What is Behind the Epidemic of Obesity and Type 2 Diabetes in Children and Teens in the U.S.?

by Gary Pepper, M.D. and Andrew Levine, Pre-med

If you ask the average person to define diabetes, a typical response might be “it’s when you have unhealthy eating habits and an overabundance of sugar in your blood.”  Although that is not far from the truth, a more accurate definition is that diabetes is a disorder in the way our body uses insulin to process digested food for energy and storage. A good part of what we eat is broken down into glucose, the principle form of sugar in the blood. Diabetes occurs when there is not enough insulin to push the glucose into our cells. This deprives the body of the energy it needs because glucose is metabolized as fuel by all the organs in the body. Therefore in diabetes despite an elevated amount of sugar in the blood,  the cells are actually starving for energy.  We sometimes conceive of glucose in the blood as the enemy , but without it we would die.

Adults are usually diagnosed with the form of diabetes known as“type 2” which is associated with being overweight and is treatable with oral medication. Children, on the other hand, are usually diagnosed with “type 1” diabetes which is not associated with being overweight and, in most cases, is treated with insulin. Common complications of poorly controlled diabetes include difficulties with vision, heart disease, and nerve and kidney damage. Just over a decade ago, only 9% of adolescents aged 12-19 years tested positive for either type 2 diabetes or pre-diabetes. Pre-diabetes occurs when blood glucose levels are higher than normal but not high enough to be formally diagnosed as diabetes. A follow up study of diabetes in adolescents  in 2007-2008 reported that 23% of teens tested positive for these conditions.

What could be the possible reasons for the percentage of teens with diabetes and pre-diabetes tripling in only one decade? One answer is a decrease in physical activity due to pervasive use of technology by teens. Children are becoming less active spending more time indoors on electronic devices which leads to poor muscle growth, slowed metabolism and weight gain. Another answer could be the rapid increase in the minority population in this country, which may be more prone to develop type 2 diabetes due to genetic susceptibility in addition to lifestyle considerations.  

Recent studies also show  that children taking antipsychotic medications are at  increased risk for developing type 2 diabetes. A recent study from Vanderbilt University showed that children taking certain psychiatric drugs tripled their risk of developing diabetes. Drugs in this group include Abilify, Seroquel, Risperdal and Zyprexa.  These medications are prescribed to children with bipolar and affective disorders, as well as for behavioral issues. Diabetes is more prevalent in cases where the medication is taken for longer periods of time and at higher dosages.  A troubling finding is that diabetic risk for these children were seen rising after one year of use but, after the medication was stopped for a year, the risk factor for diabetes did not significantly decrease.

Finally, and perhaps most importantly, poor eating habits contribute to the rise of type 2 diabetes and pre-diabetes in children and adolescents.  One of the major nutritional culprits is the high consumption of soda.  The amount of sugar in soda is astounding. According to The American Heart Association, sugar intake should be limited to six teaspoons per day for women (equivalent to about 100 calories),   nine teaspoons per day for men (about 150 calories)  and three teaspoons for children (about 60 calories) . There are numerous drinks available on the market  containing as much as 14.6 teaspoons, or 73 grams, of sugar in a 20 oz bottle.  A single 20 oz bottle therefore has almost 5 times the recommended daily sugar allowance for a child,  2-1/2 times the recommended daily allowance for women and 1-1/2 times the recommended daily allowance of sugar for men.

Data from the National Health and Nutrition Survey shows that due to unhealthy eating habits the average teenager consumes 119 g  or about 28.3 tsp., of added sugar per day.  This sugar intake equals 476 calories, or about 22% of an average teenager’s total caloric intake.

In a later installment at metabolism.com we will provide suggestions in ways to protect your child or teen from developing type 2 diabetes.

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