obese kids

Obesity Is Found to Gain Its Hold in Earliest Years

For many obese adults, the die was cast by the time they were 5 years old. A major new study of more than 7,000 children has found that a third of children who were overweight in kindergarten were obese by eighth grade. And almost every child who was very obese remained that way.

Some obese or overweight kindergartners lost their excess weight, and some children of normal weight got fat over the years. But every year, the chances that a child would slide into or out of being overweight or obese diminished. By age 11, there were few additional changes: Those who were obese or overweight stayed that way, and those whose weight was normal did not become fat.

“The main message is that obesity is established very early in life, and that it basically tracks through adolescence to adulthood,” said Ruth Loos, a professor of preventive medicine at the Icahn School of Medicine at Mount Sinai in New York, who was not involved in the study.

These results, surprising to many experts, arose from a rare study that tracked children’s body weight for years, from kindergarten through eighth grade. Experts say they may reshape approaches to combating the nation’s obesity epidemic, suggesting that efforts must start much earlier and focus more on the children at greatest risk.

The findings, to be published Thursday in The New England Journal of Medicine, do not explain why the effect occurs. Researchers say it may be a combination of genetic predispositions to being heavy and environments that encourage overeating in those prone to it. But the results do provide a possible explanation for why efforts to help children lose weight have often had disappointing results. The steps may have aimed too broadly at all schoolchildren, rather than starting before children enrolled in kindergarten and concentrating on those who were already fat at very young ages.

Previous studies established how many children were fat at each age but not whether their weight changed as they grew up. While valuable in documenting the extent of childhood obesity, they gave an incomplete picture of how the condition developed, researchers said.

“What is striking is the relative decrease in incidence after that initial blast” of obesity that occurs by age 5, said Dr. Jeffrey P. Koplan, the vice president of the Emory Global Health Institute in Atlanta. “It is almost as if, if you can make it to kindergarten without the weight, your chances are immensely better.”

Dr. Koplan, a former director of the Centers for Disease Control and Prevention, was not associated with the new study, although its lead author, Solveig A. Cunningham, is an assistant professor in the School of Public Health at Emory.

The study involved 7,738 children from a nationally representative sample. Researchers measured the children’s height and weight seven times from kindergarten to eighth grade.

When the children entered kindergarten, 12.4 percent were obese — defined as having a body mass index at or above the 95th percentile — and 14.9 percent were overweight, with a B.M.I. at or above the 85th percentile. By eighth grade, 20.8 percent were obese and 17 percent were overweight. Half of the obese kindergartners were obese when they were in eighth grade, and nearly three-quarters of the very obese kindergartners were obese in eighth grade. The risk that fat kindergartners would be obese in eighth grade was four to five times that of their thinner classmates, the study found.

Race, ethnicity and family income mattered in younger children, but by the time the overweight children were 5 years old, those factors no longer affected their risk of being fat in later years.

The study did not track the children before kindergarten, but the researchers had their birth weights. Overweight or obese children often were heavy babies, at least 8.8 pounds, something other studies have also found.

The study’s results, Dr. Koplan and others said, “help focus interventions.”

Most efforts to reduce childhood obesity concentrate on school-age children and apply the steps indiscriminately to all children, fat and thin — improving meals in schools, teaching nutrition and the importance of physical activity, getting rid of soda machines.

“This suggests that maybe one reason it didn’t work so well is that by the time kids are 5, the horse is out of the barn,” said Leann L. Birch, a professor in the department of foods and nutrition at the University of Georgia, who was not involved with the study.

The most rigorous studies of efforts for school-age children, conducted in the 1990s, randomly assigned thousands of children to either participate in intensive programs that encouraged them to exercise and improve their diets, or go on as usual.

One study involved 1,704 third graders in 41 elementary schools in the Southwest, where most of the students were Native Americans, a group that is at high risk for obesity. A second study included 5,106 children in 96 schools in California, Louisiana, Minnesota and Texas.

