Lasts month I wrote the dirty little secret on dieting: That for adults, what works is a lower calorie diet, but that for most people, dieting only results in moderate weight loss of 10-15pounds.

Luckily for adults, even a modest weight loss, combined with healthy eating habits and moderate exercize, helps lower the risk of disease. The trick is to reassure patients that the modest changes are worth the effort.

But what about children?

We even see chubby kids here in the Philippines: not in the farm kids, nor in most of the kids where we live, but among the “middle class” kids who have access to junk foods and can afford to take a tricycle (motorcycle with side car) to school instead of walking.

But chubby kids are no longer a rare sight.

One reason may be genes: There is a theory that the gene for “metabolic syndrome” that causes weight gain helped to increase survival in the days of hunter/gatherer society, when “feast or famine” was the norm. But when there are plenty of calories available, the same person will put on weight.

Is there a way to stop the problem? After all, it is one thing for a 50 year old woman to put on weight; but now we sometimes are seeing metabolic syndrome and Type II Diabetes Mellitus (adult type diabetes) in preteens: something almost unknown when I went to medical school.

The latest report on lifestyle and obesity in children comes from the ALSPAC study in the UK, that is following a couple thousand kids born in the 1990’s and observing them and their parents for lifestyle and health problems.

So far, the study suggests that those with the gene for obesity might benefit from dieting. And one part of the study suggested that the problem was calorie dense food.

Lead author Dr Laura Johnson, UCL Epidemiology and Public Health, said: “This is an important finding because it provides evidence that it’s easier to eat too much energy and gain weight when your diet is packed tight with calories, so adopting a diet with more bulk and less energy per bite could help people avoid becoming obese regardless of their genetic risk.

Another way to prevent obesity is fifteen minutes a day of vigorous exercize will cut your child’s risk of obesity by fifty percent.

None of this is exactly new news.

The problem?

Too many schools have stopped “recess”, where kids go outside and play once or twice a day. In many schools, even going outside during lunch break is forbidden.

And too often, sports are limited to the gifted–leaving klutzes like myself on the sidelines, and even gracile student like my son on the sidelines for all sports if their marks are low (even if the marks are low for reaons of dyslexia or for being an immigrant struggling with English, as was the case for my son).

So what should society do?

First of all, allow play time breaks for kids. This used to be called “recess” but now many schoolyards are unsafe, or have been made into car parks. So redesigning areas around new schools might help.

Second, encourage after school play at informal non competitive sports that allow all to participatee.

Third, healthy snack machines in the schools, so kids not wanting the cafeteria food have an alternative.

Finally, working with class leaders to popularize healthy diet can make better eating a good thing to do.

One cannot start inspecting kids for smuggling Snickers bars into school but making unhealthy snacks unpopular might help.

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Nancy Reyes is a retired physician living in the rural Philippines.

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