Tuesday, September 17, 2013

Rant Alert! Today's Teens Live More Healthfully Than Those of 10 Years Ago?

That's what the headlines would have you believe.

In fact that's what a recently published journal article would have you believe too. And truthfully, I hope the study's conclusions - that teens' screen time and the consumption of sweets and sweetened beverages are decreasing, while activity, eating breakfast and fruit and vegetable consumption are increasing - are 100% correct, but forgive me for my cynicism, I'm having a difficult time buying it.

Firstly, I don't think a comparison between the self-reported healthy living behaviours of 2001-2002 vs. 2009-2010 teens is possible. As I've pointed out before, teens, especially teens with overweight and obesity woefully under-report dietary intake, suggesting that weight, or more likely the stigma attached to it, leads teens to tell researchers what they want to hear (that they're eating less and better than they actually are). Given rising rates of obesity and more important, the ever-louder clarion calls of concern therein, I'd be shocked were 2009-2010 teens not far more likely to be under-reporting their unhealthy living behaviours and over-reporting their healthy ones than their lighter, less harassed 2001-2002, or even 2005-2006 counterparts. What I'm getting at is that kids who are primed more often as to the risks of unhealthy living by the media, their schools, their doctors and their parents, I'd bet are far more likely, consciously or unconsciously, to exaggerate the efforts they're making therein and it would seem to me our angst and calls to action have increased exponentially since 2001, and dramatically even since 2005.

Secondly their screen time assessment is flawed too as it's impossible to compare true screen time when smartphones and tablets didn't exist back in 2001-2002 or even in 2005-2006 (the first iPhone didn't come out until 2007) and yet are now nearly surgically attached to most teens' hands. So to say that TV watching is going down likely ignores the fact that iPhone/tablet use has gone up from absolutely none, to mind boggling amounts, potentially negating any benefit of a decrease in TV specific screen time.

But my biggest struggle isn't with the findings of the paper, or of their veracity, but rather the paper's conclusions. Taken straight from the abstract the authors state,
"These patterns suggest that public health efforts to improve the obesity-related behaviors of US adolescents may be having some success."
To which I have to respond with a loud WTF! Why? Because the very same paper that is explicitly suggesting that public health efforts designed to tackle obesity-related behaviours are "having some success" also found that BMI went up during the study period! And their follow up line addressing that fact is what really boiled my blood,
"However, alternative explanations for the increase in BMI over the same period need to be considered."
Again, WTF?! Moving a teeny tiny bit more and eating a teeny tiny bit less (and here that's a full on hopeful guess as calories or even amounts the teens are eating aren't quantified or even mentioned) aren't going to do the trick and it's incredibly irresponsible to infer that they ought to have. Meaning that even assuming the study's findings are true, why would the authors suggest to the world that these teeny weeny changes should have led to decreases in BMI such that given we didn't see change, we need to come up with "alternate explanations"? Even if taken at face value these changes suggest an increase of just 0.2 days a week where kids report themselves as being physically active, that kids are watching 40 minutes less TV a day (but still near 2.5 hours of the stuff) and that they've made truly minute changes to their dietary behaviours - why would we need "alternate explanations for the increase in BMI" when no one in their right mind would expect these changes to affect weight? Nearly nothing lifestyle changes don't affect weight - if they did, there would never have been a need for this study in the first place!

Moreover, by tying these findings to obesity, again, even were the findings to be true, lends weight to the let's treat this flood with more swimming lessons approach to dealing with childhood obesity reinforcing the notion that kids who struggle with weight and have not been successful with their swimming are just lazy, TV watching, soda swilling gluttons, when really, they're not inherently different than any kids who came before them - no lazier, and no more gluttonous.

Kids have not changed, the world around them has, and what we really need to be doing for our kids is building them levees, not preaching about swimming lessons.

Just to name a few top of head things we could do - we could establish zoning laws forbidding fast food restaurants and variety stores from setting up within walking distances of new schools; create reformed nutrition education programs; establish school gardens', herald the return of home economics, remove no-name junk food from our kids' cafeterias, and ban the in school use of junk food as the reward for anything and everything a kid ever does. We could put an end to advertising targeting kids. We could could pass front-of-package health claim laws that actually prevent marketing BS from preying on parents and we could regulate a diet industry that sells hope in bottles. We could enact incentive and/or disincentive taxation plans to encourage healthful eating and discourage junk, and we could re-organize farm subsidies to in turn make fruits and vegetables more affordable and junk potentially more expensive.

There is no shortage of sandbags.

Getting excited about likely exaggerated personal lifestyle improvements in the name of tackling childhood obesity, all the while watching rates rise further, is just another distraction from what really needs to change - not the kids, but rather the world in which we're sitting back and passively watching them grow up.

Truly, I'm flabbergasted by the enthusiasm this study has received. Kids haven't suffered an epidemic loss of willpower, nor are any amount of swimming lessons going to lead them to beat this flood. Kids need our help. They need sandbags, not namby-pamby excitement about at best minimal, and at worst totally made up improvements to their swimming, which while no doubt laudable, detracts from the real work of filling actual frickin' sandbags.

Sorry for the rant.

[By the way, that's a selfie of me taken immediately after I first finished reading the article]