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Pediatricians vs. Junk Food Giants: PCRM Doctors Report from Front Lines of Obesity BattleJack is a typical child in Dr. Rina Shah’s practice. Except that at 6 years old he weighs 100 pounds.

“The average child his age should be closer to 50 pounds,” says Dr. Shah, a pediatrician in Vallejo, Calif. “Jack is one of the many children in my practice who struggles with eating healthy and becoming more active.”

More than 12 million children and adolescents in the United States are obese. One in three children born since the year 2000 will develop diabetes at some point in life, according to the Centers for Disease Control and Prevention.

Dr. Shah and other PCRM pediatricians have shared firsthand accounts of how they are battling the childhood obesity epidemic in their own practices.

Fighting Fast Food

Leslie Brown, M.D., a pediatrician in New Orleans, is doing all she can to fight junk food advertising both in her practice and in her own family.

“I had my daughter watch Super Size Me when she was about 12,” says Dr. Brown. “And she really lost interest in fast food.”

Pediatricians nationwide are waging a war against unhealthy school lunches and junk food advertising targeting children. Children and teenagers see up to 7,600 food commercials each year. Almost none are for fruits or vegetables. And junk food advertising doesn’t just mean ads for candy and soda—it means ads for burgers, chicken nuggets, and even that glass of milk that is now known to be a major contributor of fat and cholesterol. Alluring, million-dollar marketing campaigns are conditioning children to opt for foods like Big Macs instead of broccoli and bananas.

Major food and beverage companies spend $1.6 billion per year advertising to children, according to a 2008 Federal Trade Commission report. Other estimates are as high as $10 billion. Food marketing to children is not just TV ads. Companies target children everywhere they spend time—including school, online, cell phones, video games, movies, and grocery store aisles. Fast food restaurants lure kids by offering a free toy with kids’ meals.

Another PCRM member pediatrician, Jay Gordon, M.D., banned fast food from his Los Angeles office. If someone walks into the waiting room with a McDonald’s bag, they are asked to leave the food at the door.

Research shows that junk food advertisements work. In fact, they are so powerful they can convince children that identical products taste different. A recent study from Yale’s Rudd Center for Food Policy and Obesity found that kids are more attracted to junk food when a cartoon celebrity adorns the package. They offered kids identical gummy fruits and other foods—some in packaging depicting Shrek and other popular characters and some in plain packaging—and half of the children said the cartoon-adorned snack actually tasted better than the same food in a plain package.

“Cultural beliefs and social eating habits are deeply entrenched,” says Roberta Gray, M.D., a PCRM pediatrician in Rock Hill, S.C. “Having practiced primarily in the rural South and Appalachia, where adult and childhood obesity prevalence has been the highest in the nation for decades, there seems to be a pervasive social complacency and acceptance of obesity. All day eating out of cellophane wrappers is the norm.”

Another recent study confirmed that it’s not sitting in front of the TV that makes kids overweight—it’s the junk-food ads they watch while sitting there. UCLA researchers compared children who watched commercial-free programming and DVDs with those watching regular TV with commercials. They found that TV watching was associated with increased obesity rates only among the kids who watched commercials.

Dr. Gray explains that junk food and fast food permeate all aspects of children’s lives, even when they’re sitting in the doctor’s office.

“I enter the exam room at 10 a.m. to see my 6-year-old, obese, hypertensive patient,” says Dr. Gray, describing a typical practice occurrence. “There’s a 1,000 pound family in this room—mom, dad, maternal grandmother, my patient, and her 4-year-old brother. The mother tells the children to be good and she’ll take them to Chuck E. Cheese’s. This visit was a follow-up to last month’s visit when they had a lengthy consultation with the pediatric dietitian.”

Rina Shah, M.D., and her daughter Diya Leslie Brown, M.D., Jay Gordon, M.D., Roberta Gray, M.D.

