Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Posts Tagged ‘obesity’

Babies Born By C-Section Twice As Likely To Be Obese

Wednesday, May 23rd, 2012

Rates of both Cesarean section birth and child obesity have soared in recent decades, and it turns out that the way children are brought into the world could have a big impact on their weight. Kids born by c-section have a different composition of bacteria in their guts than children born vaginally do, and scientists theorize this might make c-section babies more likely to be obese.

The weight difference between c-section and vaginally delivered babies showed up when researchers from Children’s Hospital Boston looked at 1,255 deliveries in eastern Massachusetts between 1999 and 2002. They measured and weighed the babies at birth, at 6 months, and at age 3.

One in four of the babies were delivered by c-section (a rate lower than the national average of one in three). Moms in the study who delivered by c-section tended to weigh more than those delivering vaginally, so the birthweight of their babies tended to be higher. They also breastfed their babies for a shorter period of time.

Even when these and other factors were taken into account, babies delivered by c-section were twice as likely to be obese by age 3 as those delivered vaginally. Just under 16% of the children delivered by c-section were obese, compared with only 7.5% of those born vaginally. Nationally, the obesity rate among kids ages 6-11 is nearly 20%, according to government figures.

Previous research has shown that children born by c-section have higher numbers of Firmicutes bacteria and lower numbers of Bacteroides bacteria in their guts than those born vaginally. This could increase the energy their bodies extract from food, and stimulate cells to boost insulin resistance, inflammation and fat deposits, say the study authors. They point out that the apparent link between cesarean delivery and obesity should prompt mothers to avoid c-sections unless they are medically necessary.

The research appears online in the Archives of Disease in Childhood, a BMJ publication.

Diabetes In Teens More Than Doubles In a Decade

Monday, May 21st, 2012

Twenty three percent of kids ages 12 to 19 in the U.S. now have diabetes or prediabetes, according to a study out today in the journal Pediatrics. A decade ago that figure was just nine percent.

Looking at risk factors for heart disease and stroke in adolescents, researchers from the U.S. Centers for Disease Control and Prevention (CDC) examined data on more than 3,300 adolescents participating in a national survey from 1999 to 2008. Along with the increase in diabetes, they found that:

• 61% of obese teens in the survey had one risk factor for cardiovascular disease – such as high LDL cholesterol, high blood pressure, physical inactivity or diabetes – besides their weight

• 49% of overweight teens had one additional cardiovascular risk factor

• 37% of normal-weight teens had at least one cardiovascular risk factor

“I think this is an eye opener,” says Steven Mittelman, M.D., Ph.D., of the Children’s Hospital Los Angeles Center for Endocrinology, Diabetes & Metabolism, who was not involved in the study. “Parents really need to think about what their kids are eating and what their activity level is. Parents have to step up and help prevent these devastating diseases that last a lifetime.”

One of every three children with diabetes now has type 2 (which used to be called “adult-onset diabetes,” but is now far too common in children to merit that name), and Mittelman points out that the disease is not easily managed in kids. Adults with type 2 diabetes can improve their health with lifestyle changes and medications, but 50 percent of kids diagnosed with type 2 will end up on insulin within five years – and need it for the rest of their lives. “Over time that number will get worse, so eventually most teenagers diagnosed with type 2 diabetes will need insulin,” he says.

The prevalence of obesity among teens did not increase during the study period. “The prevalence of obesity and overweight really plateaued in the last 10 years,” says Mittelman, who credits public education about the obesity epidemic with spurring some progress. There are still far too many overweight kids, “but at least it’s not going up like it was 10 years ago,” he says.

His suggestions for parents looking to improve their kids health:

Pay attention during checkups. Doctors should be checking children’s height, weight and blood pressure at every visit, and taking the time to calculate Body Mass Index (BMI, a measure of height related to weight) for patients. Under some circumstances, they should also test kids’ cholesterol levels, and test for diabetes.

Know your family history. Let your pediatrician know if your child’s parents or grandparents have high cholesterol, diabetes or heart disease. Find out what medications your child’s grandparents take, and share that information as well. “That helps us know what might run in the family,” Mittelman says.

