Archive for childhood obesity
Breastfeeding and lowering the risk of childhood obesity
With the rates of diabetes and obesity skyrocketing, it is always good to see studies outlining protective behaviors. Unfortunately, whether or not an infant was formula fed cannot be changed in the child’s later years. The US government is considering spending millions on educating children on exercise and healthy eating but are missing the obvious (as surprising as that may be for government…). How about a multi-million dollar advertising campaign towards the benefits of breastfeeding?
The Journal : Back Issues
In a previous blog article, we established the fact that less than 1% of adolescents were maintaining ideal cardiovascular health.
In another previous blog article, we looked at the fact that 1/3 of the US population is prediabetic, also related to the same lifestyle changes that aren’t being made.
It’s clear that our society is not willing to make the changes needed to be healthy. Luckily, that may not be a concern because the Better Living Through Chemistry folks are here to hold your hand and fix everything.
In this particular study, researchers took as small group of 26 kids 12-19 years of age with severe obesity and evaluated whether using a new, high-powered diabetic drug (the GLP-1 agonist called Byetta) that I have grave concerns about, could help them manage weight better.
Here’s what they found:
- Over the course of 3 months, the exenatide (aka Byetta, or the hila-monster spit drug) group lost about 1.13 points on the BMI charts.
- This works out to be around 5 lbs or so for a 5’7″ male, or 1.7 additional pounds per month.
Wow. 1.7 pounds for a very expensive drug that has to be injected and carries grave concerns of acute pancreatitis and thyroid cancer (and probably more that we aren’t yet awareof..).
Don’t be surprised if we start to see more and more of this type of study trying to find a drug answer for our adolescents to “solve” the obesity and prediabetes problem. Given the numbers of people who are prediabetic, there is a massive amount of money to be made in this market. But as we see from this study, it’s a high price to pay for paltry results.
This is not the first time I’ve pointed out the problems in society when it comes to health. Even First Lady Obama is promoting physical activity like it’s “the” answer to childhood obesity.
Well, guess what? The problem isn’t the exercise. I’m not saying it’s ok for your child to sit in front of an Xbox 360 for 4 hours a day. They should, in general, be active. When we were kids (maybe 10 years ago, if my math is correct…) we didn’t do “exercise.” We rode our bikes everywhere, we ran around the neighborhood and we played sports. But we didn’t exercise just to exercise. It was just a part of what we did.
This should be the end discussion on the contribution of exercise to our rising childhood obesity statistics. But it isn’t. It becomes the pivotal discussion point on combatting childhood obesity.
Previous blog articles that have focused on how little exercise promotion changes behaviors in children can be read by clicking here.
This particular study looks at the effects of physical activity recommendations from a primary care provider in 182 overweight/obese 5- to 10-year-olds after a 3 year period. They used accelerometry to study activity (think of a pedometer). Here’s what they found:
- Beginning and 3-year BMI scores did not change.
- Beginning activity scores were 334 cpm (counts / minute) and 3-year were 284.
- For those who had higher activity levels at 3 years, BMI scores dropped by a relatively small amount only.
- Looking at the bright side, those with higher activity levels were more likely to not gain weight (versus moving to a higher BMI category).
Overall, the results were pretty disappointing.
Rather than being discouraged, however, this should wake us all up to the fact that diet is absolutely critical in making sure our children stay at his or her optimal weight. No one gets hurt financially when we tell everyone to move more. Actually, companies like Nike, Reebok and Spaulding probably come out way ahead.
But telling kids to avoid soda (diet and regular) and refined carbohydrates?? THAT is going to cost the majore confectionary companies like Nabisco and Kraft millions of dollars.
As the parent, it is up to you to set the stage for your child’s health. No excuses like little Johnny is a poor eater. If he is, it’s because you have let him become a poor eater.
You can view my general recommendations by clicking here.
Seems like an awful long time to worry about. 35 years. Heck–I don’t even know what I’m doing this weekend, let alone in 3 1/2 decades. So why should anyone worry if they might have a heart attack in 35 years?
