What “The Hardy Boys” taught me about childhood obesity

Frank, Joe and Chet (with big clue!)

Frank, Joe and Chet (with big clue!) 1927

When my son John was in third grade he briefly glommed on to my collection of old Hardy Boys story books. We’d read them together at bedtime as I tried to instill in John a love for the Boys, their pals (“chums,” to be precise) and their ancient (to him) adventures. Alas, Harry Potter soon distracted him and the Hardy Boys went back to gathering dust.

For those of you too young to remember (or too Nancy Drew-ish in your literary tastes to care), The Hardy Boys was a 58-book series that ran from 1927 to 1979, coinciding with the sweet spot of my 1950s and ’60s childhood. (The success of the books also spawned a black-and-white Disney TV serial in the ’50s, a Saturday morning cartoon from 1969-71, and the truly awful Hardy Boys/Nancy Drew Mysteries, which ran from 1977-79.)* Long story short, The Hardy Boys books described the sleuthing adventures of Frank and Joe Hardy, sons of the famous private investigator Fenton Hardy, in sometimes excruciating prose.

Frank and Joe evolved over the books and years from cynical, in-it-for-the-money 1920s teenagers to paragons of 1950s authority-respecting American youth. A Hardy sidekick, Chet Morton, evolved in somewhat different fashion, which brings me to today’s topic: Parents of overweight and obese kids are getting really bad at telling that their kids have a weight problem. 

Chet was the clumsy, jalopy-driving foil to Frank and Joe’s buff manliness. In the very first book, “The Tower Treasure,” Chet is described thusly: “He was a plump boy who loved to eat and was rarely without an apple or a pocket of cookies.”** This puzzled John, who looked at the accompanying drawing and said, “Why do they call him plump? He looks pretty skinny to me.” He had a point. As you can see, Chet may have had a roundish face and a bit of fullness to his arms, but his waistline and legs are as skinny as Frank and Joe’s. “I guess that was considered fat back in those days,” I explained to John with a shrug. Then I looked it up and found that only about 2% of children were obese in the 1930s. By the time we were reading this in ~ 1999, about 15% of children were obese. By 2012, 21% of American teens were obese. It was true: back in the 1930s, an artistic bit of a double chin or a pinch of chub at the belt line was all it took to portray a kid who liked to keep his pockets lined with cookies.

Chet Morton, aka

Chet Morton, aka “Chubby,” 1971

Chet’s evolution over time says a lot about how we perceive child obesity. As time went on and obesity rates rose, his Jazz Era chubbiness wasn’t enough. Chet got fleshier. By the time the late ’60s cartoon appeared, Chet (renamed “Chubby,” in case kids zoned out on Sugar Smacks didn’t get the point) had taken on a doughy, full-figured form that signaled to contemporary viewers that Chet was, well, chubby. Today, when more than 1/3 of adults are considered to be obese, it’s getting harder to send that signal: portrayals of characters as truly “fat” have kind of gone over the top, and they’re usually pretty cruel.

A new study in the journal Child Obesity shows how society’s idea of “normal” weight has changed since the Depression. In a survey of parents of 2-5 year-olds, 94.9% of parents whose child was in the “overweight” category, and 78.4% of those who were frankly obese said that their child’s weight was “just about right.” As our kids get heavier, our “parent goggles” simply adjust. In a strange corollary, I talk to parents all the time who worry that their average-build kids are too skinny.

The sorta-good news? Parents’ mis-perception of their overweight children actually improved somewhat from a similar study done 20 years earlier.

Given all that, I wonder how Mr. and Mrs. Morton viewed their cookie-pocketed boy who got steadily heavier over the years but, strangely, never aged? Alas, in 58 books, they never said a word…

* * *

* Shaun Cassidy as Joe Hardy?? Spare me…

Joe Hardy? Looks more like Justin Bieber...

Joe Hardy? Looks more like Justin Bieber…

** Chet was also described at various times as “big boy,” fat, plump, chubby, stout, heavy-set, chunky, “the chubby one,” portly and round. (“Portly” was my favorite.)

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A good day to be in Washington!

Not much repenting going on...

Not much repenting going on…

We’re in Washington D.C. for my niece’s wedding on Saturday. When we heard the Supreme Court’s pro-gay marriage ruling this morning we headed over to the Court building from our hotel to check out the reaction. Lots of happy people, justifiably so–and a few not-so-happy hellfire and brimstone folks, too…

Between this and the ruling upholding the Affordable Care Act, it’s been a pretty Supreme week!

Anti-gay marriage or parody? Couldn't tell!

Anti-gay marriage demonstration or performance art? Couldn’t tell!

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Mode of delivery and childhood illness: A randomized trial in 2004.

03c62f38ce31d41b01e1b5a4031bf11aOne of the biggest difficulties in proving a causal link between cesarean birth and chronic health problems in childhood is the type of research studies that can practically and ethically be done during pregnancy.

The gold standard in medical research is the randomized controlled trial (RCT). In an RCT researchers randomly place subjects into either “treatment” or “control” groups, then expose the treatment group to something—a new vaccine for Infection X, for example—and then compare outcomes in the two groups later on. (In this example, how many kids in the treatment [vaccinated] group came down with Infection X versus how many in the unvaccinated control group?) If there’s a significant difference in outcomes between the two groups, you’ve got a strong argument that the treatment made the difference.

