The American Journal of Preventive Medicine recently published a study by Dr. Steven Stovitz, an associate professor of family medicine and community health at the University of Minnesota in Minneapolis. The study correlated height with weight (Body Mass Indexes – weight adjusted for height) and found that taller children tended to become more overweight over time.  This finding may help parents and primary care providers pay special attention to the eating and activity patterns of taller young children – which could decrease their risk of developing obesity. 

Wednesday, December 02, 2009

REUTERS
Children who are relatively tall may be more likely than their shorter peers to become overweight young adults, a study published Tuesday suggests.

The study, which followed 2,800 U.S. children, found that those who were both tall and overweight at age 8 were at greatest risk of being overweight or obese around the age of 18.

But even among children who were within the normal weight range, those who were relatively tall were more likely to be overweight by young adulthood.

It’s well known that overweight children often become overweight adults. However, the new findings, published in the American Journal of Preventive Medicine, suggest that extra height also puts some kids at risk for extra pounds in the long term.

This may be out of sync with what a lot of parents and doctors hope – namely, that taller children who are a bit heavy will keep getting taller while weight gain will slow — basically allowing them to “outgrow” their extra pounds.

Based on the current findings, extra height can instead be a liability. But it is not clear why that is, said lead researcher Dr. Steven Stovitz, an associate professor of family medicine and community health at the University of Minnesota in Minneapolis.

It’s likely, though unproven, he told Reuters Health, that in some children, taller height is a sign of “advanced skeletal maturity,” rather than a genetic predisposition toward being tall.

Advanced skeletal maturity essentially means that a child is moving toward his or her ultimate adult height more quickly compared with shorter kids. At a certain point, weight gain continues, but the rate of vertical growth slows down.

That results in an increase in the child’s body mass index (BMI) — a measure of weight in relation to height — and a higher risk of excess pounds and obesity.

The findings are based on 2,802 students whose weight and height were measured in 3rd grade and again in 12th grade. One-quarter were overweight or obese in 3rd grade, as were nearly 36 percent as high school seniors.

Overall, the study found, the odds of becoming an overweight young adult were greatest among overweight 3rd graders who were in the top 25th percentile for height — meaning they were taller than three-quarters of their same-sex peers.

These children had an 85 percent chance of still being overweight as high school seniors. Those odds were 67 percent among overweight children who were in the bottom 25th percentile for height.

Similarly, among normal-weight 3rd grade students, the tallest kids had a 25 percent probability of becoming overweight by 12th grade. That figure was 17 percent among the shortest children.

According to Stovitz, the findings may be most relevant to parents who are not tall but have a child who is — as that height may be a sign of advanced skeletal maturity. He noted that while all parents should try to ensure their children are eating healthfully and getting regular exercise, it may be particularly important in these cases.

When a child has two tall parents, Stovitz said, the extra vertical inches are probably just a sign that he or she will be a tall adult.

Three investigators at University College, London conducted a study to examine body image perceptions of children with varying body weights. They found that heavier children tended to underestimate their size.  Distortions in body images may decrease motivation to lose weight, a factor that may contribute adversely to the accelerating obesity epidemic.

Reuters

NEW YORK (Reuters Health) – Children are generally pretty good at estimating their true body size but heavier kids, and particularly girls, seem more prone to underestimating their body size, research from the UK suggests.

Three investigators at University College, London asked 205 boys and 194 girls, 7 to 14 years old, to match their body size to one of seven numbered images of similarly aged boys and girls. The images ranged in body size from very thin to very heavy. They also asked the youngsters privately to describe their body size, giving them choices of too thin, just right, or too fat.

Actual measurements showed that 16 percent of the kids were underweight, just over 13 percent were overweight, 5 percent were obese, and the rest were at a healthy weight.

The investigators report that both boys and girls seemed to generally perceive their actual body size, but with consistent biases.