Prescription Produce

Pediatricians and other health care professionals are finding innovative ways to counteract food advertising and help children develop a taste for fruits, vegetables, whole grains, and other healthful foods. Doctors are also taking action to improve access to healthful foods.

Doctors at three health centers in Massachusetts have started handing out “produce prescriptions” to help fight obesity in children in low-income areas. They give patients’ families coupons to purchase fruits and vegetables at farmers markets. This program is a new way to compete with the cheap, processed foods on fast-food dollar menus.

“I think the biggest problem is kids’ access to junk food and sugary drinks and parents’ unwillingness to limit them,” says Dr. Brown. “I overhear parents of kids in my practice promising lunch at McDonald’s to make up for having to come in for a visit.”

Dr. Brown says she thinks parents have been led to believe certain foods are healthful when they are not. She has been in private practice for 13 years and says the percentage of overweight and obese patients rises every year.
Dr. Brown and other PCRM doctors are trying to give both parents and children a better understanding of nutrition so they know which foods to limit or avoid.

An Apple a Day…

Dr. Shah organized a nutrition seminar for kids like Jack and their families last summer. Families came once a week for three weeks and learned about healthy food from a nutritionist and health educator. The seminars also included group counseling.

“The children were eager to participate and learn about what was healthy and what was not,” says Dr. Shah. “I saw Jack in follow up about a month later. He was eating more fresh fruits and vegetables, exercising, and trying to be healthier.”

Dr. Shah also asks patients to keep a food diary. She starts with children as young as first grade and asks them and their families to set their own goals for healthy eating. She finds that children are more willing to make changes if they create their goals rather than her telling them what they need to accomplish.

Dr. Gordon also starts talking to his patients about nutrition at a young age.

“I talk to my 5-, 10-, 15-year-olds about meat and cheese and ask them to think about what would be better for their Saturday afternoon soccer games,” he says. “I say, ‘If you eat more fruits and vegetables, you can run faster.’”

PCRM pediatricians have also been helping with PCRM’s campaign to improve school lunches. They’ve been speaking out against the fast food and cheap processed meat often served in school lunch lines and encouraging Congress to provide schools with more vegetarian commodity options.

They want children to have access to healthful foods at school, at home, and in their communities so they will develop eating habits that can help keep them healthy—and out of the doctor’s office. 


Not-So-Happy Meals

With 840 calories, 37 grams of fat, and about as much sodium as a child should consume in an entire day, McDonald’s Mighty Kids Meal has topped a list of the five most unhealthful fast-food meals marketed to children. The list, based on analysis by PCRM dietitians, also includes meals from Wendy’s, KFC, and A&W, as well as Burger King’s just-released BK Kids Breakfast Meal.

“Kids shouldn’t have to dodge cholesterol bombs packaged in colorful, toy-filled boxes,” says PCRM nutrition education director Susan Levin, M.S., R.D. “We’re losing the war against childhood obesity, but fast-food chains are still making obscene profits by targeting children with high-fat meals.” Here are the five most unhealthful kids meals, ranked from worst to least bad:


Five Worst Fast Food Kids Meals

Nutritional Profile


McDonald’s Mighty Kids Meal:
Double Cheeseburger, french fries, and chocolate milk

840 calories; 37 grams of fat

2nd Worst

Wendy’s Kids’ Meal:
Chicken Sandwich, french fries, and chocolate Frosty

770 calories; 34 grams of fat

3rd Worst

KFC Kids Meal:
Popcorn chicken, potato wedges, string cheese, and soda

800 calories; 1,800 milligrams of sodium

4th Worst

A&W Kids Meal:
Cheeseburger, french fries, and soda

780 calories; 9 grams of saturated fat

5th Worst

Burger King’s BK Kids:
Breakfast muffin sandwich meal

95 milligrams of cholesterol; exceeds recommended limit on sodium intake


Good Medicine: Pediatricians vs. Junk Food Giants

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