Study: 14% of Hawaii preteens, teens obese

Hawaii ranks 33rd in nation, ‘stealth health’ offered as remedy

Hawaii ranks 33rd in the nation for childhood obesity rates at 13.9 percent of all children ages 10 to 17, according to a study released Wednesday by the Robert Wood Johnson Foundation.

Hawaii's obesity rate was slightly below the national average of 15.8 percent. Mississippi had the highest rate at 26.1 percent, while Utah's was the lowest at 8.7 percent in combined results from 2016 to 2017.

And while rates of childhood obesity have leveled off in recent years, they're still much higher than they were generations ago.

"It's not as bad as some places, but it's still way higher than it should be, and the fact that it's increasing is evidence that we're dealing with the same problems that the entire culture is dealing with, which is a sedentary lifestyle," said Dr. Art Chasen, a bariatric surgeon at Maui Memorial Medical Center.

The study, which calculated body mass index using the child's height and weight, also found that "racial and ethnic disparities persist" when it comes to obesity. Nationwide, black youths had an obesity rate of 22.5 percent, followed by Hispanic youths at 20.6 percent and white youths at 12.5 percent. Asian youths ranked the lowest at 6.4 percent.

In Hawaii, however, the rates were lower -- 9.3 percent for Hispanics and 8.4 percent for whites. (Asian and black youths were not listed for Hawaii.)

The obesity rate among children ages 6 to 11 has more than quadrupled in the last 40 years, and among adolescents ages 12 to 19, it's more than tripled, according to the foundation, a Princeton, N.J., nonprofit focused on improving health.

Children who are overweight or obese are at a greater risk for serious health conditions, including high blood pressure, type 2 diabetes, heart disease and asthma. Every year, the U.S. spends $14 billion on childhood obesity alone, and between $147 billion and $210 billion on adult obesity, the foundation's report stated.

Chasen chalked it up to a combination of busier lifestyles with less time for healthy meals, increasing attention to electronics and social media, and kids spending less time outdoors.

"I think also, previous generations, when they got home from school and they wanted to go out and play in the neighborhood, it was thought of as safe," Chasen said. "Parents didn't have to know where their kids were at every moment. And now there's a lot more concern for the safety of kids."

Chasen also said he's noticed that many people who come seeking bariatric surgery -- a procedure performed on the stomach or intestines to induce weight loss -- have experienced childhood trauma that's increased their risk of obesity, depression or heart disease.

In the land of plate lunches, there's also the diet factor.

"In Hawaii, until we eat our starch we feel like we haven't eaten," said Dr. Lorrin Pang, Maui District Health officer.

Pang said he's been trying to replace the rice in his diet with healthier starches like ulu and sweet potato. But in a society saturated by weight-loss plans, gym membership deals and countless diet fads, how do you actually get people to live healthier? Pang thinks the key to combating obesity is a concept known as "stealth health," getting people to do healthier things for nonhealth-related reasons.

"Nobody wants to hear about health," Pang said. "But if you actually told me, 'Let's go paddle this canoe,' I love that. I'm trying to get access to canoe paddling."

"Stealth health" means getting people to do physical activities for fun or as a reward instead of for the obvious reason that they should exercise, Pang said. It means marketing fruits and vegetables not necessarily for their health benefits but because they're locally grown or taste better.

"It's either got to taste good or be real cheap or, you know, uncle grew it, so can you please eat it?" Pang said.

It's also about finding alternatives -- for example, sweet drinks that taste good but aren't as high in sugar as most sodas.

"I don't like abstinence," Pang said. "I like slow reduction. We're not going to ban these things. But we're going to show them the proper amount they can have and the alternatives."

Some of the recommendations the study made were for Congress to maintain and strengthen nutrition programs for low-income families; continue offering access to affordable, healthy food and breastfeeding support for mothers; ensure that students receive at least 60 minutes of physical education or activity during each school day; and ensure restaurant meals marketed to children meet nutrition standards and do not include sugary drinks.

As for adults, Hawaii ranks third lowest in the nation when it comes to rates of obesity among adults at 23.8 percent -- still nothing to be proud of, Chasen said. Hawaii's favorable ranking as compared to the rest of the nation may be because "Hawaii attracts these kind of people that want to be healthy," Pang said.

"They come here to surf and paddle, and they like the year-round weather," he said.

Maui County ranked third among all Hawaii counties in terms of overall health, according to the foundation's rankings, which take into account such factors as quality of life, access to health care and physical environment. Maui County had a 23 percent adult obesity rate, with 20 percent of adults over the age of 20 reporting that they did not participate in leisure time physical activity despite 92 percent of the population reporting adequate access to parks or recreational facilities.

As for access to health care, Maui County's 1,060-to-1 ratio of people to primary care physicians was the lowest among Hawaii counties; the 1,610-to-1 ratio of people to dentists the highest; and the 650-to-1 ratio of people to mental health providers was also the highest.

For a breakdown of Hawaii statistics and policies related to obesity, visit stateofobesity.org/states/hi/. For county health rankings, visit countyhealthrankings.org/app/hawaii/2018/rankings/hawaii/county/outcomes/overall/snapshot.

* Colleen Uechi can be reached at cuechi@mauinews.com.