additionally, it slows down the return of blood to the heart. This causes two problems — the heart is fatigued by the continuous extra effort it must make, and it suffers a reduced supply of oxygen.

Obese kids and teens are more likely to become obese adults, and are more likely to suffer heart disease, type 2 diabetes, stroke, cancer, and osteoarthritis. Obesity is often linked to an increased risk for many cancers: breast, colon, endometrial, esophageal, kidney, pancreas, gall bladder, thyroid, and ovarian/cervical, as well as multiple myeloma and Hodgkin's lymphoma. Not only does being obese cause physical stress on a child's body, but psychological stress as well. Obesity in kids has not only been linked to depression and other behavioral disorders but the longer a child is overweight, the more at risk he is for mental health issues (4).

The qualities of a lifetime — and the habits, healthy or unhealthy — are formed and developed in childhood. That’s why, now, more than ever, it’s so important to change things. The Sapphire at School meal program will provide children not just with the foods they need to develop properly, but with the awareness and knowledge to make good choices to promote a healthy lifestyle.

Let's Move!

F as in Fat: How Obesity Threatens America's Future 2011;
Obesity Facts and Diabetes | Centers for Disease Control and Prevention

1. Carter PJ, Taylor BJ, Williams SM, Taylor RW. Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study. BMJ. May 26 2011;342:d2712.
2. CDC Public Health Resource
3. Bloomgarden ZT, Am Diab Assoc, Diabetes Care, Apr 2004

Psychology Today 12/2011,by Willow Lawson