Because you will care in 35 years from now. Try to sound as tough as you’d like now, but once that crushing pain hits your chest and you get rushed to the ER to have your sternum cracked open with a spreader and have one of your more precious organs replumbed, you would be willing to go back and change it all.
On the other hand, maybe this is why you’ve made the right choices. You’re exercising with short burst methods, avoiding refined carbs and eating omega 3′s instead of omega 6′s. In general, you’re following the recommendations that can be found by by clicking here.
But it’s not you I’m addressing this post to. It’s your young child.
We are seeing growing evidence that heart disease begins in childhood. Or rather, we should NOT see heart disease beginning in childhood, but we are. Rest assured it is because of the preprogramming that begins in the womb and continues through childhood and adolescent. The poor lifestyle choices aquired early are very likely to perpetuate for the rest of his or her life.
This particular study took the research we have seen on risk factors for heart disease and put a practical spin on it. Basically, how likely are these risk factors going to turn into a heart attack 35 years later?
If you’re doing the math, we are talking about an adult in his or her 40′s or 50′s having a heart attack, the beginnings of which stretched back to childhood.
Researchers looked at the ESR levels of 433,577 young adult men in Sweden. ESR is a general marker of inflammation (erythrocyte sedimentation rate). And inflammation is a strong player in heart disease. So what did they find in those kids with higher levels of ESR?
Those kids who had an ESR of ≥15 mm/h had 70% increased risk of having had a heart attack 35 years later (Tweet this). And this was after accounting for traditional risk factors associated with heart disease.
70% increased risk. From behaviors your child is adopting NOW. It is becoming far too common to hear about parents in their 60′s or 70′s losing a child to heart disease. Unless we wake up and change our kids’ behaviors (which always starts with changing YOUR behaviors…), the number of parents burying their adult children will only go up.
What are YOU going to change today?
Big shocker: There is a growing obesity rate in America. And it’s starting in childhood. Some factors are obvious, some not so. This one came as a surprise to me.
The list of things that have been shown to contribute to obesity is quite long and seems to be growing every day. As mentioned, some are very obvious, like too many calories, too many refined carbs, skipping breakfast, chemical exposures like BPA in plastic water bottles and not enough exercise. Others, like having the right blend of bacteria in your gut, are less obvious, but still play a potentially large role.
This particular article highlights a new factor in the rising tide of obesity. Light at night.
Yep. Something as simple as too much light at night may have a very large impact on both your weight and your cholesterol levels. This goes doubly for night shift workers. Who would have thought?
Researchers measured the amount of light in the bedroom of 528 seniors over the course of 2 nights and broke them into 2 categories: low lux group (<3 lux) and a light-at-night (LAN) group (> 3 lux). For reference, a typical nightlight is under 3 lux and the first hints of twilight are about 3 lux. This means that the LAN group likely had a light or TV on while they were sleeping. This is not the time to get into a discussion about blue light (from computers, TV, room lighting, cell phones) and how it disrupts our sleep patterns, but feel free to research on your own.
Here is what the researchers found:
- Those with higher light exposure at night had an 89% greater risk of being obese (Tweet this).
- This group also had a 72% higher risk of having cholesterol problems (Tweet this).
While the research on the problems with night shift work as it relates to conditions such as cancer and depression is not new (previous posts on the negative effects of night shift working can be read by clicking here), this is the first time I’ve come across anything on this topic.
The bottom line is that you need to be very careful of the lighting that you have in your room at night, if any. This of course needs to be balanced against the chance of tripping over your dog in the middle of the night (we’ve got four–the odds are pretty high of this happening…). Consider a non-blue night light or looking into blue blocking glasses if you spend time watching TV or are on the computer at night. Especially for your young children who need some light at night.
What kind of light are you exposed to at night? But question–what kind of light are your kids exposed to?
Every public health recommendation pushes dairy as a healthy food for kids. Milk for toddlers is almost a requirement. But is this true or extreme misguidance?
Food pyramids. School lunches. The CDC. The commercials pushing dairy as the solution to every woe facing children today. Someone who was strongly against dairy much be absolutely crazy.
Or maybe just well educated.
