Tip-toeing around the "O" word

I had a surreal moment last week as I attended a meeting of our coalition to get kids to spend less time transfixed and inert in front of screens where they often pass the time munching junk food.

The chief motive behind the effort is childhood obesity and the resulting, astonishing rise of diabetes among children.

Our group, which consists primarily of public health professionals, is preparing an all-out effort to get child-care providers to come to a meeting where we can address the problem.

As we wordsmithed our invitation, somebody said, “Don’t use the word ‘obesity’ because many childcare providers are obese and take it personally. They’ll just tune us out and won’t come to the meeting”

Ooooooh Kaaaaaay.

After I let a politically appropriate and sensitively calibrated length of time elapse (like until the end of the meeting), I approached a colleague with the obvious question.

“If the problem is obesity and we can’t talk about obesity because the people we are talking to are obese, how are we going to make any progress?”

She didn’t blink. “Talk about fitness.”

“But fitness isn’t the problem.”

“But it is the solution.”

“But doesn’t talking about fitness offend obese childcare workers who aren’t fit?”

“Well, some of them may be fit.”

“Even though they’re obese?”

“Yup.”

“So what’s the problem with childhood obesity?”

“The kids are at risk of developing diabetes and many who are obese aren’t fit.”

“Aren’t the childcare providers also at risk?

“Well, yessss.”

“So?”

“So we talk about fitness. There’s a better chance they’ll listen.”

Unless, of course, they consider themselves and the children in their daycare to be perfectly fit — however overweight they all might be.

If that’s the case, they still aren’t going to listen.

Did somebody say the emperor has no cloths on?

Screens: When more is harmful

Jean Rystrom, my friend and fellow member of the Healthy Kids Watch Less TV coalition, once again has shared some of the 2007 research that bears on our interest in the consequences of excessive screen time for kids. Jean is Kaiser-Permanente Northwest's regional practice director for pediatrics.

Here is what she has written us:

This is the last of my series of brief impressions from important medical studies in 2007 pertaining to screen time. Consider all of the usual caveats: I'm not a researcher, and I "might" be biased.

The first message simply updated the status quo: By age 12 months, the average baby is watching about 1 hour per day, despite the American Academy of Pediatrics recommendation of no screen time before age 2.

The second message showed significant delay in language acquisition associated with screen time in very young children, and sustained exposure was associated with problems in aggression (by far the strongest), sleep, self control, attention and cooperation.

The third message looked at the rapidly growing information about attention issues, where there is still much controversy. But it appears that there is some sort of connection, perhaps a tendency to become accustomed to rapid pacing from entertainment media, which leads to boredom with the real world.

Now, finally, the news on obesity, hypertension, and one article that ties together the issues with media, sleep and learning.

Obesity:

* Family eats together, more likely to serve fruits or veg

* Television on, less likely to serve fruits or veg

* Having dinner together does not overcome the adverse effects of having the television on during mealtime in terms of fruits and veg

Fitzpatrick et al, Journal of the American Dietetic Association, April 2007

Hypertension:

Looking at children who are obese, researchers found that both severity of obesity and daily TV time were significant independent predictors of the presence of hypertension.

* As is well supported elsewhere, TV time was positively correlated with the severity of obesity.

* Children watching 2-4 hours per day had 2.5 times the odds of hypertension compared to those watching less (adjusted for BMI, race, and site, but not SES), and 3.3 times the odds for over 4 hours per day of watching.

* The odds of having hypertension increased by 26 percent for each hour of TV watched per day.

Pardee, et al, American Journal of Preventive Medicine, December 2007

Sleep, memory and learning:

Very small German study in which 13 year old boys were given sleep studies and memory tests on 3 separate days: a) after 1 hour of "mild violence" video game, b) after a PG movie, and c) no screen time.

* Significant changes in sleep patterns were found the night after the video game and the movie, with greater changes for the computer game than the movie (hypothesis: the movie was pretty ho-hum for these boys, who are generally unrestricted in their viewing)

* The sleep pattern changes seen may be related to the learning "consolidation process" which takes place during sleep

* Verbal memory performance was much lower after the video game and also after the movie (but not quite statistically significant for the movie)

* The effect of media on sleep patterns could explain some of the negative association between school performance and screen time

Dworak et al, Pediatrics, November 2007

Editorial blind spots

Editorial writing is, by definition, critical, but that doesn’t mean it is beyond criticism.

I’ve written a few editorials in my time. Among the craft's many challenges are word limits and establishing focus.

But focus and brevity shouldn’t result in tunnel vision.

Two examples:

Yesterday’s issue of The Portland Tribune carries an editorial titled “City needs new naming process.” The editorial board worried over whether Interstate Avenue should be renamed for César Chavez, as some in the Hispanic community have argued.

Why not name some parks after Chavez? the editorial board proposed.

The editorial concluded with these words: “Any naming — or renaming — of public places in Portland should help to better define and build a sense of community, while also serving to hone the contributions of worthy individuals. The city of Portland should have a renaming process that serves these goals better than it does today.”

The big blind spot in the editorial is the city’s selling of naming rights. How can an editorial address the “naming” issue without at least considering the decision to rename Civic Stadium “PGE Park.” And what about the other naming rights the city’s parks bureau is geared up to sell?

Hello?

Second example:

In today’s Oregonian, an editorial urges rapid implementation of the State’s stiffer physical education requirements in the schools. The goal is to address “our childhood obesity epidemic.” Twenty-five percent of Oregon’s eighth graders are “overweight or at risk of becoming overweight, and that rate is on the rise,” the editorial notes.

Then the editorial goes on to say that the new PE law “is only the first step.” And what is the next step? More money for PE and pressuring school boards to implement the program.

End of discussion.

What the editorial writers fail to address is the four to five hours each day that the average child spends in front of screens. During those hours, children expend zero calories and are enticed to eat calorie-laden junk food — a huge contributor to childhood obesity and early on-set diabetes.

It’s fine to bulk up PE in the schools, but the average public school graduate will have spent more time in front of television than in the classroom — including the PE classroom.

Fighting childhood obesity begins at home, but you’d never know it reading the editorial.