Check out resources that get kids moving. Mittelman recommends the CDC childhood obesity page (cdc.gov/obesity/childhood), Michelle Obama’s Let’s Move! campaign (LetsMove.gov) and your local YMCA (YMCA.org) as great places to start. “I often send my parents who say they have a tough time getting their kids to exercise [to the YMCA],” he says. “They really are focused on healthy weight.”

Mittelman is quick to point out that heart disease and diabetes are just two of the many life-threatening conditions caused by obesity. He specializes in studying the connections between obesity and cancer (and says that 20% of cancers in the U.S. are now caused by obesity). Studies show that many kids carry their weight problems into adulthood, but Mittelman and other experts consider adolescence a key window for change. And much of that change is up to moms and dads.

“Parents do have the power,” he says.

Many Obese Children With Asthma Held Back By Weight, Not Breath

Wednesday, May 9th, 2012

Two current health crises in children – asthma and obesity – often strike together. And among kids dealing with both, lack of physical activity frequently comes in to create a “perfect storm” that hits health hard.

Looking at one of these kids, it is easy to imagine a sequence of events:

1. The child is diagnosed with asthma.

2. Asthma impairs the child’s ability to exercise.

3. The child gains weight.

But if a child’s asthma is well controlled, this doesn’t have to be the case. That is the message from new research out of The Children’s Hospital at Montefiore and Albert Einstein College of Medicine in New York.

Pediatric pulmonologist Deepa Rastogi, M.D., and colleagues found that when obese children with asthma were asked to walk for six minutes, it was their obesity – not their lung function – that held them back.

Researchers looked at 140 children, among them obese children with and without asthma, and normal-weight children with and without asthma. All children in the study with asthma had their disease under good control, meaning they had not needed prednisone, a medication used to treat an exacerbation, in at least three months. Researchers tested each child’s lung function and measured the distance they could walk in six minutes.

For children who were not obese, both asthmatic and non-asthmatic, their distance was linked to their lung function. The lower their lung function, the less ground they could cover.

But for obese children, their distance was linked to their BMI (a measure of weight compared to height). Whether or not they had asthma, the higher their BMI, the shorter the distance they could walk.

“If you have well-controlled asthma, then your exercise limitation may not be your asthma, it may be your body weight,” says Rastogi.

She explains that parents often discourage children with asthma from being active because they are afraid of bringing on attacks. “By the time they are in school they become programmed that they have asthma and they can’t exercise, and by then we have missed the opportunity to teach parents about keeping their children active with appropriate use of controller medications,” Rastogi says. Instead, the focus should be on keeping kids as active as they can be while maintaining good control of asthma.

Her message to parents is to partner with their healthcare provider to get their child’s asthma under control. “That’s the first step, always,” she says. “Then, with good control, encourage activity. If it appears that your child is limited in their exercise ability, talk to your health care provider to investigate further into the cause for the limited ability.”

Her study was published in March in the journal Pediatric Pulmonology.

Type 2 Diabetes Toughest To Treat In Children

Monday, May 7th, 2012

Treatment with medications and lifestyle interventions that have been successful in adults fails in as many as half of children with type 2 diabetes, underscoring the need to get the childhood obesity epidemic under control and prevent the disease in the first place.

Researchers from the University of Pennsylvania School of Nursing looked at 699 overweight children ages 10 to 17 recently diagnosed with type 2 diabetes. They found that treatment with medication commonly used to control diabetes in adults did not help almost half of patients maintain healthy blood sugar levels, forcing those children to begin insulin injections within a year. One in five of the children in the study had a serious complication such as very high blood sugar, and many were hospitalized.

Among various treatment programs, the study found that:

• Treatment with a medication called Metformin (also called Glucophage) alone failed 52 percent of children in the study.

• Treatment with Metformin plus a medication called rosiglitazone (brand name Avandia) failed 39 percent.

• Metformin plus an intensive diet, exercise and weight-loss program failed 47 percent of children. The intervention included a lifestyle coach and a family member designated for support.

