“Obesity during childhood and adolescence is associated with a wide range of illnesses, negative social consequences, and poor academic performance,” the American Journal of Preventive Medicine said.

Kathryn Torla Photo.

Avery Santos

The national obesity rate among ages 2 to 19 rose from 19.3% in 2019 to 22.4% in 2020, according to the Robert Wood Johnson Foundation. The national average for youths who are morbidly obese (those who are 100 pounds over their recommended weight) is 6.1%. These averages, according to the preventive medicine journal, will only increase at an accelerating rate, if nothing substantial is done.

According to a Harvard University study, consuming healthier foods and drinks, limiting unhealthy foods, exercising and limiting “sit time” should begin to lower obesity rates. Schools promoting healthier lifestyles and diets among their students could lower the obesity rate among school youth, the study said.

Connecticut is ranked 26th in the U.S. for the highest obesity rate among youth. According to the Robert Wood Johnson Foundation, Connecticut’s childhood obesity rate is expected to continue rising.

For some young people, obesity can translate into low self-esteem.

“I didn’t like myself anymore,” Neema Jackson, a 16-year-old Hamden resident, said. “It was so noticeable, and I just didn’t ever like the way I looked.”

Jackson had been overweight from the age of 12 to 15. She began to lose weight and has begun to like herself again.

“My brother was also starting to lose weight, so he started to put me on a calorie diet, and I started to go to the gym,” Jackson said.

The preventive medicine journal reports that by the year 2030, 51% of the national child and adult population will be obese or severely obese. Reducing these estimates to levels seen in 2010 would save $549.5 billion in medical expenses, the journal said. Since youths who are severely obese have a higher risk of premature deaths, it could also save lives.

“Childhood and adolescents with obesity have a higher likelihood of remaining obese long term, which is termed entrenched obesity, elevating the risk of chronic disease and mortality,” the journal said.

Obesity is classified as an epidemic in the U.S. by the Centers for Disease Control and Prevention, and rates are rising for children and adults. If nothing is done to mitigate the growth of this chronic disease, then billions of dollars will be spent on health care and millions of children will be at a higher risk of dying young.

Avery Santos is a student at Middletown High School.

But research shows that the food and beverages babies and toddlers consume influences their taste preferences and eating habits throughout life.

For babies, human milk, formula and water are all they need to drink for the first year, pediatricians say.

Dr. Michelle Van Name, a pediatric endocrinologist with Yale Medicine, tells her patients that cow’s milk is the recommendation for toddlers—and it’s less expensive than juices. She said toddlers should be introduced to water at an early age so they develop a taste for it because if they get used to sweet drinks, they won’t like water.

iStock Photo.

The new guidelines say that human milk, formula and water are all babies need to drink for the first year.

Now, for the first time, parents can find such research-based nutrition guidelines for babies and toddlers in the Dietary Guidelines for Americans, produced by the U.S. Departments of Agriculture and Health and Human Services.

According to the new federal guidelines, once babies start eating solids at about 6 months, they can have water with their meals to develop a taste for it. After age 1, all children need to drink for healthy development is water and cow’s milk, the guidelines recommend. To reduce the chance of childhood obesity, the guidelines advise avoiding fruit juice or food with added sugar before age 1 and eating fruit rather than drinking fruit juice after 1. Children under 2 should avoid added sugars, including beverages sold as “toddler milks” and “toddler drinks,” the guidelines say.

Marlene Schwartz, director of UConn’s Rudd Center for Food Policy & Obesity, said the federal dietary guidelines for birth to 2 years affirmed the center’s position that all that is needed is human milk, milk and water.

Marlene Schwartz

“One of the big controversies in the field right now is ‘toddler milks’ and ‘toddler drinks,’” Schwartz said. “The Rudd Center has done a lot of research, and we think they’re unnecessary. They’re being marketed in a very deceptive way,” she said. (The labels, written in English and Spanish, include wording suggesting the product supports brain development and immune systems.)