How a randomized controlled trial works. (Credit: SUNY Downstate Medical Center)

How a randomized controlled trial works.**

As you can imagine, randomly assigning pregnant women to cesarean (treatment) or vaginal birth (control) groups is nigh onto impossible—ergo, you can’t do an RCT. This means that virtually all research studies on the issue of cesareans and chronic childhood have been observational in nature—looking backward in time at databases, for example, or trying to fish significant trends out of hospital registries, birth cohorts and the like. The best an observational study can tell you is that A and B are associated with one another, but that’s it—you can’t prove that A actually causes B. An observational study can’t prove that cesareans are a cause of asthma; it can only say that cesareans are associated with an increased risk of childhood asthma.*

So mode-of-delivery RCTs are out of the question…or are they? Actually, in 2004, a Canadian research team did one.

Well done, Northern Neighbors!

Well done, Northern Neighbors!

The multi-center, multi-nation Term Breech Trial wasn’t about whether cesareans might increase the risk of childhood asthma, diabetes and such. It was about trying to figure out whether elective cesarean section or vaginal birth was the safest way to deliver a breech baby at term. Since the existing research was somewhat murky at the time, it was considered ethical (with informed consent) to randomize women to have either a planned cesarean or attempt a vaginal birth.

The particulars of the breech birth debate are best left for another post, but tucked away in the study’s results section was this little nugget:

“…more parents in the planned cesarean birth group than the planned vaginal birth group reported that their children had had medical problems in the past several months…relative risk, 1.41; 95% CI, 1.05-1.89; P=0.2.”

Plain English version (mine): The toddlers who had been in the planned cesarean group were about 40% more likely to have been sick in the previous few months than those in the planned vaginal birth group. The types of medical problems—typical 2 year-old stuff like colds, ear infections and stomach flu—were no different between the groups. The only difference was in the numbers of children who’d gotten sick.

As is the case with all medical research, you can find things in the study to complain about: relatively small numbers, for example, the use of parental questionnaires and the fact that some mothers in planned vaginal birth group ended up having cesareans (and vice-versa), etc.

But here’s my bottom line:

In a randomized trial of pretty well-matched subjects, those babies whose mothers were in the planned cesarean group tended to get sick more often than those in the planned vaginal birth group.

This doesn’t address the issue of chronic illnesses like asthma, type 1 diabetes and the like, but it does support the theory that cesarean birth can mess with a baby’s developing immune system.

* * *

*Here’s an exaggerated example of the trouble with mistaking association for causation: Virtually all adults who die suddenly of heart attacks drank water in the 24 hours before they died. So, drinking water is associated (time-wise) with heart attacks. But you would be wayyyy wrong to say that, based on that association, a glass of water can cause a heart attack.

**Credit: SUNY Downstate Medical Center

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Filed under Asthma, Canada, Cesareans, Immune system, Maternal-child health, Newborns, Vaginal birth

A great Father’s Day column…by my Mom.


Margaret “Peg” Sloan

My mother, Peg Sloan, was a writer and editor for our hometown Kankakee (Illinois) Daily Journal from the late 1970s to the mid-1990s. She published her first column in 1977, on the trials and tribulations of being a redhead. She went on to write nearly 700 more on subjects as varied as family, human nature, Irishness, the passage of time, and the memories of a big-city girl who married into an Illinois farm family. She won multiple awards for her writing and editing–from the Associated Press, United Press International and the National Press Women’s Association–and developed a large and loyal readership along the way.

Here’s one of my mother’s most popular columns, re-run this Father’s Day by the Daily Journal. It was written in 1979 about Mom’s father, my grandfather James Dalton, the year before he died. Grandpa was the quintessential Irishman: an accomplished musician, great dancer, master storyteller and a kind, gentle man. The column still gets to me, and with Mom now the same age Grandpa was back when she wrote it, I thought I’d share it with you.

P.S Peg Sloan is still alive and kicking. She lives in Wheaton, IL, with my father, Barney Sloan (and Happy Father’s Day, Pally Boy!). They’ve been married 68 years…

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Things kids say: Disney-trashing edition

Cranky? Moi?

Bossy? Moi?

Overheard: A young girl talking to her mother at the V. Sattui winery picnic grounds in Napa, California (one valley over from where I live), last weekend…

“They call it the happiest place on earth, but it’s not. That princess-lady yelled at me for nothing.”

The girl’s mother reminded her that, in Disneyland at least, throwing a drink at her brother on a crowded sidewalk isn’t actually “nothing.” The girl paused, nibbled on a cookie, then huffed:

“Well, who made her the boss of that stuff anyway? She probably isn’t even a real princess.”

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Once upon a time in cord clamping…

Modern science at work…

Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be.

Erasmus Darwin (Charles’s grandfather), 1801

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That’s me on the radio…

Adriana Lozada

Adriana Lozada

I just had the pleasure of discussing the advantages of delayed cord clamping with the wonderful Adriana Lozada over at birthful.com.

Here’s the link:


Check out the rest of birthful.com, too–it’s a great resource–and read Adriana’s fascinating personal history. (Great photo here of Adriana with her 10-year old “mini-me,” Anika.) Adriana has a growing list of podcasts, including interviews with such well-known figures in the childbirth world as Gene Declercq, Rebecca Dekker and Sarah Buckley. I’m honored to be in their podcast presence. Thanks, Adriana!

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Filed under Cord clamping, Doulas, Iron deficiency, public appearances