Buckle up, because I'm about to throw a lot of information at you. Before we start, here's a pretty picture of a wrap I'm sure any kid would love to eat! For more healthy recipe ideas, be sure to follow me on Instagram at @ketoquinoakale.
In one of my previous blog posts, “My Fellow Americans, We are in Trouble”, I shared the disturbing facts that the USDA uncovered while surveying the nation’s population. (If you haven't read that post first, I would encourage you to do so). Recently, I woke up and thought, wait a second… Let me review some of those facts. Here’s what I read again:
“40% of children and adolescents are overweight or obese.”
“Based on 2015's average "Total Healthy Eating Index", all age groups have a lot of ground to make up to eat more healthfully. In order of healthiest eaters to least healthy eaters in our nation: ages 60+ take first, followed by ages 2-4, ages 31-59, ages 19-30, ages 5-8, ages 9-13, and ages 14-18.”
This time, I read those facts with different eyes. Why are school-aged children the worst eaters in America? Why do they progressively become worse eaters as they become teens? If it’s the fault of the parents, then why is their age group eating better than even 19–30-year-olds? I decided to investigate further.
My original hypothesis was that maybe folks older than 30 have started to have health issues that they have been told to manage through diet and exercise, but they don’t want to force these healthy habits on their children. I could envision career parents trying to meal prep on the weekend for their own healthy lunch of the same grilled chicken breast with baby carrots and making sure that they had salad available for the evenings, while their children incessantly whine about hating to eat the same things all the time. I figured, inevitably, that the children would win more often than not by either getting drive-thru, DoorDash, or heating up some frozen processed thing, served with chips and a dish of a sugary substance or two. It was my assumption that health becomes more important to us as we get older because we begin to recognize and confront our own mortality. Children can’t fully understand the connection between good nutrition and health and the game we all play to delay death, while teens have the riskiest behaviors of us all.
Not a bad hypothesis, especially when drawing from my own experiences with health coaching… But the truth is that the vast majority of individuals who I have health coached through the years have been mostly white men or women who are married with children in the home, or senior citizens (who are the best eating population in America). Here are a plethora of facts that I have discovered through my own personal research, searching for a more complete picture of why children are worse eaters and increasingly more overweight.
At first, my hypothesis was looking correct. I found a study by Tufts University from 1999-2016 that found that even though sugary drink consumption by kids had decreased over time, their sugar consumption in food did not decrease. In fact, by 2016, kids in America were still eating around 18 teaspoons (71.4 grams) of added sugar a day, accounting for one out of every seven calories consumed (Read more about the study here: https://now.tufts.edu/news-releases/national-study-finds-diets-remain-poor-most-american-children-disparities-persist). Researchers also found that sodium intake had significantly increased, which indicated more foods away from home or processed foods in general. To further hit this point home, I discovered a report from the Centers for Disease Control and Prevention that found that children and adolescents got 13.8% of their daily calories from fast food in 2015—2018, up from 12.4% in 2011 to 2012. Amazingly, still, the proportion of calories from fast food increased with age (just like overweight and obesity rates in children). Children ages 2—11-years-old were consuming 11.5% of their daily calories from fast food, compared with ages 12—19, at 18%. While doing my own research, I kept seeing statements like, “Obesity rates are higher in Black and Hispanic children.” I decided to delve even further into discovering what exactly that meant (You can read more about the last few facts here: https://www.nbcnews.com/health/kids-health/kids-u-s-are-eating-more-fast-food-cdc-reports-n1236756).
According to the CDC’s “Childhood Obesity Facts” page, “2017-2018, ages 2-19 years old: Obesity prevalence was 25.6% among Hispanic children, 24.2% among non-Hispanic Black children, 16.1% among non-Hispanic White children, and 8.7% among non-Hispanic Asian children.” Wait… what? Then I checked adult obesity rates by race, according to the CDC. “Non-Hispanic Black adults (49.6%) had the highest age-adjusted prevalence of obesity, followed by Hispanic adults (44.8%), non-Hispanic White adults (42.2%) and non-Hispanic Asian adults (17.4%).” It is clear that adults of color have higher rates of obesity, but not by the 9.5-16.9% spread that children have.
What is going on here? Why are children of color at such a significantly higher risk of obesity than that of their white or Asian-background friends?
