Overweight Kids…Trouble in Paradise

Overweight Kids…Trouble in Paradise

This article is the first in a series at metabolism.com;  “Overweight Kids….Trouble in Paradise”.  

In the opener, we touch on many aspects of what can be a toxic tangle. In coming articles we plan to break out and do a deeper dive into each of the aspects presented. Subscribe to metabolism.com below to avoid missing the next article, “ Are Overweight Kids Destined for Diabetes? 

 By Gary M Pepper, M.D.  

 Childhood obesity presents one of the most urgent public health issues in the United States today. The intimate interaction between parents and their children further complicates the problem. Parents shape the eating habits their children develop — but that also means parents can serve as important partners helping their children to make healthier nutritional choices. 

About one in three children in the United States are classified as overweight or obese, as Kumar and Kelly note in their review published in Mayo Clinic Proceedings in 2017. These authors point out the prevalence of obesity increases as children get older. A 2014 study published in The New England Journal of Medicine, following children from entry into kindergarten through the end of eighth grade, also found that the prevalence of obesity increased by the time kids reached eighth grade. This research showed more children who were overweight when they entered kindergarten became obese by age 14 years old as compared to their normal-weight kindergarten classmates, with the biggest increase in obesity occurring between first and third grades. 

 Technically speaking, obesity is defined as a body mass index (BMI) of 30 or greater https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi-m.htm.  Childhood obesity comes with other health issues that affect physical and mental health. As the prevalence of childhood obesity has increased, so too has the prevalence of health complications in childhood typically thought to afflict mostly adults. Unfortunately, childhood obesity also tracks into later years: A high percentage of adolescents with obesity continue to remain obese as adults. 

The Rise of Childhood Obesity: Complex Causes, Dangerous Combinations 

 While endocrine and genetic disorders can lead to obesity, most kids don’t have an underlying endocrine or single genetic cause for weight gain. The 2017 review published in Mayo Clinic Proceedings pinpoints a positive energy balance combined with genetic predisposition for weight gain as the most common cause of obesity for children. In other words, kids are taking in more calories through food than they are expending with physical activity. 

 Childhood obesity results from complex interactions of factors related to a child’s genetics, epigenetics, and environment along with ecological effects such as family, community, and school. The environmental factors that can lead to weight gain are also quite complex and include: 

  • Adverse life experiences. 
  • Depression. 
  • Parental and general culinary culture conditioning. 
  • Perinatal factors (such as birth size, catch-up growth, antibiotic use). 
  • Psychosocial and emotional distress. 
  • Stress. 
  • Increased caloric consumption, aggravated when specific food intake is resulting in a high sugar burden. 
  • Decreased caloric expenditure. 

 The last two factors form a dangerous intersection. Sweet snacks and beverages, fast foods, big portions, and high-glycemic foods all contribute to increased caloric consumption. Decreased caloric expenditure due to reduced physical activity and a trend toward sedentary activities (think: computers, phones, tablets, and televisions) is also on the rise. Together, more calories taken in and less caloric expenditure creates the positive energy balance spurring weight gain. 

 The current pandemic paints a dire picture. With fewer opportunities for activity and a marked increase in negative emotional triggers, today’s kids are facing a unique challenge. Children need support and guidance to make healthy choices perhaps more than ever before. 

Health Issues Associated With Childhood Obesity 

 Childhood obesity can have serious health implications, with complications manifesting both during adolescence and later in life. Related health issues include: 

Diabetes 

 Children with obesity run an increased risk of developing diabetes. Along with the challenges of managing diabetes itself comes the risk of additional acute and chronic complications. 

 Abundant research has shown an association between weight in adolescents and the development of diabetes in adulthood. In the past 20 years the incidence of obesity in children and the incidence of diabetes in adulthood has increased hand-in-hand. 

 A 2017 study by Meyers-Davis et al in The New England Journal of Medicine found the incidence of both type 1 and type 2 diabetes increased significantly among youths between 2002 and 2012. Type 1 diabetes — which usually develops before the age of 35 years and requires insulin treatment — is not necessarily associated with being overweight. Type 2 diabetes, on the other hand, is typically associated with onset after the age of 35 years and almost always has overweight as the major factor. 

 Despite the common assumption that type 1 diabetes is the “worse” of the two types of diabetes, a study by Constantino et al published in Diabetes Care in 2013 found that early-onset type 2 diabetes came with greater mortality, more complications, and more unfavorable cardiovascular disease risk factors than type 1. Early-onset type 2 diabetes can also create metabolic challenges that last a lifetime.  