For example, underweight kids tended to identify a figure heavier than their own, while heavier children “showed a striking tendency toward underestimation of size,” Jane Wardle and colleagues report in the journal Archives of Disease in Childhood.

Among overweight and obese boys and girls, the vast majority matched themselves to a figure smaller than their own.

And a little more than half of the overweight and obese kids verbally described themselves as “just right” in body size.

As overweight and obesity rates rise, how youngsters perceive their body size has garnered more attention, the investigators note. Misperceptions of body size could influence whether overweight and obese individuals recognize the personal relevance of weight management recommendations, they warn.

SOURCE: Archives of Disease in Childhood, December 2009

Dr. Judah Burns, a fellow in diagnostic neuroradiology at the Children’s Hospital at Montefiore in New York City, recently conducted a study to investigate the correlation between increased body mass index and spinal disc abnormalities in children. He and his colleagues found that obesity can lead to early degeneration in the spine.

Obesity places stress on the entire body and multiple organ systems. According to Dr. Burns, the strain of the excess weight causes back pain which is linked to higher morbidity rates among adults, as well as decreased quality and productivity of life.

PR Newswire
CHICAGO, Dec. 1 /PRNewswire/ — Being overweight as a child could lead to early degeneration in the spine, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

“This is the first study to show an association between increased body mass index (BMI) and disc abnormalities in children,” said the study’s lead author, Judah G. Burns, M.D., fellow in diagnostic neuroradiology at The Children’s Hospital at Montefiore in New York City.

In this retrospective study, Dr. Burns and colleagues reviewed MR images of the spines of 188 adolescents between the ages of 12 and 20 who complained of back pain and were imaged at the hospital over a four-year period. Trauma and other conditions that would predispose children to back pain were eliminated from the study.

The images revealed that 98 (52.1 percent) of the patients had some abnormality in the lower, or lumbar, spine. Most of those abnormalities occurred within the discs, which are sponge-like cushions in between the bones of the spine. Disc disease occurs when a bulging or ruptured disc presses on nerves, causing pain or weakness.

“In children, back pain is usually attributed to muscle spasm or sprain,” Dr. Burns said. “It is assumed that disc disease does not occur in children, but my experience says otherwise.”

According to the Centers for Disease Control and Prevention, 15 percent of U.S. children (age 6 – 11) and 18 percent of U.S. adolescents (age 12 -19) are overweight. BMI, a mathematical ratio of body weight and height, is a widely used measurement for obesity. Lower BMI is associated with being underweight or a healthy body size; higher BMI scores are associated with being overweight or obese. Children above the 85th percentile are generally classified as overweight or at risk of being overweight.

The researchers were able to determine an age-adjusted BMI for 106 of the total 188 patients. Fifty-four had BMI greater than the 75th percentile for age. Thirty-seven (68.5 percent) of these children showed abnormal findings on their spine MRI. Fifty-two patients fell into the lowest three quartiles. Only 18 (34.6 percent) of the children at or below a healthy weight had an abnormal MRI of the spine.

“We observed a trend toward increased spine abnormality with higher BMI,” Dr. Burns said. “These results demonstrate a strong relationship between increased BMI in the pediatric population and the incidence of lumbar disc disease.”

According to Dr. Burns, data revealed in the study could signal a significant public health problem given the health costs of back pain in the U.S.

“Back pain causes significant morbidity in adults, affecting quality of life and the ability to be productive,” he said.

Co-authors are Amichai J. Erdfarb, M.D., Jordana Schneider, David Ginsburg, B.A., Benjamin Taragin, M.D., and Michael L. Lipton, M.D., Ph.D.

Note: Copies of RSNA 2009 news releases and electronic images will be available online at RSNA.org/press09 beginning Monday, Nov. 30.

RSNA is an association of more than 44,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)

The World Health Organization released their latest obesity report with the rankings of obesity in various countries. Samoa has a prevalence of 93.5% of its population being obese, with the United States not far behind as number three in the world with 66.5% of its adults being overweight or obese.

