To keep his child away from obesity, a mother turns her life upside down

Irie Mazas's hands hovered over the boxes of bright red strawberries. Adams & Vermont Farmers Market in Los Angeles.

"Mami!", He called to Miriam Bautista, who was several steps away.

"How many?" Bautista asked the booth salesman in Spanish. Before the strawberries found themselves in a shopping bag, Irie was nibbling at one, the juice running down her shirt.

His mother frowned at the stain. Then she smiles.

A few months ago, Bautista feared never to force his daughter to eat healthy food. Apparently overweight since she was about 4, she would eat salty snacks, fast foods and sweets, but would cry if her mother put a carrot on her plate.

Bautista shrugged. His Mexican parents proclaimed that the bath made his daughter even more cute. Then Bautista was diagnosed with Gestational Diabetes during the pregnancy of his second child. She realized that the family's food choices were damaging not only her own health, but also Irie's.

"That's when I started reading the labels, to be more aware of what I was buying," she said. "I realized that everything I ate was harmful. I said, "My daughter must also learn that."

Bautista's struggles with the weight of his daughter are not unique. Obesity in young children is one of the most difficult health problems for Los Angeles County, where about 20% of children ages 3 and 4 are obese. Among school-age children, 45% are overweight or obese before reaching grade five, which is higher than the percentage of all Californians.

Obesity is particularly serious among young Latin Americans, which worries health officials because more than half of babies born in Los Angeles County are Latino. Nearly a quarter of Latino children aged 4 years in the county are obese, compared to 17% of whites, 15% of blacks and 11% of Asians, according to federal data.

The health consequences grow with age. Dr. Juan Espinoza, a pediatrician at Los Angeles Children's Hospital, said he routinely treated obese children in primary and secondary school with "50-year-old man" problems, such as hepatic steatosis. , hypertension, type 2 diabetes and joint pain.

"Most of these children have been overweight for a long time," Espinoza said. Obese children are likely to remain obese in adulthood, increasing their risk of heart attack, stroke, cancer and premature death.

Studies show that their offspring are also more likely to be obese. One of the major risk factors for childhood obesity is a mother's body mass index prior to pregnancy.

"Larger adults will have bigger kids," said Michael Goran, director of the program for Diabetes and Obesity at CHLA. "It's becoming a generation problem."

Bautista knew that she would fight to improve Irie. Excess books are the norm in her husband's family, and Irie's grandparents loved to spoil her daughter with pastries and other treats.

After several attempts to get Irie to eat vegetables, Bautista asked for help from the girl's pediatrician. She referred them to a seven-week obesity prevention program called BodyWorks. Organized by CHLA and AltaMed, an outpatient provider, BodyWorks uses games, exercises, videos and healthy snacks to guide children to a better path.

Irie started coming. She tried vegetables for the first time: lettuce, then broccoli, then carrots. She learned that her plate must look like a rainbow, as well as the vitamins and minerals she needed to grow.

Bautista learned how to set limits: no snack before meals, no fast food several times a week. She now offers Irie a healthy snack before leaving the house. She brings water and nuts so that her daughter does not beg for junk food. She asks the children to stay home with her husband when she goes to the supermarket so she does not have to deal with requests for french fries, cookies and sweets. And they go to the farmer's market every week instead of taking the car.

With the support of her husband, Bautista stood up to her in-laws, urging them not to give Irie unhealthy treats. Irie's grandmother initially rebuffed, said Bautista, but she complied with the request.

At a recent review conducted six weeks after the start of the BodyWorks program, Irie was no longer overweight, said Bautista.

"It makes me feel good to see these changes," she said.

Irie is happy too. She proudly recounted that she eats a serving of fruits and vegetables each meal. Broccoli, which she initially thought "had a weird taste," is now her favorite vegetable, she said.

BodyWorks is one of many initiatives aimed at breaking the cycle of obesity in young children in Los Angeles. Other efforts included free family nutrition classes in community health clinics; an anti-obesity campaign led by the Los Angeles County Public Health Department, which offered workshops and grocery shopping tours; a national law that defines milk and water as default options for children's meals in restaurants; and the ban on selling soda in public schools.

Yet experts are frustrated that childhood obesity rates remain so unacceptably high.

"Unfortunately, we are still at levels of obesity comparable to peak rates in 2009," said Shannon Whaley, director of research and evaluation for the largest of seven county agencies that administer the federal nutrition program. . Women, infants and children.

And things could get worse soon, say the experts. Families are abandoning programs such as WIC, lest their information be shared with immigration officials or undermine their efforts to obtain legal resident status. Last fall, the Department of Homeland Security said it was considering changing its policy by denying permanent resident status to immigrants with government benefits, such as WIC or Medi-Cal.

Joy Ahrens, WIC Director for Northeast Valley Health Corp. in San Fernando, said that patients had asked to be removed from the program or did not show up for their appointments.

"We try to tell them that it is in the best interest of your child and your pregnancy," she said. "But there is really a lot of fear."

Poverty also contributes to obesity by hitting families from different angles.

Single mothers in multiple jobs have little time to breastfeed, breast milk, cook healthy meals, or ensure that their children are exercising enough. Low-income parents are less likely to live near supermarkets, pushing them to shop in markets and liquor stores full of processed, high-calorie foods. Even when fresh produce is available, there may be no way for parents to prepare it.

"I have patients who live in garages or in places where they do not have access to a kitchen. Sometimes they do not have access to refrigeration, "said Dr. Gina Johnson, Pediatric Medical Director of Northeast Valley Health Corp., which operates 14 clinics that primarily serve low-income Latin American families.

The questions asked by the parents are revealing: is it acceptable to sweeten milk with chocolate powder? Can I really give my child a cup of cereal for breakfast?

"For this population, what worries them the most is what worries them the most," said Victor Solano, health educator at a clinic in San Fernando. "So, they focus on the amount of food, not so much quality."

Not surprisingly, children in the most disadvantaged neighborhoods in Los Angeles County are much more likely to be obese than those in wealthier communities.

"If you look at Malibu or Beverly Hills, the prevalence of childhood obesity is 5% or less," Goran said. "But if you look at East L.A. or South L.A., it can be 30% or 35%."

Estelita Sebastian, a single mother at MacArthur Park who works part time as a housekeeper, began buying fast food for her 11 and 5 year old sons after they became too old to qualify for WIC . She does not own a car, so stopping for food on the way to school seemed more practical than walking 15 minutes to get to her local Smart & Final and bring her shopping home, a- she declared.

Last summer, a doctor told Sebastian that his children were overweight and that his eldest, Gustavo, was suffering from high blood sugar and high cholesterol. She and her sons enrolled in BodyWorks have collectively lost several pounds and are no longer overweight. Through trial and error, she realized that she could save money by eliminating junk food and cooking at home. But she had to condense her work schedule and stay awake an hour later every night to do everything.

"It was difficult," said Sebastian. But Gustavo's diagnosis gave him the strength to persevere. "I felt guilty and said to myself:" No, it must change. "