Cardiovascular Complications 

 Weight in childhood can play into cardiovascular health later in life. Twig et al examined the association between body-mass index (BMI) in late adolescence and death from cardiovascular causes as adults, In 2016, their research paper in The New England Journal of Medicine, concludes that overweight and obesity at a young age was strongly associated with increased cardiovascular deaths in adulthood. A 2013 study in Diabetes Care also noted cardiovascular deaths drove the increased death rate associated with type 2 diabetes, with many deaths occurring right in the prime of life. 

 All in all, childhood obesity can lead to various cardiovascular complications, including: 

  • Heart disease. 
  • High blood pressure. 
  • Stroke. 
  • Sudden death
  • Cancer 

 Diabetes and being overweight have been associated with an increased risk of several cancers, both as individual causes and as intertwined factors. Pearson-Stuttard et al looked at the incidence of cancers (such as liver and endometrial cancers) that could be attributed to diabetes and high BMI in a 2018 study in The Lancet Diabetes & Endocrinology. The study found many cancer cases linked to the prevalence of both. Though the combined effects are striking, the research also indicated that high BMI alone was responsible for twice the number of cancer cases caused by diabetes itself. 

Other Health Issues in Childhood and Beyond 

 Kids (and even parents) might think about many of the above risks as “adult” problems. However, childhood obesity is not just about a risk of death many years in the future. Kids can start experiencing the effects of obesity as young adults — or even earlier. 

 For example, a study by He et al in Fertility and Sterility published in 2018 investigated the association between childhood obesity and infertility in women. The research noted that childhood obesity appeared to increase the risk of infertility for women of reproductive age. 

 The 2017 review in Mayo Clinic Proceedings also listed a range of systems in the body that can be impacted by obesity during childhood, including: 

  • Dermatological. 
  • Endocrine. 
  • Gastrointestinal. 
  • Musculoskeletal. 
  • Neurologic. 
  • Pulmonary. 

 As noted in that review, childhood obesity can have psychosocial consequences as well. Children with obesity are more likely than their peers to experience bullying and discrimination, and they may contend with anxiety, depression, and poor self-esteem. 

What Can Parents Do Today? 

 The 2017 review from the Mayo Clinic underscores family-based lifestyle interventions as a cornerstone of weight management for kids. This approach is twofold, incorporating dietary modifications and increased physical activity. 

 Parents can guide kids learning to make healthier choices for their meals and snacks while encouraging unstructured physical activity (like playing outdoors) for younger kids and more structured physical activity (such as after-school sports) for older kids. At the same time, parents should limit screen time for tasks other than schoolwork — the Mayo Clinic recommends less than two hours of screen time per day for kids older than 2 years old and avoiding screen time altogether for kids younger than 2. 

 That’s easier said than done, of course. In the current pandemic reality, finding opportunities to turn off the screens and get outside are harder to come by than ever before. Even in the best of times, financial and cultural barriers to healthy eating and physical activity still exist. We’ll explore how parents can empower kids to change their dietary and activity habits later in this series. 

 Obesity can impact just about every part of the body, and obesity in childhood can have serious implications for years to come. Parents can play a big role in getting their kids motivated to change their eating habits. By offering a compassionate, nonjudgmental source of support, parents can give their kids the tools they need to make healthy and sustainable changes. 

 Metabolism.com and Dr. Gary Pepper wish to acknowledge and thank Farryl Last for her expert assistance in the preparation of this article,  

 

