Still No Clear Solutions for Childhood Obesity

It's been 20 years of steady upward girth inflation for our nation's children, but we've yet to successfully address the critical issue of childhood obesity.

By Kantha Shelke, Ph.D., Contributing Editor

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The debate may rage on as to who is responsible for children's poor eating choices, but the key question is, how can we reverse this trend?

Overweight children — something nearly all public health experts agree is our top health-crisis challenge — has grasped the attention of our governments, researchers and society at large. The situation is so severe David Ludwig M.D., Ph.D., and his co-researchers at Children's Hospital, Boston, shook the medical and regulatory communities in March with their report that today’s generation of children may be the first group to die younger than their parents. Public attention and pressure, arguably misplaced in some respects, have intensified on the food industry to provide a solution.

Poor nutritional choices are the dietary linchpin of obesity. Today’s youth are increasingly relying on foods that are calorie-dense, sugar- and fat-laden and purchased outside the home. Sedentary lifestyle compounds the nutrition deficit leaving our children to face a lifetime of health woes.

At the April conference of the Federation of American Societies for Experimental Biology, it was revealed no other source approaches soda and fruit drinks in providing more calories to the American teenager’s diet, with cakes, cookies and candy 13 percent lower in calorie contribution. Fiber intake for U.S. kids was dismal. Put succinctly, kids are eating as regular meals foods and food components that should be occasional treats. American children are, ironically, fat yet malnourished.

Yet can food choices be blamed on, or considered the responsibility of, food companies? There’s no avoiding the fact kids take the brunt of marketing messages for “empty-calorie” products. But at the end of the day, parents and guardians influence what their children eat — by purchasing power, example and teaching. But processors have become more aware of the role they play.

Most of the food and drink brand names heavily advertised are owned by just five major food companies, Kraft, General Mills, PepsiCo, Nestle and ConAgra. These companies are very much aware they have a vested interest in the debate on how to combat the obesity epidemic. The food industry can take a pole position in ensuring adequate childhood nutrition. By creating healthier, nutrient-rich foods and marketing them responsibly, they will help abolish incentives for making poor quality foods.

Prevention

Prevention is the most effective approach to fight obesity, and there is plenty of opportunity for food processors to participate. Janice Newell Bissex, former nutrition consultant to the U.S. Senate and founder of Meal Make Over Moms, Melrose, Mass., points to Barbara’s Bakery (www.barbarasbakery.com), in Petaluma, Calif., as an excellent example of a child-friendly food processor. Foods from Barbara’s Bakery, which include snacks, cookies, crackers, cereals and other baked goods, make use of whole grains and have no added sugar or fat. The company also adds fiber and omega-3s to its many products.

Reducing sugar is probably the single best thing processors can do in their formulations. “Healthy, low-sugar eating patterns must be established in early childhood to create a lifelong routine of nutritious eating,” says Richard Visser, M.D. and founder of SimplyH (www.simplyh.com), a health-oriented children’s foods and beverages group based in Los Angeles.

Although the recent upsurge in whole grain foods, specifically breakfast cereals, was a major positive step in improving nutrition for kids, there’s still a long way to go. Endorsements from organizations such as the American Heart Assn. and the American Diabetes Assn. often appearing on products may lead them to be perceived as OK to eat unlimited amounts of. Yet a number of these products deliver 12 to 14 g of sugar per cup — that’s 40 percent of calories from sugar.

Key Nutrients

Several nutrients are gaining prominence in the fight against obesity: dietary fiber, omega-3 fatty acids, calcium, iron and pre/probiotics. Diets rich in omega-3s have been associated in research with a number of health benefits. Unfortunately, American kids do not traditionally eat diets high in this beneficial fat. Of the numerous cardiovascular and other health benefits associated with omega-3s, they are also crucial to nerve development. Other studies have shown omega-3s may help maintain lean weight status.

