Healthy childhood is disappearing

Philip J. Goscienski, M.D.

April 2007

The social phenomenon that critics refer to as disappearing childhood is an enormously popular topic. Most observers overlook a different kind of tragedy: diseases that seldom occurred before the fifth decade of life are no longer rare in early adolescence, or even earlier.

Some children's health problems obviously have a social basis and are deserving of our serious attention. Sexually transmitted diseases and pregnancy are the most obvious. Independently of social factors, several disorders that never or rarely occurred during childhood a generation or so ago are now common in pediatric offices. Diseases of middle age are tumbling down the age spectrum and there are signs that average life expectancy will have turned downward by the time today's youngest children have reached maturity.

Obesity is the common factor among several health problems of today's children but the fault does not lie simply in greater food intake and only partly on the quality of food. Decreased physical activity, inadequate energy output, accounts for most of the quadrupling of overweight and obesity of the nation's youth. To be sure, fast food, french fries, sweet snacks and sugary drinks have replaced home-cooked meals, garden vegetables and whole milk but the total number of calories that kids eat hasn't changed much since the 1970's.

In a system that allows physical education classes to disappear from the school schedule and for computer games to replace after-school bike-riding and sandlot games, packing on pounds is inevitable. The number of hours spent before the TV or computer screen is directly proportional to a child's body weight in some studies.

Not all overweight adolescents become overweight adults but about half of them do. Even before he or she reaches maturity the obese child has developed markers that clearly foreshadow coronary artery disease. High blood pressure, the single most important risk factor for coronary artery disease, is one example. It affects roughly 15 percent of teenagers. And more than the heart is at risk. As blood pressure increases, performance on tests of mental ability decreases.

The most serious threat is type 2 diabetes. A disorder that represented barely 2 percent of childhood diabetes in the middle of the 20th century now accounts for approximately half of new cases of diabetes in almost every metropolitan children's health center.

Type 2 diabetes is entirely preventable but absolutely incurable. Diabetes drugs do nothing but slow down the disease's progression toward lifestyle-destroying complications. Fewer than half of today's adult diabetics achieve adequate control of their blood sugar, the primary determinant of the severity of complications such as heart disease, blindness, kidney failure and limb amputations. Can we expect any better from the next generation? Unless science comes up with a dramatic breakthrough in treatment or prevention our children and grandchildren will break the financial back of the healthcare system.

These dismal scenarios are not inevitable. In forward-looking cities such as San Antonio, Texas, schools that provide nutrition education, prioritize physical activity and promote after-school activities are already able to measure progress. The rest of the nation should pay attention.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at