Hardly a month goes by when there isn’t some report describing obesity in children. It is considered to be an epidemic in the United States. The number of children who are overweight has doubled in the last two or three decades, with one child in five considered overweight. The increase has been found in both children and adolescents, and across all age, race and gender groups. Obesity has led to other health problems. For example, obese children now have diseases like type 2 diabetes that used to only occur in adults. As overweight kids tend to become overweight adults, they are at greater risk for heart disease, high blood pressure, and stroke. Just as important, is the social discrimination that occurs with overweight and obese children. There are many factors that lead to childhood obesity. Genetics undoubtedly plays a role, but they alone can’t account for the skyrocketing increase in rates of obesity over the past few decades. The major factors are the same as those for adult obesity: eating too much and moving around too little. It is estimated that almost half of children aged 8-16 years watch three to five hours of television a day. Youngsters who watch the most hours of TV have the highest rates of obesity.

Solving the problem of childhood obesity will require much more attention than is currently directed at the problem. A big change has been to improve the foods that children consume at school. Modifications have been made in what kids and adolescents eat in the lunchroom, as well as removing pop and junk food machines from schools. But, how do we get children to exercise more? The time youngsters have to exercise at school has been reduced in recent years. There are even calls that these opportunities be totally eliminated through the removal of recess from schools.

In his pioneering work, Len Epstein and his colleagues have looked at many variables affecting exercise by children. Recently, they reported on a study designed to understand factors associated with a child's choice to be physically active or sedentary. In particular, they looked at how neighborhood and home environments may be related to this choice by attempting to determine whether the neighborhood environment or number of television sets in the home environment were independently associated with child physical activity and television time.

In the investigation, the associations of the neighborhood and home environments on active and sedentary behaviors were studied in 44 boys and 44 girls who wore accelerometers and recorded their television watching behaviors. Neighborhood environment variables were measured using extensive geographic information systems analysis. The complex analysis found that increased access to parks was related to increased physical activity in boys but not in girls. The number of televisions in the home accounted for 6% of the variability in television watching behavior. Neighborhood environment variables did not predict television watching that occurs in the home.
COMMENT: The research by Epstein and his colleagues has added significantly to our knowledge of childhood obesity and how it might be reversed. In the present study, the neighborhood environment was more strongly associated with physical activity of boys than girls. Sedentary behaviors, as in past studies, were associated with access to television in the home environment. The authors concluded that to promote physical activity in children, planners need to design environments that support active living and parents must limit access to television viewing in the home. The latter issue is something that can only occur by parents working with their children to teach them to manage their television behavior. A goodly amount of self-management skills may be required for this to occur. The former issue is more problematic: in planning new areas for homes, most developers do add in parks and open space. As they are starting at the beginning, this presents no difficulties. In older, more established neighborhoods, however, it is often difficult to free up space for parks. Even when smaller areas become available, too many governing boards would rather go for more building, as well as the tax base that comes with it, than create a place for kids to play in. This is short sighted, particularly considering the future bill of childhood obesity. The thoughts of that bill are almost incomprehensible.

J.N. Roemmich, L.H. Epstein, S. Raja, & L. Yin. The neighborhood and home environments: disparate relationships with physical activity and sedentary behaviors in youth. Annals of Behavioral Medicine, 2007;33:29-38.