First, we need to address a few things. First, I’d really like to know the first upright mammal that looked at a cow’s udder and thought to him or herself, “I’ve GOT to try some of that!!” Most of us remain very distanced from the collection of milk and it’s easy to forget where it comes from when you’re drinking it out of a plastic jug or cardboard carton.
Second, many patients, with a look of horror when I tell them that milk is not a healthy food for kids and adults, ask how they are going to get their calcium to protect bones if they don’t drink milk?? I then ask if cows actually drink milk for their calcium. Pretty much ends the conversation there (the answer is NO–cows don’t drink milk).
Lastly, we all need to refresh our minds on what mammalian milk is designed to do. It is designed to take a newborn to a more self sufficient mammal. It doesn’t matter whether we are talking about humans, cows, sheep or dogs, the goal of mother’s milk is the same. And no other mammal uses milk for toddlers, teens or adults.
One of the needs of a rapidly growing newborn is glucose. The brand new cells of the little growing creature need lots and lots of glucose to support all of the metabolic activity going on. And how do these cells get the sugar they need? From insulin, of course. Mammalian milk is well known to stimulate the release of insulin so that the sugar can make it into the cell where it is so desperately needed.
More insulin. Great idea for a newborn. NOT a good idea as we get older. As a matter of fact, the prediabetic state is already having problems with too much insulin because insulin is not working the way it is supposed to. Forcing the body to release even more is probably not a great idea.
Now that you have some background, we can move on to this particular study. A group of overweight adolescents (12-15 years old) were studied for 12 weeks on diet that included 1 liter of either skim milk, a drink containing casein, a drink containing whey or water. Casein and whey are the principle proteins found in milk.
They looked at whether these milk drinks caused the pancreas to work harder to release more insulin (the term is insulinotropic) and whether they contributed to weight gain. The results?
- BMI scores adjusted for age increased with skim milk, casein and whey groups. (Tweet this)
- C peptide release (a marker of insulin release by the pancreas) went up in the casein and whey groups.
This is not good news, but not truly unexpected if you understand what mammalian milk was designed to do. When we give milk for toddlers up through our adult years, you are trying to stimulate rapid growth. That is what it is SUPPOSED to do. This, of course, is not such a good idea if you’re already overweight.
With this in mind, do you think we should still promote dairy and milk products as healthy food for kids?
As parents, we all try to do our best to raise our children with the best of morales and the most ideal of health. No parent looks at their child and thinks, “I love little junior, but I’m going to feed him McDonalds three times per week so he can grow obese and develop heart disease and diabetes.” Rather, the effects on our kids are more subtle.
I’ve covered many dangers associated with the rising childhood obesity statistics in this country, but damage to this vital organ caught me a little by surprise.
Ok. You know that your child is overweight. Or, maybe you don’t because statistically, parents have a tendency to downplay their child’s body weight issues.
Either way, you know it’s not a good thing, but they’ll outgrow it. And then everything will be fine once he or she gets older. Maybe not. Maybe not in a BIG way.
This particular article took an interesting long term look at what happened to 17 year old children who were overweight (85th to 95th percentiles of BMI) or obese (≥95th percentile of BMI) getting his or her physical for the Israeli military. This was an interesting chance to observe these kids because the physical examination to determine fitness level for entry into the military in mandatory. Among other things, urinalysis and body weight was determined.
With the urinalysis being done, it was easy to determine if these children had any pre-existing kidney problems and were ruled out for this study. In other words, the kidney function of these kids was in good shape with no indication of problems.
Fast forward 25 years and that is not at all the case.
Before we get into the results, let’s review what end stage renal disease (ESRD) really means. This has typically been the realm of diabetics and chronic high blood pressure because these two cause so much damage to the kidneys (although not as much damage as it causes to the heart). Long term use of NSAIDs and Tylenol can also destroy the kidneys. End stage renal disease is dialysis and kidney transplant stuff. It is not good and something we want to avoid at ALL costs.
Back to the study…
Researchers looked at two things: how much being overweight or obese at 17 years old led to the development of kidney failure up to 25 years later. Remember–these kids had no evidence of kidney problems at 17. Here’s what they found:
- Overweight adolescents had a 300% increased risk for ESRD from all causes.