Better treatment to manage type 2 diabetes in children is needed, but study author Terri H. Lipman, Ph.D., said prevention is key. “What we have learned is that the effect of the obesity-prone environment of these youths is even more difficult to overcome than we had predicted,” she said in a statement accompanying release of her study, which was published in May in The New England Journal of Medicine.

 

Getting Kids Active Is a Matter of Choice

Wednesday, April 25th, 2012

If you want your kids to be physically active, make sure they have lots of active toys and games to choose from. That’s the take-home message from recent research published by University at Buffalo experts.

Working with 8-12-year-olds, a team led by James Roemmich of the university’s school of medicine first looked at whether giving children more toy choices increased their physical play. They found that if there was just one toy to play with, boys played actively 1.3 times longer than girls. But given a choice of active toys – mini hockey, bean bag toss plus tic-tac-toe, mini indoor basketball and jump rope – girls increased their physical play nearly 200 percent.

Physical play for boys increased as well, but by just 42 percent, possibly because girls enjoy the mental challenge of evaluating the toys and choosing which to play with more than boys do. Having a choice of toys increased exercise intensity for both groups.

Next, the researchers looked at whether the exergames motivated kids to increase play time. They did, but Roemmich points out that while kids played Wii basketball twice as long as actual basketball, they expend only half the energy on the Wii.

He advises parents to find three to five active games and toys their children enjoy, and make them easily accessible at home. Exergames are best when they replace watching TV or playing other types of video games, rather than taking the place of other physical activities. Away from home, parents should look for a variety of activities – dance, zoomba, sports or martial arts – and find fitness or youth centers that promote choice by including a variety of programming with membership, rather than charging extra.

His studies were funded by the National Institutes of Health. The first was published in the Journal of Science and Medicine in Sports, and the second in the International Journal of Behavioral Nutrition and Physical Activity.

Obesity in Pregnancy Linked to Autism in Kids

Monday, April 9th, 2012

Moms who struggle with diabetes, hypertension or obesity while pregnant are more likely to have children with autism spectrum disorders (ASD) or developmental delays, a new study has revealed.

The findings come on the heels of a well-publicized report by the national Centers for Disease Control, which revealed that autism and ASD diagnoses continue to rise, with one in 88 children in the United States now affected.

In this new study, researchers from the MIND Institute at UC Davis and the Vanderbilt University School of Medicine looked at California children, ages 2 to 5, enrolled in a population-based study from 2003 to 2010. Of the group, 500 had ASD, 200 had developmental delays and 300 were developing typically. The researchers reviewed medical records for the children’s mothers during pregnancy, asked the mothers about a history or diagnosis of diabetes or hypertension, and noted the women’s body-mass indexes (BMIs), a measure of weight related to height.

Women who were obese before pregnancy had a 60 percent higher chance of having a child with ASD, and twice the risk of having a child with a developmental delay. Those with high blood pressure or diabetes before or during pregnancy were also more likely to have children with ASD or delays, but the increase wasn’t statistically significant.

Diabetes during pregnancy has previously been associated with developmental problems in children, but not consistently linked with ASD.

Obesity is a significant risk factor for hypertension and diabetes, and all three conditions impact the body’s ability to regulate blood sugar (glucose). Exposing a developing fetus to too much glucose can trigger a condition called fetal hypoxia (increased metabolism leading to lack of oxygen), as well as iron deficiency – both of which can profoundly impact development of the brain.

The authors point out that nearly 60 percent of U.S. women of childbearing age are overweight, one-third are obese, and 16 percent are at risk of diabetes.  “Our findings raise concerns that these maternal conditions may be associated with neurodevelopmental problems in children and therefore could have serious public health implications,” they note.

The study appears in the April 9 issue of the medical journal Pediatrics.

A Healthy Turnaround – For You and the Kids

Thursday, February 23rd, 2012

The volume of statistics about childhood obesity has exploded along with America’s waistlines. Around 20% of kids ages 6-11 are now obese, putting them at risk for type 2 diabetes, hypertension and heart disease and a host of other health problems. And the chorus of experts raising the alarm about this situation keeps coming back to the same root cause – our diets.