Source Food Technologies (www.nextraoil.com), Raleigh-Durham, N.C., recently launched Nextra Gold, a trans fat-free oil enhanced with heat-stable phytosterols. The heat stability is the key for this nutrient, previously difficult to keep stable even at ambient temperatures. President Hank Cardello says, “Every little bit counts, and processors that can invisibly enhance the nutritional profiles of their food products are likely to help win the fight against obesity.”

Horizon Organic has incorporated NutriFlora from GTC Nutrition into its lunchbox organic smoothies, providing added digestive and immune health benefits.

Calcium has perhaps the most profound influence on long-term health of children. Adequate intake in the early years is critical to bone health and growth. While dairy products are excellent sources of calcium, there are a number of alternative calcium-rich foods that can be incorporated into the diets of children.

Interestingly, fiber may help calcium absorption. Orafti Active Food Ingredients (www.orafti.com), Malvern, Pa., makes an enriched blend of the fiber inulin (Raftilose Synergy 1) which has been clinically proven to improve bone health. When consumed along with calcium, inulin helps boost the body's absorption of calcium by as much as 20 percent, which in turn leads to an increase in bone mineral density.

In a study at the Baylor College of Medicine, Dallas, supplementation for one year with 8 g per day of the enriched inulin led to a 15-percent increase in calcium retention and accretion. These findings suggest adding enriched inulin to calcium-fortified foods could help enhance bone health.

Fiber is essential in children’s diets and may come from vegetables, fruits and whole grains. The general rule of thumb for calculating fiber for children is “their age plus 5 to 10 g of fiber per day. So, a 4-year-old requires 9 to 14 g per day; adults over 20 years need 25 to 35 g per day.

Fiber-rich diets may play an important role in reducing and preventing obesity. Jennifer Lovejoy, research professor and chair of the nutrition and exercise science department at Bastyr University (www.bastyr.edu), Seattle, demonstrated conclusively in 2001 that the amount of fiber in the diet is the greatest single predictor of obesity. Individuals who consumed the highest levels of dietary fiber were significantly less obese than those who consumed the least. Non-refined grains and fiber-rich foods supposedly satiate the body more and encourage a healthier metabolic system than diets laden with fats, sugars and refined grains.

Food processors also can help fight the obesity epidemic by making more tasty foods containing adequate amounts of dietary fiber. Introducing more fiber in children's diets helps improve diet quality, as higher-fiber diets are generally more nutrient-dense.

Best of all, fiber is not a difficult ingredient for food processors to incorporate into product. HiMaize, from National Starch Food Innovation (www.foodinnovation.com), Bridgewater, N.J., is one of many resistant starches the company produces to improve the nutrition profile of processed foods. Instead of being digested and absorbed in the small intestine, HiMaize passes through to the large intestine and acts as an effective prebiotic. Rhonda Witwer, Ph.D., business development manager-nutrition, says HiMaize can be used to replace as much as 50 percent of the flour in a baked item without a noticeable difference.

FiberWise, a fiber-rich pasta product developed by Foulds Pasta Co., Libertyville, Ill., is another case where thinking of kids benefits the processor. “Whole wheat pasta can be markedly astringent to the sensitive palates of young children. But fiber is too critical for their well-being, as it is for the whole family,” says Chris Bradley, Foulds’ president. “FiberWise was formulated to taste mild and nutty, and a single 2-oz. serving contains 12 g of fiber – almost all a child’s daily recommended intake,” Bradley adds.

Horizon Organic Dairy, Boulder, Colo., has effectively incorporated NutriFlora from GTC Nutrition (www.gtcnutrition.com), Golden, Colo. in its lunchbox organic smoothies. The short-chain fructo-oligosaccharides act as prebiotics, help increase calcium and magnesium absorption and add digestive and immune health benefits.

Cargill Inc., Minneapolis, has prototypes in the works of breakfast cereals made with resistant starch and fiber-enhanced hamburger buns. Other products aimed at improving child dietary health include low-calorie juice, zero-trans fat cinnamon scones and fruit smoothies made with CoroWise plant sterols. Cargill is banking that such ingredients can be used to successfully, and profitably, create more healthful versions of foods and beverages typically found in school lunchrooms across America.

