Saturday, March 20, 2010

Extreme obesity affecting more children at younger ages

Extreme obesity is affecting more children at younger ages, with 12 percent of black teenage girls, 11.2 percent of Hispanic teenage boys, 7.3 percent of boys and 5.5 percent of girls now classified as extremely obese, according to a Kaiser Permanente study of 710,949 children and teens that appears online in the Journal of Pediatrics.

This is the first study to provide a snapshot of the prevalence of extreme obesity in a contemporary cohort of children ages 2 – 19 years from a large racially and ethnically diverse population using the recent 2009 U.S. Centers for Disease Control and Prevention extreme obesity definition. Previous research was based on recent National Health and Nutrition Examination Survey (NHANES) data and included information on obesity but not extreme obesity.

"Children who are extremely obese may continue to be extremely obese as adults, and all the health problems associated with obesity are in these children's futures. Without major lifestyle changes, these kids face a 10 to 20 years shorter life span and will develop health problems in their twenties that we typically see in 40 - 60 year olds," said study lead author Corinna Koebnick, PhD, a research scientist at the Kaiser Permanente Southern California's Department of Research and Evaluation in Pasadena, Calif. "For example, children who are extremely obese are at higher risk for heart disease, type 2 diabetes, fatty liver disease and joint problems, just to name a few."

Researchers used measured height and weight in electronic health records to conduct a cross-sectional study of 710,949 children ages 2 – 19 years in the Kaiser Permanente Southern California integrated health plan in 2007 and 2008. Children in the study had an average of 2.6 medical visits per year where height and weight were measured.

The study found that 7.3 percent of boys and 5.5 percent of girls were extremely obese, translating into more than 45,000 extremely obese children in this cohort. The percentage of extreme obesity peaked at 10 years in boys and at 12 years in girls. The heaviest children were black teenage girls and Hispanic boys. The percentage of extreme obesity was lowest in Asian-Pacific Islanders and non-Hispanic white children.

According to the recent CDC recommendations, extreme obesity is defined as more than 1.2 times the 95th percentile, or a body mass index (BMI) of more than 35 kilograms/meter squared. Obesity is defined as more than the 95th percentile or a BMI of more than 30 kg/m2. Overweight is defined as more than the 85th percentile or a BMI of more than 25 kg/m2. The BMI is a reliable indicator of body fatness and calculated based on height and weight. For children, BMI percentiles are the most commonly used indicator to assess the size and growth patterns of individual children. The percentile indicates the relative position of the child's BMI number among children of the same sex and age.

"Our focus and concern is all about health and not about appearance. Children who are morbidly obese can do anything they want -- they can be judges, lawyers, doctors -- but the one thing they cannot be is healthy," said study co-author Amy Porter, MD, a Kaiser Permanente Baldwin Park pediatrician who leads the Pediatric Weight Management Initiative for Kaiser Permanente's Southern California Region.

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Wednesday, March 10, 2010

Most Common Causes of Obesity in Children

by Phillip Stone

There's something quite sad about seeing a child who is so overweight that they're unable to walk up stairs without breathing hard or are unable to play outside with their friends without stopping to sit for a few minutes. Childhood obesity is a growing problem that is becoming more serious as time goes on, leaving worried parents wondering how to help their children, and children running the risk of developing a multitude of weight-related health problems.

There are a number of factors that can cause childhood obesity and weight problems. One of the biggest causes of the condition is twofold: unhealthy eating habits and lack of physical activity. Children in previous generations had no way to entertain themselves but to be active and to use their imaginations, while children today have video games and television to keep them entertained. Instead of getting physical activity, children are plopping themselves in front of the TV for hours on end. In fact, some studies show that children spend at least four hours a day watching television or playing video games. This is clearly a contributing factor to sedentary lifestyles in children, which is a contributing factor to childhood obesity.

Unhealthy eating patterns are also becoming a problem in today's society, as parents and children are rushing here and there in order to get their daily routines completed. Oftentimes, families are forced to head to the drive-thru to get a quick bite. Eating all this unhealthy fast food is contributing to weight problems as children are not getting proper nutrition, instead filling their bodies with foods that are high in fat, carbs, cholesterol, and sodium. Couple this with a lack of exercise, and it's no wonder that childhood obesity is on the rise.

