By Tom Walsh
Courtesy of The Ellsworth American

“The part that makes me really, really sad is how diabetes is affecting kids. I’ve seen 5-year-olds who weigh 100 pounds, which is what an 11- or 12-year-old should weigh.” — DIABETES EDUCATOR MARY JUDE Health care providers concerned about obesity in children contributing to an ongoing epidemic of diabetes agree that kids today eat more and exercise less than did their parents’ generation. They also agree that fat kids are often a reflection of the unhealthy eating habits and sedentary lifestyles of their parents. About two-thirds of adults in America are now considered overweight. Growing concern about the increase of obesity in children and childhood onset of what used to be termed “adult onset” diabetes is driving efforts by public health and school officials to ensure kids get more physical exercise, both in school and out. Some public schools have banned sugar-laced soft drinks and high-calorie snacks, while others make a point of offering students healthy choices in school cafeterias, including salad bars and fresh fruit. Diabetes Education at MCMH Maine Coast Memorial Hospital The Medical Office Building Suite 2600 50 Union Street Ellsworth, ME 04605 (207) 664-5434

Confronting Maine’s epidemic of diabetes remains an enduring challenge for health care professionals working within a fast-food culture populated by a sedentary citizenry that is fat and getting fatter.  

“What’s most frustrating to me is that diabetes is preventable,” said Mary Jude, a registered dietitian and a certified diabetes educator at Maine Coast Memorial Hospital in Ellsworth.  
“There are now conclusive studies that show that lifestyle changes can prevent diabetes from developing. And, what’s also frustrating is that, for every two people who are diagnosed with diabetes, there’s another person who has it and doesn’t know it.”  

Only West Virginia has a higher incidence of diagnosed diabetes than does Maine. A statistical analysis by the U.S. Centers for Disease Control and Prevention shows 8.7 percent of West Virginians have been diagnosed, compared to 6.6 percent of Mainers.  
Maine’s own statistics reflect even higher numbers for adults. A recent survey by the Division of Community Health of the state’s Bureau of Health shows 7.4 of Maine’s adult population has been diagnosed with diabetes, and another 3.7 percent have diabetes and don’t know it.  

Other data make it clear that diabetes isn’t just an inconvenience for those who require daily insulin injections or need to pursue other costly treatment regimens. It’s deadly.  

The state’s death records show a 62 percent increase in deaths attributed to diabetes between 1979 and 2000. And it’s suspected that figure is too conservative, as diabetes is considered to be under-reported on death certificates, as diabetes is a significant risk factor for cardiovascular disease.  

Jude and her team of diabetes educators realize that diabetes often results in death by lifestyle.  

“In Maine, we tend to hibernate in the winter, sitting inside and watching TV while we eat,” she said. “There are Dunkin’ Donuts and McDonald’s that in bad weather offer the convenience of drive-throughs. And every ‘labor-saving device’ we have, down to the remote for the TV, means we’re burning fewer calories.”  

The grim reality, says Dr. Dora Anne Mills, Maine’s public health director, is that life expectancy in America could decrease as the direct result of the impact of obesity in fueling the diabetes epidemic.  

“This may be the first generation in America that doesn’t live as long as their parents, because of obesity,” she said. “It’s a very visible problem; just look around any schoolyard.”  

Jude is most distressed by the growing susceptibility of children to diabetes as they become more and more overweight.  

“I’ve been doing this for 40 years, and the obesity problem has increased dramatically over that time, but it’s gotten really bad in the last 20 years,” she said. “The part that makes me really, really sad is how diabetes is affecting kids. I’ve seen 5-year-olds who weigh 100 pounds, which is what an 11- or 12-year-old should weigh.”  

Fat kids tend to have fat parents, which isn’t surprising when approximately 62 percent of American women and 67 percent of American men are considered overweight.  

“Kids are often modeling the obesity of their parents,” Jude said. “We have obese parents who serve their 2-year-old child what normally you would serve an adult. And, when you talk with them about reducing intake, they just freak out about it.”

Dr. Jonathan Fanburg, an Ellsworth pediatrician, has been waging professional war against childhood obesity for years. He estimates that approximately 27 percent of Hancock County children are either “overweight” or “obese” based on body mass index, which factors in weight and height.  

“This epidemic of obesity has been on the rise at about 1 percent a year for the last 10 to 20 years,” he said. “Unfortunately, the solution is not simple. It will need to be led by multiple influences on a child’s life, including the doctor’s office, the schools, the environment, the homes, their peers and legislation. No one solution will work for all children.  

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Unfortunately, educating the public as to the unhealthy effects of obesity has been proven to not change a child’s behavior.”  

Jude understands the reality that she’s in the behavior modification business. Like alcohol, gambling and other addictions, food addicts, she said, need to admit they have a problem with food and must commit to addressing it.  

“They have to be willing to make a change,” she said. “I can’t change somebody’s lifestyle, but I can give them tools to work with. People come to me and say ‘Give me a diet,’ which is a very negative approach. We don’t talk about diets. We talk about making healthy eating a part of permanent lifestyle changes.  

“For some people, sometimes nothing works. They have to reach a point where they say to themselves ‘I’ve had enough, and I don’t want to be like this.’ For some, it’s a matter of being scared because of the death of a friend or a family member due to complications of diabetes.”