The Threat From Within

This may be the first generation in which children live a shorter life span than their parents. If this were caused by a new virus or pathogen, or if some madman was harming our children, there would be a call to action from most parents, an uprising and an uproar. But it's not some external germ or sinister force that's eating our young; it's what our young are eating—too much fat, salt and sugar. And it's not only what they're doing, but also what they're not doing—a lack of regular exercise.

So many kids in our country are overweight, they're getting sick and dying prematurely. Overweight kids suffer disproportionately from diabetes, asthma, high blood pressure and other serious health problems. A study last summer in the Annals of Internal Medicine found that being overweight at 18 is associated with an increased risk of premature death in younger and middle-aged women.

Since 1970, the percentage of kids who are overweight or obese has risen almost fourfold, from 4.2 percent to 15.3 percent. Overweight kids have an estimated 70-80 percent chance of becoming obese adults, and 65 percent of adults are overweight or obese.  As Tommy Thompson, the former secretary of Health and Human Services used to say, "We're just too fat."

If you want to see something really scary, download the maps on the Centers for Disease Control and Prevention Web site . You can see the obesity epidemic spreading like cancer metastasizing across the country from 1985-2005. It looks like an alien force or a conquering army is taking over the United States, state by state, year by year.

It gets worse. Another study in the Annals of Internal Medicine that followed 4,000 people over 30 years found that 9 out of 10 men and 7 out of 10 women will eventually become overweight. Diabetes in 30-year-olds has risen 70 percent in the past decade. The complications of diabetes include heart disease, impotence and damage to the eyes, nerves and kidneys. Amputations of feet and legs are not uncommon.

According to former surgeon general Richard Carmona, M.D., "As we look to the future and where childhood obesity will be in 20 years ... it is every bit as threatening to us as is the terrorist threat we face today. It is the threat from within."

If you're a parent, like me, this is scary stuff. It can paralyze us, or we can do something about it. It doesn't matter if you're from a Red State or a Blue State, this is a profoundly human issue that transcends ideology and politics.

The good news is that childhood obesity is almost completely preventable. And we don't have to wait for a new drug or technology. We just have to put into practice what we already know. Now, imagine you have an intervention that can help cure childhood obesity. It doesn't cost anything, it's playful, fun and easy to learn, and the only side effects are good ones.

It's called exercise.

Obesity, childhood and otherwise, is an imbalance between energy intake and expenditure, calories in and calories out. While several factors affect this equation, the ones we have the most control over are what we eat and how much we exercise.

In my earlier NEWSWEEK columns , I described what you and your kids can eat to stay healthy and wrote about efforts to make healthier beverages, snacks and foods available in schools. Here, I want to focus on the exercise part of the equation.

With the rise in videogames and the lack of exercise in schools, fitness is going down and fatness is going up. I was shocked to learn that only one state in the country—Illinois—mandates physical education in schools. That's pitiful.

I called my friend Dr. Kenneth Cooper, one of the pioneers of preventive medicine who coined the term "aerobics," and asked him why. "When we went to school many years ago, 90 percent of us had physical education,” he said. “Now it's just reversed—only 10 percent of schools have physical education. Why can't we change this? One of the single most important things that America could do to reverse this trend is to put physical education back in schools and mandate it for all students."

I also spoke with Jim Whitehead, who is vice president of the American College of Sports Medicine and is serving this year as president of the National Coalition for Promoting Physical Activity. I asked him, "Why can't we pass laws that mandate physical education in every school? What would have more public support than something that's proven to prevent something really awful in kids?"

According to Whitehead, one of the unintended consequences of the No Child Left Behind Act was to significantly reduce the number of schools offering physical education. Schools are rewarded or punished based on results from standardized tests, so many schools are cutting physical education out of the curriculum in order to spend more time teaching students to do well on these tests. "The physical fitness of students is not one of the metrics used to incentivize schools," he said, "so it worsens the trend of getting physical activity out of the school systems on a national basis."

Ironically, studies have shown that physical education in schools improves academic performance as well as physical fitness. A study by the California Department of Education of more than 350,000 fifth-grade students found a direct correlation between physical fitness and SAT scores, with the most fit in the 71st percentile and the least fit in the 36th percentile—almost half as much. When they looked at 322,000 seventh-grade students, they found an even bigger gap—the most fit scored in the 66th percentile on their SAT tests whereas the least fit scored in the 28th percentile.

Surely we can find some time in the academic curriculum for an hour of physical education each day, or at least three times per week, especially since exercise improves academic performance. Not every class is essential to our kids' academic development. As Paul Simon sang, "When I think back on all the crap I learned in high school, it's a wonder I can think at all."

At the Woodland Elementary School in Kansas City, discipline incidents involving violence decreased by 59 percent and the number of school suspension days decreased by 67 percent only one year after returning physical education to fourth and fifth graders. According to Craig Rupert, the school's principal, "It's not just the increased levels of fitness we are seeing in our kids which has everyone excited. Students are also more motivated throughout the day, their enthusiasm is way up, and discipline issues are way down."

These findings are consistent with a recent article published in the Journal of Pediatrics. Dr. Jennifer Miller and her colleagues reported that kids with early-onset morbid obesity had significantly lower cognitive function and more behavioral problems than those with no history of childhood obesity due to abnormal hormones and metabolism found in obese kids.

What can we do?

As Margaret Mead once wrote, "Never underestimate the power of a small group of committed people to change the world. In fact, it is the only thing that ever has." We need an uprising of concerned parents and other citizens to call their members of Congress. We need 50 states to mandate physical education in K-8 schools, not just one state. Also, we need to revise the No Child Left Behind act to incentivize rather than disincentivize regular physical education in schools.

You can also contact your state legislators, which tend to respond if they hear from enough concerned parents. For example, in California, where I live, Gov. Arnold Schwarzenegger's 2006-07 budget designated $500 million for physical education and the arts. Given the economic and health consequences of childhood obesity, as well as the continued rise in health-care costs, this is a wise investment in our most important national resource: our children. It's time to tell our legislators to start exercising ... good judgment.

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