What has caused this global health crisis, and what are we to do about it?

A new release from Perseus Books, Generation Extra Large: Rescuing our Children from the Epidemic of Obesity investigates the cultural roots of this crisis and comes up with some startling truths about the epidemic. Calling upon the latest research and real-life stories to show how families, neighborhoods, and communities can take action, the authors also give us the tools to fight an ever-growing threat.

Written by award-winning journalists Elaine Herscher and Chris Woolston, along with Yale-New Haven Hospital nutritionist Lisa Tartamella, the book provides the one element that’s been missing in the ongoing debate about obesity: the voice of children themselves. In the first obesity book to do in-depth interviews with kids and their families, the authors also criss-crossed the country to speak with scientists, physicians, teachers, nutritionists, cafeteria directors, “New PE” instructors, and other experts from Alabama to California. Readers will meet parents in Georgia fighting in vain for 15 minutes of recess, a principal in California who kicked junk food out of her cafeteria, a phys ed instructor in Las Vegas who puts the fun back in physical activity, and a doctor in San Antonio who works to stop type 2 diabetes in kids before it starts. Among the authors’ findings:

· The federal act known as No Child Left Behind might be better titled “No Child Let Outside.” Since the act financially penalizes schools whose students don’t score well in standardized math and reading tests, many schools have responded by cutting back on “nonessentials” like PE classes and recess. Only eight percent of elementary schools and six percent of middle schools and high schools now provide daily physical education – despite studies that show physical activity helps kids perform better on tests.

· People may be drinking more fruit juice these days, but overall, the American diet has become more childish. A survey of more than 60,000 people conducted between 1977 and 1996 showed that consumption of salty snacks doubled during those years. As evidenced by our expanding waistlines, the percentage of calories coming from pizza, French fries, candy, and soda also rose sharply across the board.

· Cash-strapped schools have flung open their doors to fast food and soda companies. As a result, kids are seeking out more and more treats and leaving healthier foods behind. By the mid-1990s, kids were getting a full forth of their daily calories from desserts and sweeteners. Boys now average about nineteen ounces of soda a day – and according to the medical journal Lancet, each daily serving of soda raises the risk of obesity by sixty percent.

· Meanwhile, some leading health organizations have fallen down in their job to protect children. Despite the soda-obesity link, the American Dietetic Association published a recent fact sheet that cast soft drinks in a good light, noting “all beverages can have their place in a well-balanced eating pattern.” The sponsors of the fact sheet? The National Soft Drink Association, which paid the ADA $25,000 for the material.

· The average American child watches three and a half hours of TV a day, although television watching is one of the greatest risk factors for becoming overweight, according to a recent Harvard study. Most people see a straightforward story: kid spends all day on the sofa watching the tube, kid gains weight. But research also shows that kids who sit and stare at the TV also sit, stare, and snack. For many kids, the TV habit becomes hopelessly entwined with the junk food habit, and both end up working together to make them fat.

· Parents’ fears about safety and traffic mean that kids play outside far less than other generations – and that they ride or bike to school only thirteen percent of the time, according to the Centers for Disease Control and Prevention. And suburban sprawl puts up other barriers to exercise, including dead-end cul de sacs and side streets that don’t connect to each other. In fact, the “good life” of suburbia comes with a price: a 2003 study by researchers at the CDC estimated that suburban life adds an average of six pounds to every adult.

· A daily walk with our children and a renewed commitment to the family meal is one of the most important gifts we can give kids. A recent study of more than 16,000 boys and girls between the ages of nine and fourteen found that kids who regularly ate at home with their families had the healthiest diets. Not only did they eat less fat, they got more fiber, iron, calcium, folic acid, and vitamins C, E, B6, and B12. For parents concerned about our fast-food culture, the family meal is a perfect place to take a stand.

The book has been enthusiastically received. In a March 13 review, the Washington Post said “Generation Extra Large is science-based but uses a zingy prose style to enlighten, alarm and, the authors hope, activate.”Calling the book’s revelations “frankly shocking,” the Post went on to call the book “a must-read for parents whose children are overweight -- or who hope to avoid the problem.” The Cleveland Plain Dealer said the book views childhood obesity through the lens of science while the authors “weave a tale that reads more like ‘A Civil Action.’" Publisher’s Weekly called it “a welcome voice…comprehensive and briskly written,” and Library Journal praised it as “an informative, engaging guide.”

This spring, the authors completed radio interviews in 40 cities in four days, followed by local television appearances. Tartamella appeared on CBS’s Early Show to discuss the book and the ongoing epidemic. The San Francisco Chronicle published a Q & A with Herscher, and Newsweek and MSNBC featured the book on their websites. Book readings and other events are ongoing.

Aside from exploring the social roots of the epidemic, Generation Extra Large offers many practical tips that cut right to the challenges real families face. The book doesn’t advise kids to join a gym or start radical diets. Instead, it shows how small steps—from tweaking recipes to reading labels in the grocery store to taking family walks and making more meals at home—can make a big difference. When families make a commitment to a healthy lifestyle, kids really can slim down.

Along with small solutions, the book also encourages big changes on the part of communities and government and shows how some of them are already under way: from schools unplugging soda machines and offering healthy cafeteria food to parents fighting for a return to recess and physical education classes.

More and more people are starting to talk about the crisis of childhood obesity. This is one book that should be part of the conversation.

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About the authors: Lisa Tartamella, MS, RD, is a dietician at Yale-New Haven Hospital’s Centers of Nutrition, where she provides nutrition and wellness counseling to both adult and pediatric patients. In 1997, she was named Young Dietician of the Year. She lives in Milford, Connecticut. Elaine Herscher is special projects editor at Consumer Health Interactive, an online health and medical news organization in San Francisco. Her work on the San Francisco Chronicle AIDS reporting team resulted in a Pulitzer Prize nomination in 1989. She lives in Berkeley, California. Chris Woolston, who lives in Billings, Montana, is a contributing editor at Consumer Health Interactive, where he writes about children’s health, obesity, and nutrition. He is a former staff writer for Hippocrates, a national magazine for physicians, and has written for Time Inc. Health, WebMD, the Chronicle of Higher Education, and many other publications. He and Herscher also shared an award for outstanding feature writing from the northern California Society of Professional Journalists for their reporting on an online series on work and health.

© 2005 HealthNewsDigest.com