Children's diets need medical vigilance.

Byline: THE HEALTH FILES By Tim Christie The Register-Guard

Christine Bezley grew up in a German household, where gravy-topped meat and potatoes and rich desserts were staples at the dinner table, and where a little chubbiness was equated with healthiness.

So when she was raising her daughter, Jasmine, "I really wanted to pile on the food," Bezley said. "Here, eat - food is love."

But by the time Jasmine was 4, she was starting to get a bit chunky, her mother said. When she took her daughter to the pediatrician in Springfield, he offered some blunt, simple advice: Start serving more healthful foods and get your daughter active - or else.

"The big concern was her health" - the risk of diabetes, in particular - "and her social life," Bezley said. "So we started changing our diet. That's the big thing. It's something that has to be a whole family project."

Today, at age 9, Jasmine is still overweight, but she's not obese, her mother said. She's involved in T-ball and soccer, and her weight has stabilized as she has grown taller.

"She is the only kid in her class who likes spinach," her mother said.

Parents may start hearing more straight talk from their doctors, now that the American Academy of Pediatricians has urged its members to be more vigilant in identifying and preventing obesity in children.

Doctors have long tracked children's weight and height on special charts, but the new policy statement released last week suggests pediatricians take a more proactive approach in addressing the problem.

The policy, for instance, suggests doctors measure a child's body-mass index, or BMI, once a year. Doctors have long tracked children's growth through height and weight charts, but tracking their BMI, a ratio of height to weight, may help catch rapid increases in weight that could signal a child is at risk for obesity.

The policy comes as public health officials, from the U.S. surgeon general on down, have sounded a warning about obesity-related health problems that have reached epidemic proportions in America.

It's estimated that obesity overall contributes to 300,000 deaths each year in the United States, and one recent study found obesity-related health costs total about $93 billion a year - about the same as smoking-related health costs.

Obesity, fueled by fast food and sedentary lifestyles, is becoming a big problem among children.

Recent studies indicate that the percentage of severely overweight American children ages 6 to 19 has doubled to 15 percent in the last 20 years. In Oregon, the problem is worse: rates of overweight teens have tripled in the last two decades, and the state holds the dubious distinction of being "fattest state west of the Rockies," according to Dr. Mel Kohn, state epidemiologist.

In addition to checking body-mass index each year, the American Academy of Pediatricians policy recommends that pediatricians:

Identify and track patients at risk of obesity by looking at family history, birth weight, socioeconomic factor and ethnic, cultural or environmental factors.

Encourage , support and protect breast-feeding, which studies have shown may reduce a children's risk of becoming overweight or obese.

Encourage parents to promote healthy eating by offering nutritious snacks, such as vegetables and fruits, low-fat dairy foods, and whole grains.

Encourage parents to promote physical activity, including unstructured play.

Limit television, video and computer time to a maximum of two hours a day.

Take a leadership role in their communities in promoting anti-obesity programs, including discouraging the sale of sugary sodas and snacks at schools and encouraging physical education programs that focus on personal fitness, not just team sports.

Dr. Robert Mendelson, a Portland area pediatrician who speaks to pediatrician groups and parents about childhood obesity, said it's never too early for doctors to look for obesity risk factors.

Doctors can have tremendous influence on people's lives simply by offering straightforward advice, he said.

He starts with prenatal visits, telling obese parents things they can do to reduce the chance that their child will become obese.

Parents who are obese understand firsthand the health and social risks of being overweight.

"The greatest factor in whether a child is going to be obese is family history," he said.

The pediatrician who talked with Christina Bezley was Dr. Todd Huffman. The Springfield doctor said he has no problem speaking frankly with parents about at-risk children. What's hard is getting to the root of the problem.

For Huffman, three things add up to "a total recipe for obesity" for young people:

Fast food. One in five childhood meals in America is a fast-food meal, Huffman said. "That's astounding," he said.

Screen time - the time children spend in front of televisions, video games and computers. It's estimated that the average child spends four to five hours a day in front of a video screen, Huffman said.

The marketing of junk food and drinks to American children.

It's estimated that the food and drink industry spends $100 billion a year marketing to children, Huffman said.

A child's obesity also is tied to a family's choices and lifestyle, he said. So he approaches the problem almost like a family counselor.

"You can't just say this is what you need to do for Johnny," Huffman said. "You have to address the family lifestyles and eating habits of a family all together or you have no hope of fixing Johnny's weight problem."

Tim Christie can be reached at 338-2572 or [e-mail].

CHILDHOOD OBESITY

Pediatricians offer these tips for parents concerned about their children becoming obese.

Set a good example, through diet and exercise.

Encourage children to be active.

Limit children's time in front of a screen - whether the TV, video game or computer - to two hours or less a day. Studies have found that children who watch a lot of television are more likely to become obese.

Decrease their total caloric intake, get them off milk with fat and offer fruits and vegetables for snacks.

If you can't quit the fast food habit all together, set limits - once a month or once a week.

If your child is picky, offer a well-rounded diet and let the child choose whether to eat it or not. If the child refuses to eat and comes back in an hour demanding a snack, don't give in. Offer more of what there was for dinner.