Such a high percentage of obesity in the United States causes significant health problems associated with the disease. This places a strain on the health care industry and financial well being of the United States. The World Health Organization attributes the skyrocketing of obesity rates in the U.S. to the lack of health education of the new generations and unhealthy lifestyle choices.
December 02, 2009 10:11 PM EST (Updated: December 02, 2009 10:44 PM EST

Gather.com

With the WHO (World Health Organization) latest obesity report, America has landed in at #3 as the worlds fattest people closely followed by Germany. There was a real outright winner in America Samoa with 93.5% of its people being overweight or Obese.

Samoa and Kiribati,(second at 81.5%)  both south pacific island countries, blame the impact of people traveling overseas and bringing back food recipes and food from other countries. Since 1964 the intake of foreign food into these countries has increased  by over 700% with most of this food a direct conflict to their normal traditional diet of native foods high in complex carbohydrates and low in fat, such as bananas, taro root, coconut, yams, and fish and seafood.

America by sheer population size of over 300 million people means that there are over 198 million people in the US who are overweight or obese. The sheer strain on the health system in America and the amount of taxes Americans will have to pay just to pay hospital costs of weight related health issues must surely be a major concern to Americans as they skyrocket into the biggest eating, smoking, prescription drug nation in the universe. How can any nation be economically sound when in excess of 66% of its population are obese and will have self inflicted health issues just based on their diet intake. All things aside, you cannot just laugh this off as a fast food fad, as this has to be directly attributed to lifestyle choices by individuals and the health education of generations of children. In the mid 1960′s, just 24% of Americans were overweight.

The small south pacific nations of Samoa and Kiribati are pin heads on a blanket compared to the health issues Americans and all the other countries in the top 10 have to face. All 8 other countries in the top 10, are above 61% and come in at just under 750 million people.

Top 10 list below(of population that’s overweight):

1. American Samoa, 93.5 percent

Food imports to blame

2. Kiribati, 81.5 percent

Food imports to blame

3. U.S., 66.7 percent

Health experts attribute the rise to an over-production of oil, fat and sugar by subsidizing farming and food production. Food manufacturers were paid by governments to include these products in larger quantities to support the farmers. Obesity was considered an acceptable result of this.

4. Germany, 66.5 percent

Governments are blaming the usual suspects: beer, fatty processed foods and lack of physical and sporting activities.

5. Egypt, 66 percent

Egypt blames processed food imports, which created poorer eating habits and the nations lack of sporting programs due to cultural and religious taboos

6. Bosnia-Herzegovina, 62.9 percent

WHO blames smoking, drinking and eating cheap processed foods high in calories unhealthy and low in nutritional value.

7. New Zealand, 62.7 percent

Watching television is said to be the cause rather than what they ate. Those who were overweight at the age of 26 were those who watched TV the most. Some how I think it is what they ate in front of the TV, and not the TV.

8. Israel, 61.9 percent

Obesity is highest in Arab women, and their lower level of education is to blame, so say the Israeli Government.. (If you can believe their studies)

9. Croatia, 61.4 percent

Cardiovascular disease is the leading cause of death in Croatia. They blame the globalization of the food market and the import of excessive amounts of processed foods. Croatian men are more obese than Croatian women, according to statistics.

10. United Kingdom, 61 percent

British living in low-incoming housing eating takeaways and playing computer games is said to be the blame. The UK is in the bottom 3 countries in Europe as far as physical exercise go.  To combat this, the UK has just embarked on a healthy food program for schools and is spending several hundred billion dollars on sporting facilities to encourage a healthy lifestyle.

On November 24, 2009 CBS reported an analysis conducted by the Center for Science in the Public Interest. Their findings were that nearly 80% of all food ads shown on Nickelodeon are food ads for foods with poor nutritional quality.

