In the United States, the percentage of children and adolescents with obesity has more than tripled since 1970. Today, approximately one in five school-aged children (ages 6 to 19) is obese, according to the Centers for Disease Control and Prevention — and that figure doesn't include children who are considered merely overweight and not obese.

According to Alka Sood, M.D., a family medicine physician with Penn State Health Medical Group - Park Avenue in State College, children with obesity face physical, social and emotional hurdles while growing up.

"Children with obesity are more likely than their classmates to be teased or bullied and to suffer from low self-esteem, social isolation and depression," Sood said. "They are at higher risk for other chronic health problems, including asthma, sleep apnea, bone and joint problems, and Type 2 diabetes, and are more likely to be obese as adults — resulting in increased risk of heart disease and other serious medical conditions."

A child's risk of becoming obese depends on several factors:

—Diet: Consuming too many high-calorie, low-nutrient foods and beverages, such as potato chips and soda, leads to excess weight gain.

—Physical activity: A sedentary lifestyle means a child can't burn off those excess calories.

—Genetics: A family's genetic background can influence a tendency toward obesity.

—Emotions: Children may overeat due to stress or simply because they are bored.

Of these risk factors, Sood said genetics is the only one that can't be changed. Parents and physicians can work together to help a child make positive changes to their diet, physical activity and reaction to emotions.

Kara Shifler Bowers, a registered dietitian and a project manager at Penn State PRO Wellness, recommends making small changes around the house instead of discussing weight and health with the child directly.

"Talking to children about weight has lasting consequences," Bowers said. "Instead, implement an easy change like keeping a bowl of fruit available. One change at a time is more sustainable than a complete lifestyle overhaul."

Parents can help by making good choices the most convenient choices for their children:

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—Food shoppers control 72 percent of what families eat. Keep unhealthy snacks out of site and out of mind. Do not allow sugar-sweetened beverages or foods in your home. Save these foods for holidays and celebrations.

—Keep a large attractive bowl of fruit available for easy access.

—Some good snack choices include fruit and nut butter, whole grains such as plain popcorn, veggies and ranch dressing or hummus, whole corn chip with salsa, or berries.

—Keep healthy snacks, such as low-sugar Greek yogurt and raw veggies available.

—Allow your child to be involved in meal planning. Let them choose the fruit and vegetables for side dishes.

—Sit down together for as many meals as possible, away from the television. Children who see their parents eating nutritious foods are more likely to make similar choices.

—Be active with your children. Go for walks, play ball or whatever gets your family moving. Allow time for your children to be active for 60 minutes a day and join them for at least 30 minutes.

—Reward your children with extra play time or family activities together, not with food. Food is for nourishment, not reward.

Bowers also advises to be patient as your child and family gradually learn to make better food and activity choices. By taking it slow, parents can help move the entire family toward healthy lifestyle — now and throughout life.

"Food is powerful. It has the potential to heal and to cause sickness," Bowers said. "Don't underestimate the power of small changes that progress over time. All it takes is one step to start the process."

(A Wellness Update is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at www.awellnessupdate.com.)

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