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We really need to start obesity prevention pre-conception

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CHICAGO – If the recently announced dramatic decline in obesity among 2- to 5-year-olds holds steady, then in about 18 years it will be fair to say a dent has been made in the obesity epidemic.

It is absolutely fantastic that toddlers – and in no small measure, their parents – have started making healthier dietary choices. If these youngsters can keep their weights under control throughout adolescence and into adulthood – and even pass on good dietary habits to their own kids – we’ll have quite a lot to celebrate.

But until then, the rest of us are in dire straits.

The children who have hopefully dodged the bullet of lifelong obesity make up a very small fraction of our population. The verdict on their elders is just as frightening as it has always been.

According to the Centers for Disease Control and Prevention data, more than one-third of adults and 17 percent of youths in the United States are obese. Overall, there have been no significant changes in obesity prevalence in children or adults between 2003-2004 and 2011-2012.

Even worse, there have been increases in some subgroups, especially among women 60 and older.

And those are just the aggregate numbers.

It is well known that obesity rates are even higher among blacks and Hispanics – something of a health time bomb as these two groups come to represent larger swaths of the population.

Early last week, the National Institutes of Health released findings from the first phase of its ongoing Hispanic Community Health Study/Study of Latinos, the largest health study of Hispanics in the U.S. to date. The numbers were bleak.

Based on data collected between 2008 and 2011 from 16,415 Hispanic adults living in Chicago, San Diego, Miami and the Bronx, New York, the study found that:

• About 40 percent of all adults ages 19 to 44 were obese and nearly half of women 45 and older were obese.

• The number of participants with either prediabetes or diabetes increased as their weight increased.

• Among participants 40 to 49, six out of 10 had either diabetes or prediabetes.

• One out of three participants with diabetes was not aware of having the disease.

• Only about half of the men and women with diabetes had their diabetes under control.

According to Martha Daviglus, the principal investigator for the Chicago survey, awareness of obesity, the chronic illnesses that flow from it and the healthy habits necessary to prevent obesity needs to stay in the spotlight.

“Now that we have seen that so many programs aimed at young children have had an impact, we need to do the same thing for groups of adults,” Daviglus told me. “It used to be that the medical community would say you need to do prevention in middle age and then in young adulthood, and now we’re talking about childhood.

“What we really need is to start obesity prevention at preconception, not even during pregnancy, but well before, when the lifestyle habits of nutrition and exercise can impact both parents and babies.”

In other words, everyone of every age should have the basic understanding necessary to maintain basic nutrition and a healthy weight – a goal that, in a country with free K-12 education and increasingly accessible health care, sounds seductively simple.

But even medical professionals get little education in nutrition throughout their training, while many parents not only have poor skills at estimating their own calorie needs but also have a difficult time estimating their children’s calorie intake and weight.

Still, baby steps can grow into great strides and even a decrease limited to such a small slice of the population is worth celebrating.

Though public awareness programs, medical community calls to action and campaigns for healthier food choices in stores and restaurants have not targeted high-risk adults in the same way they have children, that will come as obesity reaches its zenith.

At some point, the obesity awareness in adults combined with better health in youngsters could make this a healthier nation.

E-mail: estherjcepeda@washpost.com. Copyright, Washington Post Writers Group.

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