 References

  1. Seema Kumar, MD, Aaron S. Kelly, PhD. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clinic Proceedings 2017;92(2):251-265. 
  2.  Solveig A. Cunningham, Ph.D., Michael R. Kramer, Ph.D., K.M. Venkat Narayan, M.D. Incidence of Childhood Obesity in the United States. The New England Journal of Medicine 2014;370:403-411. 
  3.  Elizabeth J. Mayer-Davis, Ph.D., Jean M. Lawrence, Sc.D., M.P.H., M.S.S.A., Dana Dabelea, M.D., Ph.D., Jasmin Divers, Ph.D., Scott Isom, M.S., Lawrence Dolan, M.D, Giuseppina Imperatore, M.D., Ph.D., Barbara Linder, M.D., Ph.D., Santica Marcovina, Ph.D., Sc.D., David J. Pettitt, M.D., Catherine Pihoker, M.D., Sharon Saydah, Ph.D., M.H.S., Lynne Wagenknecht, Dr.P.H. Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002–2012. The New England Journal of Medicine 2017; 376:1419-1429. 
  4.  Maria I. Constantino, Lynda Molyneaux, R.N, Franziska Limacher-Gisler, Abdulghani Al-Saeed, M.D., Connie Luo, R.N., Ted Wu, M.D., Ph.D., Stephen M. Twigg, M.D., Ph.D., Dennis K. Yue, M.D., Ph.D., Jencia Wong, M.D., Ph.D. Long-Term Complications and Mortality in Young-Onset Diabetes. Diabetes Care 2013; 36(12): 3863-3869. 
  5.  Gilad Twig, M.D., Ph.D., Gal Yaniv, M.D., Ph.D., Hagai Levine, M.D., M.P.H., Adi Leiba, M.D., M.H.A., Nehama Goldberger, M.Sc., Estela Derazne, M.Sc., Dana Ben-Ami Shor, M.D., Dorit Tzur, M.B.A., Arnon Afek, M.D., M.H.A., Ari Shamiss, M.D., M.P.H., Ziona Haklai, M.A., Jeremy D. Kark, M.D., Ph.D. Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. The New England Journal of Medicine 2016; 374:2430-2440. 
  6.  Jonathan Pearson-Stuttard, B.M.B.Ch., Bin Zhou, M.Sc., Vasilis Kontis, Ph.D., James Bentham, Ph.D., Marc J Gunter, Ph.D., Majid Ezzati, F.Med. Sci. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. The Lancet 2018; 6(6): e6-e15. 
  7.  Ye He, Ph.D. , Jing Tian, Ph.D. , Wendy H. Oddy, Ph.D. , Terence Dwyer, M.D., Alison J. Venn, Ph.D. Association of childhood obesity with female infertility in adulthood: a 25-year follow-up study. Fertility and Sterility 2018; 110(4)P596-604.e1. 

Which Pesticides Create Precancerous Changes in Thyroid Cells?

pesticidesBy Gary Pepper, M.D.
Last week I posted a few highlights from the just concluded International Thyroid Congress. One of the research papers presented at the meeting generated particular concern. Endocrinologists and scientists at UCLA Medical Center led by Dr. Jerome Hershman investigated the potential for pesticides to damage the DNA of thyroid cells. The group focused on double strand breaks, the type of damage that could eventually lead to cancer. This is a particularly relevant point due to the explosion in newly diagnosed thyroid cancers being reported in many areas of the world. The increase is likely related, at least in part, to improved diagnostic techniques for thyroid cancer but could also represent environmental influences. (more…)

Dael Challenges the Conventional Wisdom about Smoking and Weight Control

Dael is taking a lonely path as a confirmed smoker. So far the benefits seem to out weigh the risks, but we all know what the end of this road will look like. I am posting Dael’s comments to see if the community at metabolism.com can make a positive impact on Dael’s rebellious attitude.

Dael writes:

hey guys and gals just to let you know,

am down to 130lbs and feeling fit as a fiddle. have the 6 pack and abs i dreamed of and am fitter than i have ever been.. it really is odd cos i hate smoking but here i am having lost 42 lbs and loving every second of it apart from the smoking. what can i say – maybe rather die skinny and liking myself, than a fatty with some self righteous notion of how wonderful i am for not smoking… i hated myself with the extra weight, sorry but true…. i really can’t give a f***k for what anyone thinks on here but at least i can bear to look at myself in a mirror and like what i see, not loathe what i look like and try to bullshit myself into believing that i am sooooo happy cos i gave up the cigs….. but next is the NRT – lets see what happens there, and b4 anyone says it, yes i lost two of my best friends to cancer, of the spine and brain, but all i can say is like james dean , i’d rather live fast and furious, that be fat and dumb til 101, you can all choose, but in the end what do you all want?
i do not advocate smoking !!!

I know who i am

Sandy Shares Her Thoughts on Ways to Prevent Diabetes

Occasionally, at Metabolism.com, we publish articles sent to us by our members. Here is a contribution by Sandy Harris explaining why maple syrup may possess surprising health benefits. Among the benefits Sandy highlights is a possible link to prevention of diabetes. Metabolism.com welcomes your thoughts on these issues so feel free to post a comment at the bottom of her article.

Sandy writes:

Little Known Ways to Prevent Diabetes with Maple Syrup by Sandy Harris; Guest Writer for Metabolism.com

Are you looking for a natural solution to reduce the risk of diabetes and slow down the growth of cancer cells?
Your search is probably over because recent studies have shown that maple syrup holds the key to these problems.US researchers have found that maple syrup has the ability to substantially decrease the risk of diabetes. The syrup also showed great potential in slowing down the growth of cancerous cells. Maple syrup has thirteen active antioxidant substances.
These antioxidants were previously unknown but were discovered only recently. Because of these antioxidants, researchers have firmed up that maple syrup has a great potential in fighting cancer growth, diabetes, and infections.