In a country being swept by the obesity epidemic, it is difficult enough to keep children eating healthfully. It is important to protect children’s health by advertising healthy, nutritious food options.
NEW YORK, Nov. 24, 2009
(CBS)  Nickelodeon may be a kid-friendly network, but when it comes to nutrition they are serving up the wrong ads.

According to an analysis conducted by the Center for Science in the Public Interest (CSPI), “nearly 80 percent of food ads on the popular children’s network Nickelodeon are for foods of poor nutritional quality.”

During an obesity epidemic in the United States, it’s hard enough for parents to control what their children are eating – and the group says airing a lot of junk food ads on Nickelodeon doesn’t help.

Although the findings show a modest drop from about 90 percent in 2005, it’s not significant enough to make a dent.

The CSPI points out that between the 2005 and 2009 studies, the food industry instituted a self-regulatory program through the Council of Better Business Bureaus, the Children’s Food and Beverage Advertising Initiative (CFBAI).

But for junk food lovers, self-regulation doesn’t always work.

CSPI took a closer look at the practices of the food companies that participate in that self-regulatory program.

They found that “of the 452 foods and beverages that companies say are acceptable to market to children, that 267, (or nearly 60 percent), do not meet CSPI’s recommended nutrition standards for food marketing to children.”
The list includes: General Mills’ Cookie Crisp and Reese’s Puffs cereals, Kellogg Apple Jacks and Cocoa Krispies cereals, Kellogg Rice Krispies Treats, Campbell’s Goldfish crackers and SpaghettiOs, Kraft Macaroni & Cheese, and many Unilever Popsicles.

“While industry self-regulation is providing some useful benchmarks, it’s clearly not shielding children from junk food advertising, on Nick and elsewhere,” said CSPI nutrition policy director Margo G. Wootan. “It’s a modest start, but not sufficient to address children’s poor eating habits and the sky-high rates of childhood obesity.”

Puddings, cookies, or fruit-flavored snacks don’t meet CSPI’s nutrition standards – but they are fans of yogurt. Seventy-three percent of yogurts were up to par.

Other foods that meet CSPI’s standards include:

•Nabisco Teddy Grahams
•Kellogg Frosted Mini-Wheats
•Kellogg Eggo Waffles
•Several Kid Cuisine frozen dinners
•Only three of 47 Kraft-approved products
•One of eight McDonald’s-approved meals, and 22 of 86 General Mills-approved products
•Burger King only identified one meal as appropriate to market to children at the time of the study
•A Kids Meal with Kraft Macaroni & Cheese, apple fries with caramel sauce, and a Hershey’s 1 percent milk

Other foods that don’t meet CSPI’s standards include:

•Fruit drinks, often high in sugar with little fruit juice as well as high-fat milk
•PepsiCo’s 10 products that they say are appropriate to market to children
•CSPI also has urged Chuck E. Cheese’s, IHOP restaurants, Topps Candy, Yum! Brands (which owns KFC, Taco Bell and Pizza Hut) and Perfetti van Melle (maker of Air Heads candy) to join the CFBAI.
•Four companies that belong to the CFBAI (Coca-Cola, Hershey’s, Mars, and Cadbury Adams) state that they do not advertise any products to children (according to the CBBB definition).

According to CSPI, a fourth of the food ads on Nickelodeon were from companies that don’t participate in the industry’s self-regulatory program.

“Almost none of those ads were for foods that met CSPI’s nutrition standards, and only 28 percent of the ads from companies in the CBBB Initiative met them,” CSPI said.

In 2006, the National Academies’ Institute of Medicine also jumped on the health food bandwagon. It recommended that food and media companies should market healthier foods to youth within two years.

Other organizations have nutrition standards for foods marketed to children in the works, including: an Interagency Working Group on Food Marketed to Children, representatives from the Federal Trade Commission, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the U.S. Department of Agriculture.

These soon-to-be-defined nutrition standards are expected in July of 2010, and CSPI is urging the Council of Better Business Bureaus to adopt them for the CFBAI.