Frances Flemin-Milici, director of marketing initiatives at the UConn Rudd Center for Food Policy and Obesity, stated, “Compared to white youth, Black youth view twice as many ads for fast food and other restaurants.” She added that on Spanish-language television, “about half of all the food ads that they view are fast-food restaurants.” According to the CDC’s National Center for Health Statistics, Black and Hispanic kids eat more fast food than their white counterparts, and over one third ate fast food on any given day. The fast food and junk food industry knows who their target market is, and they are exploiting them— especially children of color. (You can read about how this was brought to light more during the COVID-19 pandemic here: https://www.ehn.org/obesity-coronavirus-2645861896.html. I also highly suggest visiting this site just to use the interactive map of obesity in the world from 1975-2016). Also studying this issue is Aarti Ivanic, a University of San Diego professor (read more about her findings here: https://www.vox.com/the-goods/2018/9/28/17910518/black-hispanic-obesity-rates-food-marketing-mcdonalds-commercials-sprite-fast-food-junk-food).
It isn’t all just junk food advertising, though. This is definitely a more complex issue than that. Another disturbing fact, found on the CDC’s website, reads “Obesity prevalence was 18.9% among children and adolescents aged 2-19 years in the lowest income group, 19.9% among those in the middle-income group, and 10.9% among those in the highest income group.” This may indicate that those who receive SNAP or WIC benefits may have slightly less of an obesity rate than children considered in the middle-income group, but the children of the highest income group are significantly less at risk for obesity. According to the US Census Bureau, in 2019, the rate of poverty for blacks was 18.8%, Hispanics was 15.7%, and 7.3% for both non-Hispanic whites and Asians. It is also widely known, after multiple studies, that poorer neighborhoods often have fewer supermarkets with fresh produce, more convenience stores (which means more processed foods and sugary drinks), and higher concentrations of fast-food establishments. Harvard’s nutrition department has been studying the causes of obesity extensively for 20 years and have a lot of great points to consider (You can read more here: https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/food-environment-and-obesity/).
Harvard University’s "Obesity Prevention Source" led me to read the final source of my research, a report written and submitted by the Special Rapporteur on The Right to Food to the United Nation’s Human Right’s Council in 2011 (You can read the entire report here: http://www.srfood.org/images/stories/pdf/officialreports/20120306_nutrition_en.pdf). The report was written very passionately to point out that the entire food system in America is broken and will take government action, not just self-regulation by the food industry, to turn it around and prevent further obesity and chronic illness rate increases. My favorite portion of the report reads, “Taxpayers pay for misguided subsidies that encourage the agrifood industry to sell heavily processed foods at the expense of making fruits and vegetables available at lower prices; they pay for the marketing efforts of the same industry to sell unhealthy foods, which are deducted from taxable profits; and they pay for health-care systems for which non-communicable diseases today represent an unsustainable burden.” The author was not only critical of the current system, but offered recommendations, which include:
· Regulate marketing practices (not just for children)
· Impose taxes on unhealthy foods (like soft drinks and highly processed foods) and use those tax funds to bring down the prices of fruits and vegetables
· Review the current agricultural subsidies (focus on health and nutrition rather than profit— like how corn is grown for HFCS instead of a local vegetable)
· Increase support to connect farmer’s markets with urban customers
· Pass nutrition-based policies to benefit people of all races and socioeconomic status.
Though America has made some strides in raising the nutrition standards for school lunches, reducing the consumption of sugary drinks by children and adolescents, and slightly increasing the amount of whole grains eaten, we have continued on a very scary trajectory of increasing obesity rates. Not only have our overall statistics increased, but the disproportionate amount of minority populations affected sends another message entirely... One that sends a warning sign doused in gasoline and on fire, indicating that there are clearly racial and socioeconomic inequalities in our food system and environments. Of course I believe as a Registered Dietitian that nutrition education is important and vital, but it is simply not enough. We need public policy changes to even the nutrition playing field for people of color. This is a human rights issue for every tax payer in America. Improve the quality of food and we will lower the cost of healthcare for all— not just the white or Asian American.
Next, I will be researching why the rate of obesity is lowest in Asian-Americans. My hypothesis is that they have the lowest rate of poverty, higher levels of overall education, and are not marketed to by the junk food industry… But I am still curious as to what they are eating! So stay tuned for the next post.