While weight problems can run in families and some scientists theorize that genetics play a role in obesity, this does not necessarily mean that certain children will be overweight. All kids should be getting proper nutrition, regular exercise, and a good amount of sleep to stay healthy and fit, but particularly children of obese parents. These kids are at a higher risk of becoming overweight or obese themselves, so these healthy lifestyle choices should be introduced early on.

About the Author
To learn more about obesity surgery in New York and gastric bypass in New York, schedule a consultation at a New York bariatric surgery center.

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Monday, March 1, 2010

Childhood obesity prevention: Prenatal and infancy period upto age 5 crucial

Efforts to prevent childhood obesity should begin far earlier than currently thought-perhaps even before birth-especially for minority children, according to a new study that tracked 1,826 women from pregnancy through their children's first five years of life.

Most obesity prevention programs-including the national initiative recently launched by First Lady Michelle Obama-target kids age 8 and older. Scientists at the Harvard Pilgrim Health Care Institute's Department of Population Medicine, an affiliate of Harvard Medical School, now say that factors that place children at higher risk for obesity begin at infancy, and in some cases, during pregnancy. Their research also suggests that risk factors such as poor feeding practices, insufficient sleep and televisions in bedrooms are more prevalent among minority children than white children.

"This early life period-prenatal, infancy, to age 5-is a key period for childhood obesity prevention, especially for minority children," says Elsie Taveras, lead author of the study and an assistant professor of population medicine at Harvard Medical School, as well as the director of the One Step Ahead Program at Children's Hospital Boston. "Almost every single risk factor in that period before age 2, including in the prenatal period, was disproportionately higher among minority children."

For the study, which appears online March 1 in the journal Pediatrics, researchers interviewed 1,343 white, 355 black and 128 Hispanic pregnant women at the end of the first and second trimesters, in the first few days following delivery, and when the children were 6 months and 3 years of age. The women also completed questionnaires when the children were 1, 2 and 4 years old.

When compared to Caucasian women, the researchers found that minority women were more likely to be overweight when they became pregnant and Hispanic women had a higher rate of gestational diabetes, both risk factors for childhood obesity. Although the prevalence of two other risk factors-smoking and depression-during pregnancy was higher among African-American and Hispanic women, those rates dropped considerably when the researchers adjusted for socioeconomic status, suggesting that at least those two risk factors may be impacted by income and education levels.

When researchers looked at other risk factors during children's first five years, they found that African-American and Hispanic infants are more likely than their Caucasian counterparts to be born small, gain excess weight after birth, begin eating solid foods before 4 months of age and sleep less. During their preschool years, the study suggests, minority children eat more fast food, drink more sugar-sweetened beverages and are more likely to have televisions in their rooms than Caucasian children.

One commonly held theory is that the presence of these and other risk factors is caused by limited access to health care, poverty and low educational levels. However, when Taveras and her colleagues adjusted for socioeconomic status, they found that the prevalence of many of the risk factors remained the same.

More likely, Taveras says, the risk factors stem from behaviors and habits passed from generation to generation or that may be culturally embedded. "For a lot of patients I see in my clinic, it's intergenerational-for example, the grandmother in the home is influencing how her daughter feeds her own child." That's especially true when it comes to at what age mothers begin giving their infants solid food or when the mothers decide to stop breastfeeding, Taveras says.

"Sometimes trying to tackle those intergenerational influences can be very difficult, but actually, it's promising that some of the areas where we did find disparities are modifiable," Taveras notes. "Anyone who works with families of young children, including pediatricians and child care providers, can work on these issues."

The far more difficult task would be to address problems that are related to socioeconomic status. In this study, that didn't play as large a role because participants had access to good prenatal and pediatric care for their children and were well-educated.

"We found these striking disparities even in this population, where we had racial and ethnic minority families who were of relatively higher education and income," she says. "Imagine what the disparity would be in a population that's of lower socioeconomic status."

That's a question Taveras plans to tackle next. The goal now is to look at other novel risk factors that might be more common among minority populations-including those that will likely be tied to income and education.

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