Growing childhood obesity rates drove many of the new recommendations: 14% of 2- to 5-year-olds have obesity; 18% of 6- to 11-year-olds have obesity; and 21% of 12- to 19-year-olds have obesity, the Centers for Disease Control and Prevention (CDC) reported in 2019. Among those 2 to 19, obesity prevalence reached 26% of Hispanics and 22% of Blacks, while 14% of whites and 11% of Asians, respectively, were obese, reports the CDC.

Schwartz would have preferred seeing the guidelines recommend avoiding even 100% fruit juice in the first two years of life, rather than saying that up to 4 ounces of 100% juice could be included in a healthy diet after age 1.

“I don’t love that,” she said. “It sounds like you should give your kids 100% juice.” Rudd Center-conducted studies found many parents thought some sugary drinks were healthy options because of how they’re marketed, she said.

It’s not the parents’ fault, she said. In the United States, food, beverage and restaurant companies spend nearly $14 billion per year on advertising, and more than 80% of the advertising promotes fast food, sugary drinks, candy and unhealthy snacks, according to the Rudd Center. This overshadows the $1 billion budget for all chronic disease prevention and health promotion produced by the CDC, the Rudd Center found.

“I would have liked to see a stronger statement [in the guidelines] about providing small amounts of plain water when introducing food. And be more explicit: Water should be the beverage of choice,” Schwartz said. The guidelines state that after 12 months, toddlers only need milk and water, a clarity she appreciated.

With more mothers breastfeeding, infant formula sales have decreased, “so the formula companies had to create a new product to sell,” Schwartz said. “We’ve been very vocally critical of these products. These take advantage of young mothers.”

Bonnie Phillips Graphic.

Yale’s Van Name agreed, adding, “Kids do not need juice. It’s more nutritious to eat a piece of fruit than drink it as juice.” Juice “could contribute to excess calorie consumption,” she said.

Alia Reynolds wasn’t exposed to added sugar until she was 4, so she’s planning to keep processed sugar out of her baby’s diet for as long as possible. Based on her reading, the West Hartford mother says she has not given her 10-month-old daughter, Vivienne, any juice and doesn’t plan to. Vivienne drinks water from a straw with her meals, which Reynolds started giving her at about 6 months, again based on her reading.

Schwartz, who has been studying obesity for 15 years, said water needs to be the default beverage from the start. When elementary-school-aged children are overweight and pediatricians advise them to stop drinking juice and soda, parents say their kids don’t like water, she said.

Van Name also recommends children avoid sports drinks, which were designed for elite athletes. Children playing on local soccer and basketball teams do not need anything but water, she said.

“It’s important to start early on,” Van Name said. “Most of what we recommend is eat real food.”

This complex food system feeds directly into greenhouse gas emissions and accelerated climate change. Last year the journal The Lancet identified a global “syndemic” linking climate change to obesity and poor nutrition, referencing dozens of studies. Earlier, in 2017, the journal Public Health reported “significant and new insight about the causal link between obesity and environmental emissions.”

In Connecticut, 27% of all adults, almost 12% of children and 14% of toddlers (ages 2-4) have obesity. In 1990, the rate for adults was 10%, reports Connecticut Data Haven in its 2019 Community Health Well-Being Survey.

Obesity affects people of color at higher rates: more than 30% of Hispanic adults and more than 35% of Black adults are obese, compared with 25-29% of white residents, the Centers for Disease Control and Prevention reports.

Many factors have contributed to the obesity crisis: lack of access to healthy food, socioeconomic factors, a car-oriented culture, and food marketing, said Marlene Schwartz, director of the University of Connecticut Rudd Center for Food Policy & Obesity. She said the center studies “how we can use policy to change the food environment. You can’t expect personal responsibility and willpower to be enough to overcome all the factors in the environment.”