McDonald's has stepped up to the (healthier) plate by adding Apple and Walnut Salad to its menu and offering Apple Dippers as an alternative to fries in its kids’ Happy Meals.

Fun with Fruit

As a first step to manage the obesity epidemic, the USDA released the 2005 Dietary Guidelines to motivate and educate consumers to make positive diet and lifestyle choices. According to USDA, many children do not obtain adequate amounts of calcium, potassium, fiber, magnesium and vitamins A, D and E – an open invitation to food processors to meet that need.

Food companies are responding with several technologies that revolve around fruit, but it’s hard to beat fresh — something McDonald’s Inc. (www.mcdonalds.com) understands well. The Oak Brook, Ill.-based restaurant chain offers Apple Dippers as an alternative to french fries in its kids’ Happy Meals. These, and the newer apple and walnut salads, have been so successful they’ve made the company the world’s leading purchaser of apples — more than 55 million pounds of them annually.

“Restaurants can help be a part of the solution, to have consistent messages and menu choices that meet consumer demand and dietary guidelines. But food does not become ‘nutrition’ until it is eaten. That’s where the aspects of fun and taste come in,” says Cathy Kapica, Ph.D., R.D., director of global nutrition for McDonald’s.

Sunkist Growers Inc., Sherman Oaks, Calif., is another kid-forward thinking company. Its Fun Fruits line of sliced fruits (oranges, apples or pineapples, or red grapes with no stems) in half-cup serving packages has been a hit since it was launched. Combining convenience with clever packaging that incorporates pictures of kids, the product clearly connects with its target audience. By engaging children in the benefits of fresh fruits, Sunkist has found a way to benefit children and the co-op’s bottom line.

Field Fresh Farm LLC, Missoula, Mont., found another way to get more fruit into the diet with its Cereal Toppers freeze-dried, preservative-free fruit. The company’s freeze-drying process retains the taste of the fresh fruit, releasing it when rehydrated with milk or water.

Back to School

Is it viable for big companies to participate in the wellness sector? Absolutely. Stonyfield Farm, Londonderry, N.H., strategic partner of Groupe Danone, the Paris, France-based water and dairy products conglomerate, has a grassroots program called "Menu for Change: Getting Healthy Foods Into Schools." Stonyfield is working to make healthy choices an easy choice in school. The company has even experimented with in-school vending machines for its yogurt products.

There are several examples of governmental and business enterprises stepping in to help tame the childhood obesity beast. In the UK, celebrity chef Jamie Oliver has become involved in creating healthy food alternatives for school lunches with help from the British government.

On this side of the pond, ADM, Decatur, Ill., is collaborating with researchers from the Illinois Center for Soy Foods at the University of Illinois. They plan to introduce healthier and tastier soy-enhanced foods into the school lunch programs. The project is titled Project ISoy.

Turning the Corner

The war against obesity is really a war against apathy. As society and the food industry become more involved in the critical importance of nutrition and physical activity in warding off obesity, we can hope to see the trickle of positive changes turn into a flood. In spite of the child obesity problem being one of individual choices, it seems apparent it cannot be addressed on an individual basis. As a primary influence, the food processing industry is poised to capitalize on a paradigm shift in how it creates — and markets — foods designed with healthy kids in mind.


Industry Takes Steps to Police its Own On-Air Messages

The food industry is serious about stepping up to the plate when it comes to the childhood obesity crisis.

In July, the Grocery Manufacturers Assn. (GMA) announced it has the support of Kraft Foods, General Mills, Hershey, PepsiCo, Campbell Soup, Nestle, Sara Lee and Unilever to eliminate product placement in kids’ television shows and create ad guidelines covering video games and the Internet. The companies are also calling on the Children’s Advertising Review Unit of the Council of Better Business Bureaus to put new limits on product placement and to conduct more advance reviews of ads aimed at kids.

Reports on these new endeavors quoted GMA executives as declaring, “We want to be part of the solution.”

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