Maple Syrup as an Anti Diabetic Food

Considerable amounts of the phytohormone, abscisic acid, are found in maple syrup. This acid is a powerful defense against diabetes and metabolic syndrome, because it encourages the release of insulin through pancreatic cells and enhances fat cells’ sensitivity to insulin. Seeram revealed the results of his tests on Canadian maple syrup during the annual meeting of the American Chemical Society in San Francisco.

Maple Syrup as Your Best Chance against Cancer

A recent study by researchers in Quebec showed that maple syrup has the ability to slow down the growth of cancerous cells. The results of the study were published in the Journal of Medicinal Food. The study was an attempt to test the capability of maple syrup in inhibiting the growth of cancer cells.
The researchers proved that maple syrup is effective against cancer. More specifically, the syrup can significantly slow down cancer growth in the brain, lungs, and prostate. However, the effect of maple syrup on breast cancer cells was less significant.
Better Than Other Anti Cancer Foods
Maple syrup can serve as your tasty alternative in fighting cancer and diabetes. There are many anti cancer foods today like blueberries, tomatoes, broccoli, and carrots. However, recent studies have shown that maple syrup is more effective against cancer compared to other anti cancer foods. Laboratory testing results also show that the syrup is more potent compared to the maple sap
.It is also ideal to use the pure dark syrup rather than the lighter syrup. Dark syrup has high color oxidation. This is the reason why darker maple syrup should be preferred. So if you want a better alternative to fight cancer and diabetes, then your favorite maple syrup is a good option.
Reference: Journal of medicinal food. 01/02/2010; ISSN: 1557-7600, OI: 10.1089/jmf.2009.0029
About the Author – Sandy Harris writes for the diabetic appetizer recipes blog , her personal hobby blog focused on tips to prevent, cure and manage diabetes using healthy snacks and recipes.

Disclaimer for Metabolism.com:
The author’s views do not necessarily reflect the views of Metabolism.com, and this website is not responsible for the research or accuracy of the statements in this article.

5 Steps to a Healthy Being by Beth Ellen DiLuglio M.S., R.D., C.N.S.D., C.C.N., LD/N,

5 steps, 5 simple steps can help us reduce dis-ease and induce ease.

1)  EAT WHAT GROWS OUT OF THE GROUND.  A pretty simple concept, yet the best way to have a healthy diet high in fiber, antioxidants, phytonutrients, good fats and good carbs.  Eating 5 or more servings of fruits and vegetables combined can reduce your risk of cancer, heart disease,  high blood pressure and even osteoporosis.  Ideally eat 9 or more servings per day for optimal health.  Add whole grains, legumes,  nuts, seeds, herbs and spices and you are on your way to a truly health promoting diet.  Of course it is important to minimize exposure to pesticides and toxins that can end up in our produce and we’ll cover that in a future post.

2)  HYDRATE.  Drinking adequate amounts of fluids is extremely important to our metabolism.  Our bodies are at least 60% water and even mild dehydration can lead to headaches, fatigue and impaired athletic performance.  Preferably our fluid intake will mostly come from purified water (I recommend Reverse Osmosis for several reasons we will cover in a future post).  You can use RO water to make tea, coffee, lemonade and fruit seltzers.  Most of us need at least 1 ounce per kilogram of body weight to start.  We need to take in additional fluid in case of hot weather, losses during exertion, fever and other specific conditions.

3)  BE ACTIVE.  We all know that a sedentary lifestyle can increase our risk of heart disease and even cancer!  Moderate activity that lasts at least 60 minutes should be done daily , or at least 5 days per week.  To improve our fitness level, aerobic activity can be added a minimum of 3 times per week along with some weight training to build and maintain lean body mass.

4)  RELAX.  Stress can be as detrimental as a poor diet.  The “fight or flight” response is great if you have to wrestle a foe or escape from one.  A chronic “fight or flight” response is not great as the hormones coursing through our bloodstream can actually wreak havoc on our systems over time.  A constant barrage of cortisol can even negatively affect parts of the brain.  Deep breathing can reverse the stress response and begin to restore balance and harmony.  Plan play time and get adequate sleep in order to keep that balance.

5)  SMILE!  Just the thought of a smile can make us feel really good.  Imagine what the real thing can do!

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