“The American eating style is basically upside down from what it should be,” says Jennifer Nelson, R.D., Associate Medical Editor of The Mayo Clinic Diabetes Diet (Good Books, November 2011). We eat too many fat-filled and cholesterol-laden animal products, and too little fruit, vegetables and whole grains.

Clearly, change is in order, and Nelson wants to start with our view of the word “diet.” “The origin of the word is much broader than the restriction of food,” she explains. The word comes to us from the Greek “diaita,” which means “lifestyle,” or, as Nelson puts it, “what gives you life, enjoyment, vitality.”

In their new book, she and other weight-loss experts at the Mayo Clinic suggest lifestyle changes that can help families do an about-face weight-wise, stave off diabetes and other health problems, and maybe pump up their “enjoyment and vitality” quotient.

The Most Important Meal

The book isn’t specifically targeted at children – especially the portion sizes and eating plan specifics – but Nelson says the habits suggested and types of foods recommended are all healthy and all appropriate for anyone, including kids.

Starting every day with a healthy breakfast is the first habit they suggest for all families. And every day the plan calls for four or more servings of vegetables, three or more servings of fruits, and whole grains whenever possible. Healthy fats like olive oil, vegetable oil and nuts are also encouraged.

Not encouraged are sugar (except what’s found naturally in fruit), outsize portions of meat (the size of a deck of playing cards or bar of soap is enough at mealtime), and full-fat dairy.

Moving toward a diet based on energy density – which means eating foods that are higher in nutrients, fiber and volume so that you have “the biggest bang for your bite,” will help everyone in the family maintain or achieve a healthy weight without feeling deprived.

Adults are advised to snack only on fruits and vegetables, but Nelson says kids shouldn’t adhere to this rule. “Their energy needs are different,” she explains, adding that children filling up on plant-based foods at mealtime will not get enough energy to sustain themselves without substantial snacks, so you can add whole grains and even some nonfat dairy to their between-meals fare.

The ideal is to eat as many natural, whole foods as possible, and stay away from heavily processed foods as much as you can. As a “bonus” habit, consider keeping a food diary.

Keep On Moving

Mayo Clinic experts advise that everyone in the family walk or exercise for at least 30 minutes per day, and that 60 minutes or more is a good goal to work toward. Eating in front of the TV is a definite no-no, and it’s best to balance “screen time” with equal amounts of physical activity.

This can be easier if you do it as a family. Consider heading out the door together to walk the dog or play a game, Nelson suggests. You’re setting an example that could lead to healthier lives for your children. “Mom and Dad are kind of the gatekeepers of a lot of practices, and over time, those practices do become habits,” Nelson says. Eventually those habits impact – for better or worse – children’s health. Turning your own health around is great. “If you pass those habits along to your children, that’s even better,” she says.

A Healthy Inheritance

And because genetic predisposition to diabetes (even type 2) tends to run in families, she Nelson it is essential to address these issues across generations. If a child has a weight problem, “chances are, Mom and Dad are struggling with some nutrition issues, too,” Nelson says.

Rather than being overwhelmed by trying to make a complete lifestyle turnaround at once, Nelson suggests making just one healthy change at a time. “Over time, the cumulative effect will make a big difference,” she explains. “Also, find a way to make these lifestyle changes enjoyable. If you and your family don’t enjoy the food you eat or the activities you do, you are less likely to stick with it. So find foods that your family will enjoy, and find activities that you’ll enjoy, too!”

Despite the dire statistics about the state of America’s weight, Nelson says she is hopeful because many important efforts, such as Michelle Obama’s Get Moving campaign, are beginning to align in an attempt to address the epidemic of childhood inactivity and obesity. “It’s a very tough problem that we’re facing,” she says, “but it takes just one person at a time making a choice to change, and sharing that with their family.”

