Kids: Eat now, diet later?
Charles R. Attwood, M.D., F.A.A.P.

ome parents have insisted to me that their overweight children will have plenty of time to "grow out of it." They point out other family members who were fat as children but now, as adults, have lost the weight. This may be wishful thinking, in light of recent findings about excessive weight in children and adolescents. Dietary fat during childhood may be more life-threatening than was originally suspected. Excessive body fat appearing at two periods of childhood -- during infancy, or later during adolescence -- may increase the number of permanent fat cells. Later weight loss just shrinks them but doesn't take them away. This increased number of fat cells essentially remains in place for a lifetime, ready to absorb excess fat. So your child may not be able to eat now and diet later without a future health hazard.

A Tufts University study by Dr. Aviva Must (an epidemiologist at the university's Department of Agriculture's Human Nutrition Research Center) reported in 1992 that adolescent obesity in males is associated with a much higher death rate (double) from heart attacks, strokes, and colon cancer by age 70 than among their peers of normal weight, even when the youngsters later lost the excessive weight. The death rate was also higher than when obesity had its onset later when they were adults. Dr. Must insisted that obesity must be prevented during childhood, rather than trying to reverse it later on.

A child's obesity health risks remain,
even if the weight is lost later in life.

The increased number of permanent fat cells created during infancy and again during adolescence is probably the chief reason for the gradual weight gain in adults as they age, reduce their physical activity, and experience a metabolic slowdown. For example, old photographs of John Kennedy, Lyndon Johnson, and Richard Nixon as congressmen contrast sharply with later, presidential photos. Although none of them became seriously obese, the change in body weight is obvious and striking.

This weight gain over the decades of adulthood is neither normal nor inevitable. When the excessive numbers of fat cells are prevented during childhood by a low-fat, high-complex-carbohydrate diet -- which likely continues for a lifetime -- there is little excess fat consumed, and fewer fat cells into which it may be deposited. Also, as I will discuss later, this kind of food isn't easily converted into body fat.

(excerpt from "Dr. Attwood's Low-Fat Prescription for Kids")

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