Former Rudd Center researcher Rebecca Boehm led a study in 2018 that found 68% of greenhouse gas emissions from food production came from industrial farming and manufacturing, 30% of which was from animals.

“A majority of the emissions are coming from the production phase,” said Boehm, who now works for the Union of Concerned Scientists.

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Boehm’s research showed that “consumption activities of all kinds create greenhouse gas emissions, and food is one of those integral parts of our lives that’s a consumption activity. It’s less obvious than the emissions coming out of your car. It’s a little hard to think about and conceptualize because the food system is so complex.”

Farm To City

In Connecticut, small farms have been working for many years to help those who live in cities and some rural areas far from markets get affordable fresh produce.

Teri Smith of Smith’s Acres in East Lyme said she started selling produce in downtown New London about 35 years ago and expanded to Stamford, Bridgeport and a dozen more farmers markets. She said part of the work was talking to customers about how to use what she was selling. “I was amazed at the mothers and the children who would come in and ask questions about vegetables: ‘Why is this cucumber curly? The cucumbers at the grocery store are straight. Why are the beans different sizes? What can I do with Brussels sprouts?’”

She added, “That was the best part of doing the markets in a place like New London or Stamford, talking to the people. You can buy $10 worth of apples and go home and make applesauce and freeze it for your baby. How about this butternut squash, how about cooking and mashing them up and saving them and you have baby food for a year for your baby?”

Staying healthy has become even more challenging during the pandemic. Just getting out, running errands, and getting exercise has gotten more complicated or even impossible for many people, especially those who live in food deserts. In cities, food deserts are where markets are more than a mile away and in rural areas where they are 10 or more miles away. Connecticut’s food deserts are mostly in its cities.

Thirteen years ago, to help those who live in food deserts, Connecticut farmers markets in cities began doubling coupons from federal assistance programs like Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). These programs are designed to help people living at 130% of the poverty level and below afford produce and other healthy food. Of Connecticut children between 2 and 4 years old whose families participate in WIC, 14.4% fall in the obese range.

The SNAP and WIC discounts at farmers markets were the project of the Connecticut nonprofit Wholesome Wave, which formed in Bridgeport in 2007. It pushes for better federal benefits for low-income people. Its co-founder, Michel Nischan of Fairfield, is a nationally recognized leader in bringing locally grown food to the underserved.

Wholesome Wave’s first initiative was boosting SNAP benefits at farmers markets. Today, the initiatives started with private donors in 2007 are part of the federal Farm Bill. Two years ago, Congress designated the Gus Schumacher Nutrition Incentive Program, which gives states grants to make fresh produce easier to buy. It’s named for Wholesome Wave co-founder August Schumacher, a local food advocate who served as the Massachusetts agriculture chief from 1984 to 1990 and USDA undersecretary of agriculture for farm and foreign agricultural services from 1997 to 2001.

A dozen farmers markets across Connecticut—including in Bridgeport, Hartford, New Haven, Stamford and Willimantic—now double SNAP benefits with support from UConn Cooperative Extension. They issue tokens or coupons for fruits and vegetables that can be spent that day or later.

Melanie Stengel Photo.

Wooster Farmers Market manager Alyssa Gant, left, settles up with Kyle Tamo of Rose’s Berry Farm, Glastonbury. Gant has baskets of tokens that she collects from the vendors. In the background is Elpidio Trejo-Ramirez.

CitySeed’s farmers markets and stores in the New Haven area have one of the highest redemption rates of food assistance in the state, said Cortney Renton, its executive director. Last year, CitySeed redeemed $63,000 in SNAP, WIC and Senior Farmers’ Market Nutrition Program coupons at its markets and stores.

Renton said many activists have begun referring to food deserts as “food apartheid.” They believe the lack of access to healthy food grows out of broader policies that need to change.

