Post hosts summit on childhood obesity epidemic

Last week, Washington Post Live hosted a conference on the health crisis called “Weighing In on America’s Future: Childhood Obesity Summit.” Those in the auditorium and watching online heard how children have become so sedentary that they don’t even know how to jump rope, and how our “all you can eat” culture has led to an alarming rise in diabetes in children.

Celebrity TV chef Carla Hall proved you don’t need a lot of money to make tasty meals. Decked out in her chef’s apron, Hall cooked the lunchtime meal for $2.32 a plate — the amount the federal government spends on many lunches provided in school cafeterias. On that tight budget, she whipped up chicken pot pie, tossed salad and a poached pear topped with rosemary oat crumble.

Eating well affordably was also the message of Deputy Secretary of Agriculture Kathleen Merrigan. Her advice: Don’t get paralyzed in the grocery store aisles about which kind of apple or tomato to buy. Just buy fruits and vegetables (and wash them). A mom herself, Merrigan advised parents not to think in terms of “good foods and bad foods.” As she noted, “If I start making foods prohibited, then they become very attractive.”

Greg Jennings, the Green Bay Packers wide receiver who scored two touchdowns in this year’s Super Bowl, took the stage to congratulate local students who won a KidsPost contest that sought their ideas for curbing obesity. Read today’s KidsPost (on the back page of the Style section) to learn from the winners, including the 11-year-old who wrote that kids need to learn to prepare meals because “many parents grew up eating fast food so they may not even know how to cook.”

Jennings and other football players at the event urged children to join the “Fuel Up to Play 60” program, which urges children to exercise 60 minutes a day. He and just about everyone in the audience got into the spirit and exercised between panel discussions, loosening ties and kicking off high heels for jumping jacks and scissor kicks, all in the name of powering a movement to make Americans trimmer.

What follows are comments excerpted from hours of discussion of one of the most important health issues facing America today.

Source: The Washington Post

Obesity Problems Fuel Rapid Surge Of Type 2 Diabetes Among Children

Today, about 3,700 Americans under the age of 20 receive a diagnosis annually of what used to be called "adult-onset" diabetes, according to the Centers for Disease Control and Prevention. That relatively small number makes it a rare disease in children, but it represents a trend with larger ramifications.

"In a little more than 10 years, the numbers went from nothing to something," says Larry Deeb, a pediatric endocrinologist and past president of the medicine and science division of the American Diabetes Association. "And that's something to worry about."

Diabetes can cause a litany of medical woes, including heart disease, kidney failure, limb amputations and blindness. It costs the U.S. health-care system $174 billion a year, according to the National Institutes of Health.

Those statistics are grim enough when patients are in their 60s. When the diagnosis is made decades earlier, new fears are raised: Will these children suffer heart attacks in their 20s, need kidney dialysis in their 30s or go blind before they see their own children graduate from high school?

Because about 80 percent of Type 2 diabetes patients are overweight or obese, it's not surprising that patients such as Annie ask if they've done this to themselves. But there are other risk factors that no one can control: family history, ethnicity (blacks, Hispanics and American Indians have higher rates of diabetes), genetics or a mother who had diabetes during her pregnancy.

Instead of wallowing in regret, doctors suggest that young patients and their parents seize the opportunity for a crash course on how to improve their health.

"I used to wear a button that said 'Stamp Out Guilt,' " says Fran Cogen, director of the Child/Adolescent Diabetes Program at Children's National Medical Center in Washington, D.C. "I try to tell people that no one caused their diabetes. I emphasize that they can make changes now."

Alarm bells are going off among those who study diabetes in children because of what they know about the adult version of the illness. More than 25 million Americans have diabetes (more than 90 percent have Type 2), according to the National Institute of Diabetes and Digestive and Kidney Diseases -- but another 79 million have a condition called pre-diabetes, in which blood sugar levels are higher than normal but not as high as in diabetes.

Pre-diabetes isn't a disease requiring medical treatment -- it's a wake-up call. A large national study showed that adults with pre-diabetes who lost 7 percent of their body weight reduced their risk of diabetes by 58 percent.

Officials are concerned that the number of children already identified as having Type 2 diabetes is just the tip of the iceberg. In a national study of 2,000 eighth-grade students from communities at high risk for diabetes, more than half of the kids were overweight or obese. Only 1 percent had diabetes - but almost a third of them had pre-diabetes, according to Lori Laffel, chief of the Pediatric, Adolescent and Young Adult Section of the Joslin Diabetes Center in Boston and a principal investigator on the study.

It's crucial, she says, to find those children before their condition progresses to diabetes so that it can be reversed by lifestyle changes, without medication.

Making Progress

If there is any good news in childhood diabetes, it is that pediatricians are starting to look for it.

"It's in the news, and all over the medical literature," says Susan Conrad, a pediatric endocrinologist at Inova Fairfax Hospital. "Pediatricians are on top of it."


For example, sometimes children whose bodies are beginning to have problems regulating insulin develop a telltale dark, velvety rash around their necks. A decade ago, such a child might have been referred to a dermatologist.

In addition, CDC guidelines suggest that a child with a family history of diabetes, or one whose weight is above the 85th percentile for age and sex should be screened, with blood and urine tests, for diabetes.

Family experiences made John Perrone of Winchester, Va., aware of diabetes and its consequences. John's mother, who developed gestational diabetes during all three of her pregnancies, now has Type 2 diabetes. His mother's aunt had diabetes, and by the time she died in her 70s, she was on dialysis, in a wheelchair, legally blind and had suffered two strokes.

John got a diagnosis of Type 2 diabetes four years ago, and he has worked hard ever since to keep the disease under control. He says he's gone from an overweight 11-year-old to a husky but fit 15-year-old. He has progressed from needing insulin injections to keeping his glucose under control with oral medication, combined with healthful eating and a lot of exercise.

He has learned enough to want to teach other kids with the disease. As an Eagle Scout project, he has developed a PowerPoint presentation aimed at youngsters. He has translated medical terms, such as glucose and glucometer, into words they understand, such as sugar and meter. He has also wanted to simplify for kids the basics of weight loss, which is so crucial for diabetes control.

"It's all about in and out, what you eat, how much you exercise," he says. "Maybe if kids understand it better, they can do it."



Source: Kaiser Health News

Losing weight can be fun!

A new study, published in the "Applied physiology, nutrition, and metabolism" journal has shown that  interactive video game stationary cycling (GameBike) is as efficient as stationary cycling to music for losing weight.

This was observed in a group of thirty overweight or obese adolescents aged 12-17 years, who were stratified by gender and randomized to video game or music condition to complete two 60-min sessions a week for 10 weeks.

Both interventions produced significant improvements in submaximal indicators of aerobic fitness as measured by a graded cycle ergometer protocol. Also, when collapsed, the exercise modalities reduced body fat percentage and total cholesterol.

Source: Applied physiology, nutrition, and metabolism

Cannabis use and obesity. Can it be protective?

The American Journal of Drug and Alcohol Abuse has just published a follow-up study on the relationship between cannabis and obesity in young adults.

The authors, who examined the data of cannabis consumption and BMI for 21 years, found that 50.9% of young adults reported use of cannabis in the last month or year and 34.1% had BMI ≤ 25. Multivariate analysis showed that those who had used cannabis were less likely to be categorised in the BMI ≥ 25 group with the least prevalence of overweight/obesity being observed in every day cannabis users. 

Therefore, they concluded that there is a lower prevalence of overweight and obesity among young adult cannabis users. However, they also admit athat further research is needed to examine the mechanism of this association.