Neither study found any effect on children’s weights.

Some obesity researchers said the new study following kindergartners over the years also hinted at another factor: the powerful influence of genetics on obesity, something that can be a challenge to overcome.

Source: New York Times

 

Diabetes Drug Won’t Help Obese Kids Keep Off Weight

Few children who become obese are able to lose and keep off weight with diet and exercise alone, leading some doctors to prescribe drugs, such as the diabetes drug metformin, to treat childhood obesity. However, a new study suggests that metformin may not help kids and teens without diabetes lose weight over the long term.

The study, which reviewed information from previous research, found no evidence that children and teens who took the drug lost more weight after one year than those who did not take the drug.

While some adolescents who took the drug did experience short-term weight loss (six months or less), the effect was modest, and it’s not clear whether such limited weight loss would actually improve their health, the researchers said. [Lose Weight Smartly: 7 Little-Known Tricks That Shave Pounds]

Given the current evidence, metformin has not been shown to be superior to other weight-loss treatments for kids, such as diet and exercise, the researchers said.

“Unfortunately, this drug is not going to be the answer,” said study researcher Marian McDonagh, of Oregon Health & Science University. Overall, the drug does not appear to provide enough weight reduction for children to experience meaningful health benefits in the long term, McDonagh said.

Still, it’s possible that certain groups of children, such as those who are very obese, may benefit from taking the drug. A large study is needed to identify these groups, the researchers said.

The study analyzed information from 14 previous studies (eight in the United States and others in Canada, Australia, Mexico, Europe, Iran and Turkey), which included a total of 946 children ages 10 to 16 who did not have diabetes. The children’s body mass indices (BMIs) ranged from 26 to 41. In most studies, children who took metformin also engaged in lifestyle changes aimed at helping them lose weight.

On average, children who took metformin for six months achieved a 3.6 percent greater reduction in their BMI compared with those who practiced lifestyle changes alone.

However, studies in adults suggest that, in order for a weight-loss treatment to lead to meaningful improvements in health down the road, it needs to reduce BMI by 5 to 10 percent, McDonagh said.

Children in the studies who took metformin for a year saw about the same decrease in BMI as those who practiced lifestyle changes alone. And after one year, both groups started to slip back to their original weight.

The researchers would like to see more studies on weight-loss treatments that involve a child’s entire family. It’s possible that family-based interventions may help children lose more weight — whether they are taking a drug or not — than interventions that don’t consider the child’s family, McDonagh said.

Metformin is approved by the Food and Drug Administration to treat children and adults with Type 2 diabetes.

Source: Fresh news

Stressed parents make for obese kids

Researchers including an Indian-origin scientist have linked parental stress to weight gain in children.

The study found that children whose parents have high levels of stress have a Body Mass Index, or BMI, about 2 per cent higher than those whose parents have low levels of stress.

Children with higher parental stress also gained weight at a 7 per cent higher rate during the study period than other children.

Those figures may sound low, said lead author Dr. Ketan Shankardass, but they’re significant because they are happening in children, whose bodies and eating and exercise habits are still developing. Plus, if that weight gain continues and is compounded over a lifetime, it could lead to serious obesity and health issues.

Dr. Shankardass, a social epidemiologist with the hospital’s Centre for Research on Inner City Health, studied data collected during the Children’s Health Study, one of the largest and most comprehensive investigations into the long-term effects of air pollution on the respiratory health of children.

The childrens’ BMI was calculated each year. Their parents were given a questionnaire to measure their perceived psychological stress that asked how often in the last month they were able or unable to control important things in their life and whether things were going their way or their difficulties were piling up so high they could not overcome them.

Dr. Shankardass noted that more than half the students followed in the California study were Hispanic, and that the effects of stress on their BMI was greater than children of other ethnic backgrounds.

The research has been published in the journal Pediatric Obesity.

Source: top news