- Obese adolescents increased risk was 689% for all-cause treated ESRD.
- Overweight kids had a 596% increased risk of being treated for kidney failure associated with diabetes.
- Obese kids had a whopping 1,937% increased risk for diabetic associated kidney failure.
These are shocking statistics and suggest that these kids, at age 17, are on a trajectory to a very, very poor health outcome with devastating consequences.
I do have to point out that the absolute number of these kids who are developing end stage renal disease was small, but the risk is so high that I felt the need to point this out.
If your child is overweight or headed that way, you need to recognize this threat to their long term health and begin to address it TODAY. Later may be too late.
Society has promoted exercise to solve the issue of rising childhood obesity statistics. But will exercises for kids actually solve the problem?
I have made it clear in my blog posts that I place dietary choices above exercise in importance for avoiding chronic disease. This is, of course, based on the research, which is supportive of my position (or rather-I’ve developed my opinion based on the research). I have a good friend who began to use MyFitnesPal.com on his phone to monitor his caloric intake. Now, some 6 months later, he’s down a whopping 45 lbs. And he is only now beginning to add in exercise.
It’s great to see this happening to him, but also good for me because it means I haven’t been giving out the wrong information….
Now for my pure speculation NOT based on medical literature.
We promote exercise as a society because no one has money to lose. Reebok, Nike, La Fitness….the list of businesses that can profit from more exercise is quite long. No one is hurt when we promote exercise.
Michelle Obama’s Let’s Move program, even by it’s title, supports increased activity with not enough focus on the hard recommendations for dietary changes.
Let’s look at who dietary changes like avoiding refined carbs and other processed foods would affect. Kelloggs, Quaker, Nabisco and Kraft just to name a few. These companies would be devastated by national inititives to eat better because few of their products would actually be considered healthy.
So, to summarize my speculation, we make national recommendations to exercise more and get our kids to be less sedentary because there is only money to be made. We avoid solid lifestyle recommendations because the companies that would take a beating financially are the ones in the trenches helping to decide on guidelines.
So why am I bringing all of this up? You guessed it–it relates to this particular article looking at how much effective attempts at increasing kids activity levels were.
Researchers looked at 30 studies over 14,326 participants and evaluated how well they worked. The overall end result?
Four minutes more.
Yup. 4 more lousy minutes of walking or running per day. Hardly enough to overcome the large Starbucks.
I’m not saying that promotion of exercise to our kids is not important. What I’m saying is that we spend millions of dollars on research and promotion and advertisement to get kids to move more and
I’ve addressed the chemical and dietary aspects of childhood obesity statistics. Clearly, though, exercise plays a role as well. Could technology help obese kids?
It’s a dream that every kid has. The parents condoning the use of video games. In the past, this really hasn’t been an option due to the inherently sedentary nature of video game playing.
But that has been changing. It started with the Nintendo Wi and has moved forward with the Playstation move and the Xbox Kinect. If you’ve never played these games before, they vary from sitting on the couch swishing around the controller to all out physical activity with games like Just Dance, Kinect Sports, Fighters Uncaged or Kinect Adventures.
These games can really help you break a sweat. But just how much?
This particular study was designed to answer just that question.
Researchers looked at the calories burned while a small group of kids aged 11-15 played two different Xbox Kinect games for 15 minutes: Dance Central and Kinect Sports Boxing. Here are the findings:
- Heart rate, oxygen uptake, and energy expenditure were considerably higher with these games.
- The Dance Central increased calorie burning by 150%.
- The Boxing increased calorie burning by 263%.
Not too shaby for something the kids may actually enjoy and can be done year round, regardless of hot or cold temps. AND, to top it all off, this is clearly something you can do as a family. Many of the games, like Kinect Adventures, allows you to compete against one another. We break the family into two teams for some nice competitive fun.
Incidentally, this is not the first study to look at what might happen in a household that uses these types of games. In May of 2011 a study looked at the weight of children who were given a Wii system instead of their normal, sedentary-type video games and found definate improvements in 6 months.
If you have played the Xbox Kinect before, what games did your family really seem to like and helped everyone get more exercise?