“Nickelodeon should be ashamed that it earns so much money from carrying commercials that promote obesity, diabetes, and other health problems in young children,” Wootan said. “If media and food companies don’t do a better job exercising corporate responsibility when they market foods to children, Congress and the FTC will need to step in to protect kids’ health.”

A new study on diabetes was conducted at the University of Chicago and reported by CNN on November 17, 2009. The study showed that it is very likely that the prevalence of diabetes will double in the next 25 years  and that the cost of treating diabetes will triple by 2034.

The most common risk factor for diabetes is being overweight and can be prevented by modest weight loss efforts. Lifestyle changes, such as diet, exercise, and assistance through counseling drastically lowered the risk of diabetes, without medication. With diabetes being a very preventable condition, this article argues the money and healthy years of life Americans could save by changing their lifestyles.

11/27/09

(CNN) — The number of Americans with diabetes will nearly double in the next 25 years, and the costs of treating them will triple, according to a new report.
The figures, in a University of Chicago report released Friday, add fuel to the congressional debate regarding reining in the cost of health care.

By 2034, 44.1 million Americans will be living with diabetes — nearly twice the current number of 23.7 million, according to the report, published in the December issue of the journal Diabetes Care. About 90 percent of those with diabetes have type 2, a version of the condition that develops over time.

Accounting for inflation, the direct medical cost of treating them will rise from $113 billion annually to $336 billion, the report says.

Current health care proposals in Congress attempt to slow the growth of spending on chronic diseases such as diabetes by funding programs to prevent disease in the first place, and by offering incentives for insurers and medical providers to encourage early treatment through so-called “accountable care organizations.”

In those organizations, doctors might be paid a flat fee to treat a diabetes patient for a year, with bonuses if they meet certain benchmarks of patient health.

The staggering numbers in the new paper dwarf potential savings that have lately been discussed. For example, Health and Human Services Secretary Kathleen Sebelius earlier this month released a report urging improvements in diabetes care. If the most successful statewide programs for controlling diabetes could be duplicated nationwide, it estimates, annual savings from reducing hospitalizations and treatment for various complications would total $216 million.

The numbers are disturbing, said Dr. Elbert Huang, an assistant professor of medicine at the University of Chicago and lead author of the report. But he said he considers the predictions “very conservative” because they don’t account for the growing proportion of overweight children and teenagers, who are at higher risk for developing diabetes.

The estimates also don’t factor in immigration, or the rising population of ethnic minorities. Latinos and African-Americans suffer diabetes at higher rates than the U.S. population as a whole.

Type 1 diabetes is a condition in which a person loses the ability to break down glucose in the blood and turn food into energy. The condition often develops when people are young.

In type 2 diabetes, the condition develops over time. The process is complex, but aside from ethnic background, risk factors include having a family history of diabetes, high blood pressure or heart disease. The most common risk factor is simply being overweight.

Even modest weight loss will reduce the chance of developing type 2 diabetes, according to the Centers for Disease Control and Prevention.

More ambitious lifestyle changes, such as diet, regular exercise and assistance through counseling lowered the risk of diabetes by 58 percent, even without medication, in a major federally funded study.

The model used by Huang and his colleagues assumes that the prevalence of diabetes in each age group will stay constant, but that the number of cases will grow as the population gets older. For the Medicare-eligible population alone, the paper predicts the diabetes caseload will rise from 8.2 million people to 14.6 million, and that the total annual cost of treatment will go from $45 billion to $171 billion.

To estimate cost, the researchers assumed that the standard progression of the disease, and mix of therapies used to treat it, will remain constant. According to a 2005 federal report, nearly three in four adults with diabetes uses oral medication to control the disease. About one in four takes insulin.

Diabetes is the leading cause of kidney failure, according to the American Diabetes Association, and nerve damage and damaged blood vessels are also common. About 15 percent of diabetics require amputation of a lower extremity at some point in their life, according to a 1998 paper in Diabetes Care.

