In this Tuesday, Jan. 21, 2014 file photo, Oumou Balde, 4, left, plays with her teacher Jacqualine Sanchez, right, and some pretend food in a pre-kindergarten class at the Sheltering Arms Learning Center in New York in a program that was produced in conjunction with Sesame Street to educate children about nutrition and health. A new study published in the New England Journal of Medicine on Wednesday, Jan. 29, 2014 finds that much of a child's "weight fate" is set by age 5, and that nearly half of kids who became obese by the eighth grade were already overweight when they started kindergarten. Researchers think there may be a window of opportunity to prevent it, and "we keep pushing our critical window earlier and earlier on," said Solveig Cunningham, a scientist at Emory University. (AP Photo/Seth Wenig)

By Bobby Bozeman

TimesDaily

FLORENCE, Ala. - A new study in the New England Journal of Medicine found that among children between ages 5 and 14, nearly 12 percent developed obesity - 10 percent of girls and nearly 14 percent of boys.

The study finds that much of a child's "weight fate" is set by age 5, and that nearly half of kids who became obese by the eighth grade were overweight when they started kindergarten.

Nearly half of kids who started kindergarten overweight became obese teens. Overweight 5-year-olds were four times as likely as normal-weight children to become obese (32 percent versus 8 percent).

The study tracked a nationwide sample of more than 7,700 children through grade school.

Dr. David Colvard, of the Infants and Children's Clinic in Florence, echoed the results of the study, saying children who are overweight have an increased risk of all the problems associated with overweight adults.

"Recent studies have shown increasing problems for adults who were overweight as children," he said by email.

"We are seeing more children with high blood pressure, high cholesterol, liver problems. And these problems worsen with time."

Lee Renfroe, an associate professor of health promotion at the University of North Alabama, said a child's weight is largely determined by the environment they grow up in.

"You need to look at the genetic possibility, but you also have to examine the environment by the people who raised you," she said.

"If they eat a poor diet, the child will also eat a poor diet. If they are inactive, the child is inactive. But it's not a life sentence."

Meredith Pate, a dietitian at Helen Keller Hospital in Sheffield, said a person is more likely to be overweight if the parents are overweight.

"I can remember as a kid, we were outside playing, riding around the neighborhood," she said.

"Kids don't do that now. People are eating out more, portion sizes are bigger."

But responsibility, especially for younger children falls to the parents, Pate said.

"Plan better," she said. "I'm guilty of it, too. My daughter had piano lessons. What did we do? We went through the drive-thru.

"I should have planned better. If you just plan better, you can do a lot better for your family and for yourself."

Parents who are concerned about a child's weight should talk with their child's doctor, because it may be hard to tell what is normal at various ages, and appearances can be misleading.

In children, obesity and overweight are defined by how a child ranks on growth charts that compare them to other kids the same age and gender.

Kids at or above the 85th percentile are considered overweight and are considered obese at the 95th percentile or above.

But no child should be placed on a diet without a doctor's advice, the Centers for Disease Control and Prevention advises.

"My number one thing is don't put them on a diet or make comments about how much they're eating," said Pate, who was put on a diet as an 11-year-old. "That will lead to putting bad thoughts in their head.

"You see anorexia and bulimia when they get to adolescence."

According to the CDC, to help keep kids healthy, the calories a child gets from food and beverages should be balanced with how much exercise he or she gets; allowing enough for normal growth, some weight gain is normal.

Renfroe said it's rare for an average overweight child to be put on a diet.

"In general, we don't like to talk about diets to children," she said. "We like to talk to them about eating healthy and being active."

Pate said since children with overweight parents are more likely to become overweight themselves, parents should practice what they preach in helping their children.

"Instead of telling your kid to go outside and be active, go outside and be active with them," she said. "We don't eat around the table as much anymore. We don't spend time with our families, that's my own personal opinion."

When it comes to what you put in front of your kids to eat, Pate said that responsibility rests with the parents, especially at younger ages.

"I see 3-, 4-, 5-year-olds toting around a soda or juice drink that's 10 percent juice and the rest sugar water," Pate said. "It's basically sugar water with some flavoring."

She said teaching your kids how to eat is important as well as what to eat.

"I don't ever point (calories) out as a mom, but I will something when my daughter eats really fast," Pate said. "When she eats really fast, she wants to put more on her plate. It takes your brain about 20 minutes to realize you've eaten. I tell her to slow down to see if you're really still hungry."

Renfroe said she understands parents and children are busy and it's more and more difficult to make healthy meals at home, but she recommended looking up healthy slow cooker recipes and planning meals before going grocery shopping.

"Most people don't say I hate healthy food," she said. "What you hear people say is it takes more time to prepare it. I'm sorry, but yes, you do have to do those things. And there are times during everybody's week they can do these things."

Renfroe said involving children in all the activities of making a meal - planning, grocery shopping and cooking - not only pass along basic life skills but make them more likely to eat the healthy food they're given.

"Give kids options," she said. "If they think they have a choice they're more inclined to eat it. Give them two vegetable choices. If they think they picked it, then they'll eat it. Sometimes kids don't want to be told what to do all the time."

According to the study, most of the shift occurred in the younger grades. During kindergarten, about 5 percent of kids who had not been obese at the start were so by the end of the year. The greatest increase in the prevalence of obesity was between first and third grades. It changed little from ages 11 to 14.

From kindergarten through eighth grade, the prevalence of obesity increased by 65 percent among whites, 50 percent among Hispanics, almost 120 percent among blacks and more than 40 percent among others - Asians, Pacific Islanders and Native Americans and mixed-race children.

By eighth grade, 17 percent of black children had become obese, compared to 14 percent of Hispanics and 10 percent of whites and children of other races.

Obesity was least common among children from the wealthiest families and most prevalent among kids in the next-to-lowest income category. The highest rate of children developing obesity during the study years was among middle-income families.

At all ages, obesity was more common among children who weighed a lot at birth - roughly 9 pounds or more. About 36 percent of kids who became obese during grade school had been large at birth.

The study's findings do not mean it's too late for schools to act, but their best tactic may be to focus on kids who are overweight and try to encourage exercise and healthy eating, said Solveig Cunningham, a scientist at Emory University.

The work also shows the need for parents, doctors, preschools and day care centers to be involved, said Dr. Stephen Daniels, a University of Colorado pediatrician and a spokesman for the American Heart Association.