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Expert on childhood obesity Add to ...

In Weight training , Carolyn Abraham writes about California's Wellspring Academy, an institution that bills itself as the world's first academic boarding school for overweight children.

"Rates of childhood obesity have soared in the past 30 years. In North America, they have tripled. One in four Canadian children is now estimated to be overweight and 1 in 10 is clinically obese," she writes.

"Weight-loss camps for kids have surged in popularity around the world. But officials at Wellspring insist that their year-round school is no typical 'fat camp,' where kids tend to drop pounds each summer but return every year to lose the same weight again."

You may not be ready to send your kid off to a school dedicated to helping them lose weight. But if you're concerned about your child's health and weight, Dr. Jean-Pierre Chanoine, who focuses on the study of nutrition and childhood obesity, was online earlier to take your questions on childhood obesity.

Your questions and Dr. Chanoine's answers will appear at the bottom of this page.

Dr. Jean-Pierre Chanoine is the head of the endocrinology and diabetes unit at the B.C. Children's Hospital and a professor in the department of pediatrics at the University of British Columbia. Dr. Chanoine focuses on the study of nutrition and childhood obesity, from the laboratory to the patient and the community. The main line of research aims at understanding the physiological events leading to the onset of obesity, with emphasis on the regulation of ghrelin, a newly discovered hormone secreted mainly by the pancreas in the fetus and the neonate. Community projects propose an original intervention (peer-led curriculum) to prevent the development of obesity in schoolchildren.

Editor's Note: globeandmail.com editors will read and allow or reject each question/comment. Comments/questions may be edited for length or clarity. We will not publish questions/comments that include personal attacks on participants in these discussions, that make false or unsubstantiated allegations, that purport to quote people or reports where the purported quote or fact cannot be easily verified, or questions/comments that include vulgar language or libellous statements. Preference will be given to readers who submit questions/comments using their full name and home town, rather than a pseudonym.

sc smith from Canada writes: How much do parents contribute to the problem of childhood obesity? They are ultimately the role models who teach their children habits about food and exercise, as well as the ones providing/making meals. I know in today's society everyone is pressed for time, but if the parents lived an active lifestyle (e.g, the whole family going for a bike ride one evening instead of sitting watching t.v.) would that make a difference?

Dr. Chanoine: Thank you for this great question. Indeed, our society has changed as a whole. This is true not only for our diet (what and how much we eat), the overall level of activity associated with a day-to-day-life (cars, TV, time..) but also the way we build our society (secluded home developments far away from everything, visible elevators and invisible stairs, remote control for every appliance and so on, every bit counts!). I often hear that the school has a major role to play in ensuring our kids are healthy but I fully agree with you that role modeling by parents is crucial. My 2 practical comments will be 1. prevention and treatment should focus not on what families should do (we all know what to do) but more on how to do it. What practical changes need to be made in the family life so that these apparently logical measures are implemented. What are the obstacles to these apparently easy changes? 2. This should start very early in life (prevention), when our kids are developing and are more amenable to change. Pregnancy might be a good time to talk to parents about healthy lifestyles for their children as this has been shown to be a period where parents are very open to change.

cathy RD from kelowna Canada writes: Many youth sport teams offer kids sports drinks during their activities. A 591 mL bottle has as many calories as a can of pop, and I know my dental hygienist says it ruins kids teeth to sip on them. Are active kids actually active enough to need sports drinks?

Dr. Chanoine: Sport drinks bring calories as well as minerals and are in theory designed to replace losses during exercise. So, if this is used during or after an intense physical exercise (soccer, hockey...), I believe this is reasonable (and brushing teeth sure is a plus!). Sport drinks do not NEED to be used (my daughter's coach (soccer) requests water in abundance, orange quarters during half-time and a snack at the end). But the main issue is that these drinks are replacing water as the drink of choice, outside physical activity, and this leads to excessive intake.

L. Morgan from Toronto Canada writes: We know people can lose weight if they are a controlled environment, but how effective are weight loss treatment camps for children in helping them keep weight off over the long term? What tools do the children get to cope with the environment that caused them to gain the extra body fat in the first place?

Dr. Chanoine: Weight loss camps are indeed effective in promoting very significant weight loss in the short term. They are also often expensive and require removal of the child from his/her family, his/her friends and so on. Weight loss camps put emphasis not only on the child but also on modifying the environment (family, school, habits...) and often offer a very comprehensive program that goes well beyond "weight loss." It is however not clear to me what the long term effects are (at 1, 5 and 10 years). This should be the number one focus of those organizing these camps.

D ster from North Vancouver Canada writes: I have a 1 year old who is bigger than average (99th percentile according to the charts but height/weight proportions are normal)and a big appetite. He gets lots of playtime and we take pains to set a good example when eating. However I'm concerned that we need to start restricting his diet so as to prevent him from creating bad eating habits (with regard to portion size) later on. Without knowing any more specifics is there any way you can tell that I am being completely paranoid or are these concerns legitimate? Also - some tips for preventing young kids from developing emotional eating habits? Thanks

Dr. Chanoine: A: At BC Children's Hospital, I see more and more very young children (1-3 years) with a very rapid weight increase. Of course, at that age, complications are not an issue. They are usually very healthy-looking infants/children who are growing very well. Usually, I am unable to find any specific (hormonal or other) cause for this rapid and sometimes very impressive weight increase. Whether these children later become obese adolescents or adults is also unclear and it is generally thought that about 1/3 rd of heavy 1-3 year old will become obese adults (meaning that 2/3 won't!). Nevertheless, I think it is appropriate to take some sensible steps and try to promote a very healthy lifestyle in these children and to ensure that their weight increases proportionately less than their height. It is also interesting that this rapid weight gain often occurs when solid food is introduced (shift from breastfeeding/formula to diversified food). I suggest the following steps: 1. Look in the family to see whether the parents had a similar early growth; this seems to sometimes "run" in families 2. See a dietitian once, not for a weight loss diet (which would be inappropriate at that young age) but to ensure that there is no obvious dietary mistake (portion size, excess juice, hiden calories and so on). Parents sometimes do not have a good idea of what a normal portion is; 3. Ensure that he/she is indeed kept "busy" with non-food related activities. 4. Ensure that the number of meals/snacks is appropriate but don't offer comfort food in between. 5. Offer healthy choices that can be consumed without restriction (low density) with the intention of promoting satiety, as well as enough water. 6. Whether food should be limited once calorie needs are fulfilled, and whether weight should be measured regularly would be a recommendation that is not based on hard science but I feel it is a reasonnable approach provided that parents maintain a very healthy attitude towards food.

J Fraser from Canada writes: Hello. I have two children ages 2 and 4. The older boy, quite frankly, looks pudgy in his bathing suit unlike many of the other preschoolers I see in the pool. He even has a little belly and the beginning of 'love handles'. He looks like me at that age. In contrast sister is slender and long-limbed, like her father. The kids are exposed to the same diet and both have the same opportunities for active play. Years ago people talked about 'body type'. Is that still considered relevant today? Thanks.

Dr. Chanoine: We have to remember that our children get part of the genetic information from the mother and part from the father. The determination of body mass is closely linked to the genetic background (more than 50-80% depending on the studies) and thus it is not surprising that 2 siblings offered the same lifestyle/diet may respond differently to this same environment and look more like one of the parents depending on which genes they "received". The same goes for the height, shape of the face and so on. Once your children are old enough, the reason why they look "different" can be explained to them in simple and positive words.

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