Wholesome Wave co-founder Nischan said his desire for policy change dogged him from his early career as a chef. A native of Chicago, he spent childhood summers helping out on his grandfather’s small Missouri farm. “The farm was in a state of decline for a long time because food policy made it really hard for small family farms,” Nischan said. He struggled in the 1980s and 1990s to incorporate fresh produce into restaurants where he cooked in Milwaukee and New York. Then, 25 years ago, Nischan’s son was diagnosed with Type 1 diabetes, so good nutrition became even more important to his family.

For the past decade, Wholesome Wave has been working with hospitals to subsidize fresh produce purchases after prescribing their patients nutrition counseling. “What we are trying to prove is if we invested Medicaid dollars in prevention [like good food], it might cost less than treatment,” Nischan said.

Healthy food “should be an essential right for every American, regardless of income,” he said.

For information on Connecticut farmers markets go here.

On the medical side, a recent study says that obesity is three times more deadly for men than it is for women. The study, published in the July edition of the British medical journal The Lancet included 3.9 million adults in Europe and North America. The adults were between the ages of 20 and 90, none of them smoked, and none had any known chronic disease.

So here’s irony: Though obesity is far more dangerous for men, women suffer the most social pressure over it, from the dieting industry, from their employers, and even from medical professionals.

For example, while all signs point to a diet industry that is flagging over all—even the word “diet” is disappearing from advertisements—diet ads are still primarily aimed at women.

And so has everyone else, and not in a good way. Recent scholarship says that women tend to suffer from weight discrimination more than their male peers, and that’s even when they aren’t as obese as their male peers. This is particularly true in the workplace, where, research says, larger women don’t get hired as quickly, or evaluated as positively as their thinner peers, or promoted at the same rate, and they tend to earn salaries that are 6 percent lower than thinner women. In fact, according to University of Florida research, the thinner the woman, the bigger the paycheck—to the tune of some $22,000 a year.

(For obese men, the salary disparity hovers closer to 3 percent lower than their thinner peers.)

Obesity is based on an increase in weight above the BMI (body mass index) of 30, which is considerably above normal, and it’s is a serious public health issue, second only to smoking as a cause of premature death.

iStock Photo.

CT has the ninth lowest obesity rate in the country, at 26.3 percent, but that’s higher than 2000.

According to the Food Research & Action Center, more than a third of Americans are overweight, and the heaviest Americans have become even heavier in the last 10 years. A June article in the Journal of American Medical Association said that 35 percent of men in the U.S. are obese, compared to 40.4 percent of women—and that latter number is growing, researchers said.

Weight discrimination doesn’t stop at the workplace, though. A North Carolina study said that nearly two out of five medical students had an unconscious bias against overweight people. That can severely affect the quality of care given to an obese patient when a medical professional isn’t engaged with—or is disdainful of —a patient.

Some of the risk factors that accompany obesity include stroke, heart disease, diabetes, hypertension, and certain types of cancer. For women, that includes postmenopausal breast and endometrial cancer, particularly if the obesity is consistent over the course of years.

According to the Trust for America’s Health and the Robert Wood Johnson Foundation’s “The State of Obesity” report, Connecticut has the ninth lowest adult obesity rate in the country, at 26.3 percent. But that’s up from 16 percent in 2000, and 10.4 in 1990. According to the report, Connecticut residents’ obesity is highest among people between the ages of 45 and 64 (31.3 percent) and lowest among adults between the ages of 18 and 25 (11.4 percent). The obesity rate by race is: 34.7 percent among African Americans, nearly 31 percent among Latinos, and 24.2 percent among Caucasians. Twenty-seven percent of Connecticut men are obese, and 24 percent of Connecticut women are obese.

There’s a fine line between body acceptance and obesity health risks, but if obesity is a fact of life–if we are getting bigger by the year—surely we can figure out a better and more gender-neutral way to live with our larger selves.

Susan Campbell is a distinguished lecturer at the University of New Haven. She can be reached at slcampbell417@gmail.com.