It’s certainly possible that medical breakthroughs will improve care, but it’s unlikely to lead to lower costs, Huang said. “In the past, in general, medical discoveries have driven costs up, not down.”

The study was funded by the company Novo Nordisk, which makes insulin delivery systems to treat diabetics. Novo Nordisk approved the final manuscript, but the authors say the company did not play a role in designing the study or collecting data.

“Without significant changes in public or private strategies, this population and cost growth are expected to add a significant strain to an overburdened health care system,” the report concludes.

The new report is concerning, but doesn’t change the big picture of health care spending, said Jonathan Gruber, an MIT economist who has schooled many politicians about the intricacies of health care.

“Even without this change, over the next 75 years we’ve made promises that exceed the revenues we have to pay for them,” he said.

There’s no compelling evidence that better preventive care can significantly reduce the cost of treating diabetes, Gruber said, but he believes accountable care organizations could make a big impact. He also likes the idea of allowing insurers to charge higher premiums to people who don’t meet certain health benchmarks, such as losing weight if they’re obese.

“The thing about diabetes, it’s among the most preventable of major illnesses,” Gruber said. “We need to put patient financial incentives at stake.”

Huang said he won’t be surprised if the surge in diabetes turns out to be even worse than he projects.

“Prior estimates have all said there would be a dramatic rise in the diabetes type 2 population,” he said, but in every case “the actual [diabetic] population has ended up being larger than the estimates.”

In the FASEB Journal, researchers reported that a diet that is high in fat and sugar may cause our bodies to store too much fat by activating a gene. Dr. Traci Ann Czyzyk-Morgan and her colleagues conducted tests in two groups of mice to find the mice with high fat and sugar diets had an activated receptor and were storing too much fat – leading to a weight gain.

ScienceDaily (Nov. 30, 2009) — Those extra helpings of gravy and dessert at the holiday table are even less of a help to your waistline than previously thought. According to a new research report recently appearing online in The FASEB Journal, a diet that is high in fat and in sugar actually switches on genes that ultimately cause our bodies to store too much fat.
This means these foods hit you with a double-whammy as the already difficult task of converting high-fat and high-sugar foods to energy is made even harder because these foods also turn our bodies into “supersized fat-storing” machines.
In the research report, scientists show that foods high in fat and sugar stimulate a known opioid receptor, called the kappa opioid receptor, which plays a role in fat metabolism. When this receptor is stimulated, it causes our bodies to hold on to far more fat than our bodies would do otherwise.
According to Traci Ann Czyzyk-Morgan, one of the researchers involved in the work, “the data presented here support the hypothesis that overactivation of kappa opioid receptors contribute to the development of obesity specifically during prolonged consumption of high-fat, calorically dense diets.”
To make this discovery, Czyzyk-Morgan and her colleagues conducted tests in two groups of mice. One group had the kappa opioid receptor genetically deactivated (“knocked out”) and the other group was normal. Both groups were given a high fat, high sucrose, energy dense diet for 16 weeks. While the control group of mice gained significant weight and fat mass on this diet, the mice with the deactivated receptor remained lean. In addition to having reduced fat stores, the mice with the deactivated receptor also showed a reduced ability to store incoming nutrients.
Although more work is necessary to examine what the exact effects would be in humans, this research may help address the growing obesity problem worldwide in both the short-term and long-term. Most immediately, this research provides more proof that high-fat and high-sugar diets should be avoided. In the long-term, however, this research is even more significant, as it provides a new drug target for developing therapies for preventing obesity and helping obese people slim down.
“In times when food was scarce and starvation an ever-present threat, an adaptation that allows our bodies to store as much energy as possible during plentiful times was probably a lifesaver,” said Gerald Weissmann, M.D., Editor-in-Chief of TheFASEB Journal. “By taking that opioid receptor off the table, researchers may have found a way to keep us from eating ourselves to death.”