In the Deep South, food is a congenial tool whose consequences are dealt with in hindsight. But the warm-hearted traditions of recipe sharing and elaborate Sunday dinners have contributed to an unhealthy culture.

The National Initiative for Children’s Healthcare Quality states that Mississippi ranks 51st in overall prevalence with 44.4 percent of children considered either obese or overweight compared to the national average of 31.6 percent. Mississippi’s prevalence has increased since 2003.

Obesity in children is measured by following growth parameters in infants then a body mass index is used once a patient turns 2.

“A BMI greater than 26 is overweight, over 30 is obese and over 35 is morbidly obese,” said Janell Vinson, a pediatrician at Merit Health. “We base a lot of our growth charts and parameters on percentiles. A lot of our kiddos who are above the 99th percentile we feel as though that kind of indicates that they’re overweight.”

In Mississippi 54.3 percent of blacks are overweight or obese while 36 percent of whites fit the category.

Combating childhood obesity simply starts with diet and exercise, however, with younger children it could become tricky, as it requires a change in lifestyle that most don’t control.

This is the time when Vinson talks with family members about changing the way they see food.

“Whatever they’re eating is what the child is eating. With pediatric obesity it’s so difficult because you have to change the entire family,” Vinson said. “I can’t just change the child and say ‘OK you have to have a salad instead of French fries.’ If that’s all they have and they drive to McDonalds at the end of the day then that’s the only choice the child has.”

America’s unequal food-to-price ratio has played a role in this epidemic.

Fast food restaurants continue to release value menus comprised of items priced just under a dollar, thus being cheaper for a low-income family for a night to feed two children on $6 than buying the groceries needed to cook dinner.

“It’s double the cost to be healthier, which is very difficult for the single mom to do that. I think eating out in general gets expensive and I know that groceries are expensive as well,” Vinson said before acknowledging how difficult it could be for a single parent to clip coupons as a way to save.

“I think cooking at home in any situation is going to be better than eating out.”

Vinson cautioned parents about portion sizes and allowing children more than one serving. She advises parents to limit portion sizes and try to find ways to save on groceries.

Chronic illnesses like diabetes and hypertension that develop early in a child’s life can be difficult to treat.

“It’s difficult because the best treatment is lifestyle choices and that’s even for adults too,” Vinson said. “You can decrease your cholesterol, blood pressure and control your blood sugars better all with lifestyle modifications. But that is a very strict regimen to stick to.

“There are medicines to control blood sugar levels that are safe in the pediatric population. When you know of an alternate solution, you’d rather them adhere to a different lifestyle.”