And that change is about so much more than just putting down the cookies and chips. The idea is to change your family environment and lifestyle so that you can be the best you can be, and be in better balance. “The family unit is at many people’s core,” Nelson says. “What better way of recreating your lifestyle than doing this as a family unit?”

Calories, Not Protein, Mean Extra Body Fat

Tuesday, January 3rd, 2012

Overeat on a low-protein diet and you’ll gain less weight – but just as much extra body fat – as you would on a high-protein one. That’s the finding from a study published in the Jan. 4 issue of JAMA.

Investigators from the Pennington Biomedical Research Center in Baton Rouge, La., fed low-, normal-, and high-protein diets to 25 healthy adult volunteers, and gave them each around 954 extra calories per day. After eight weeks, those eating the low-protein diets gained 6.97 pounds, compared with 13.3 pounds in the normal-protein group and 14.4 pounds in the high-protein group.

But body fat increases among the three groups were similar, while lean body mass in the low-protein group decreased. Lean body mass in the normal- and high-protein groups went up. Neither the high-protein nor the low-protein diet helped maintain body weight if participants were over-eating, as some research has suggested it might.

An editorial that accompanied the study suggested that healthcare providers might need to concentrate on excess body fat, rather than weight or body mass index, in assessing people’s health risks, and that the focus of obesity treatment should be fat reduction rather than weight loss.

 

Rat Study Shows the Perils of Snacking

Friday, June 17th, 2011

snack-mouseResearchers studying obesity have found a new, more efficient way to fatten their lab rats: feed them the type of snack foods we humans love most.

During a 15-week study, rats with free access to tasty junk foods such as cookies, chips and processed meats (which the researchers dubbed the “cafeteria diet”) ate more food and gained more weight than those on the lard-based high-fat diets usually used to make them fat. And they gained almost double the weight of those on standard rat chow.

In fact, the snacking rats took in about 30% more calories than the rats eating a high-fat diet, eventually ending up showing warning signs of diabetes. The rats on the high-fat chow actually dropped their food intake by the second week of the study, so that they were taking in the same level of calories as the rats on a healthy diet.

Authors of the study, conducted at the University of North Carolina at Chapel Hill and published in the June issue of the journal Obesity, say they can’t pinpoint what component of the snack foods is causing the pre-diabetes conditions, but that their effect on the snacking rats mimics what is happening to humans who eat these foods regularly.

So next time you find yourself reaching for that bag of chips, maybe consider leaving it for the rats.

Ask the Lactation Consultant

Tuesday, May 10th, 2011

Q: I’m hearing a lot about how breastfeeding can help prevent obesity, and how extended bottle feeding can help contribute to it. Is this true? If so, why? How long do moms need to breastfeed to give babies the maximum benefits? What is the biggest “don’t” when it comes to breastfeeding?

drwoodChristine Wood, M.D., answers …

Many studies support the idea that breastfeeding has a small protective effect on later obesity. Breastfeeding is recommended for obesity prevention by the American Academy of Pediatrics. How breastfeeding protects is unclear, but an interesting study points to the bottle itself as a possible factor. Researchers found that infants who were bottle-fed during their first six months – whether formula or pumped breast milk – showed less appetite “self-regulation” later in infancy, which is a risk for obesity. When it comes to feeding in a bottle, parents have the notion that the baby needs to finish the bottle and this may encourage babies not to develop their own regulation of when they are full. When breastfeeding, a mother does not have a set amount that she sees that her baby is taking and so the baby’s cues for being full are more readily used to determine if a baby is finished feeding.

The American Academy of Pediatrics recommends breastfeeding for at least the first year of life to receive all the health benefits of breastfeeding. Moms can become discouraged early on if they are having any trouble breastfeeding, such as sore nipples, engorgement, poor latching, or low weight gain in the baby. My advice is don’t give up if you are having nursing problems until you have been assessed by a certified lactation consultant (their title is IBCLC, International Board Certified Lactation Consultant), because many problems can be resolved with the help of a qualified person.

Christine Wood, M.D., (www.kidseatgreat.com) is a pediatrician, Certified Lactation Educator (CLE), and spokesperson for USANA Health Sciences.