Childhood Obesity: In-home intervention improves risk reduction routines

This is one of the pieces sent to parents as part of the "Healthy Habits, Happy Homes" program.

Credit: Healthy Habits, Happy Homes Study Group, Harvard Pilgrim Healthcare Institute

In the battle to reduce childhood overweight and obesity, several in-home factors have been identified as reducing those risks – participation of children in regular family dinners, getting enough sleep and less time watching television or other "screen time."

A new study appearing in JAMA Pediatrics describes how a home-based program that helped at-risk families improve household routines was able to slow weight gain in a group of young children.

"While childhood obesity rates may have stabilized in some population subgroups, overall rates remain stubbornly high, and racial/ethnic and socioeconomic disparities persist.

Elsie Taveras

For these reasons, seeking solutions that will particularly influence high-risk families is important." says Elsie Taveras, MD, MPH, chief of General Pediatrics at Massachusetts General Hospital for Children who led the study.

"Our findings demonstrate that relatively simple, no-cost changes in routines within the home can help children maintain or achieve a healthful weight."

The study was conducted at four community health centers in Boston, Cambridge, and Somerville, Mass., all of which serve predominantly low-income, minority populations.

The research team enrolled 121 families – each with a child aged 2 to 5 who slept in a room with a television – that were randomly divided into two groups.

At the beginning and end of the 6-month study period, each family received an in-home visit during which research assistants administered surveys about household routines, measured the child's height and weight, and observed other aspects of the home environment.

Throughout the study period, the control group received monthly packages with educational information on early childhood development.

Families in the intervention group participated in a program called "Healthy Habits, Happy Homes," designed to encourage families to have regular meals together, ensure adequate sleep for children, limit the time children spend watching television and remove television from rooms where children sleep.

The intervention also encouraged parenting practices such as role modeling and limit setting. Parents were not told that these changes were designed to limit weight gain in their child.

Interventions were delivered in four home visits that addressed project goals and checked in on progress, monthly coaching phone calls, and frequent text messages to encourage healthy practices.

Mailings included newsletters for the parents and, for the children, toys focused on the program goals – such as stickers, coloring books, a copy of Good Night Moon for bedtime reading, and toys for active play.

At the end of the study period, children in the intervention group were sleeping about 45 minutes longer than children in the control group.

Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing.

Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group.

Neither group had any significant change in the frequency of family meals together – which may reflect the fact that participating families already shared an average of six meals per week together – and there was little change in the presence of television sets in the rooms where children slept, possibly because 80 percent of parents reported that their child slept in the parents' bedrooms.

At the end of the study period, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group.

Taveras explains that increasing height, weight, and body mass index would be expected among children in this age group, as they are developing and growing.

"The Healthy Habits, Happy Homes intervention was able to slow weight gain relative to height increase in these children, which is important because – as our earlier research has shown – rapid weight gain in these early years can lead to higher rates of obesity later in life."

Jess Haines

Jess Haines, PhD, MHSc, RD, University of Guelph, Ontario, lead author of the study, adds, "Our findings suggest that, by encouraging parents to establish household routines that increase children's sleep and decrease TV viewing, health professionals can help prevent children from becoming overweight or obese.

Almost 90 percent of participating parents reported they were satisfied with the program, and 98 percent said they would recommend it to family and friends.

A longer-term study, currently being planned by our research group,will tell us how long the changes we observed here can be maintained.

We also need to investigate how large an interventional 'dose' is required to change these behaviours – for example, could they be accomplished with a single visit or just with phone calls?"

Taveras, an associate professor of Pediatrics and Population Medicine at Harvard Medical School, adds, "For now, interventions such as ours can be one way of keeping young children off an obesity trajectory that would be hard to alter by the time they enter middle school."

Children with behavioural problems more at risk of chronic conditions

Karestan Koenen

Children with behavioural problems may be at risk of many chronic diseases in adulthood including heart disease, obesity, diabetes, as well as inflammatory illnesses (conditions which are caused by cell damage).

Analyzing data on more than 4,000 participants in the Children of the 90s study at the University of Bristol, researchers from Harvard and Columbia's Mailman School of Public Health found that children with behavioral problems at the age of 8, had higher levels of two proteins (C-reactive protein—CRP; and Interleukin 6—IL-6) in their blood when tested at the age of 10.

This was the case even after a large number of other factors, including sex, race, background, and medication use, were taken into account.

Having raised levels of CRP and IL-6 can be an early warning sign that a person may be at risk of chronic or inflammatory conditions later in life.

Previous research has shown that children with behavioural problems can go on to develop health problems during adulthood, but this is the first time that a link has been found between mental health and inflammation in childhood.

The researchers believe the link may be due to the fact that many behavioral problems are associated with how the hypothalamic pituitary adrenal (HPA) axis works.

The HPA axis plays a major role in controlling reactions to stress and the immune system and, if it malfunctions, it can stimulate the release of the two proteins that cause chronically elevated levels of inflammation, which is tissue's response to injury.

Speaking about the findings, Karestan Koenen, PhD, the report's senior author and associate professor of Epidemiology at Harvard, said:
"This new research shows for the first time that having behavioural problems in childhood can put children on the path to ill health much earlier than we previously realized." 

"The important message for healthcare professionals is that they need to monitor the physical health as well as the mental health of children with behavioural problems to identify those at risk as early as possible."

Findings are published in the journal Psychoneuroendocrinology.

More Information: article/pii/S030645301300262X

Soft Fizzy Drinks Linked to Obesity and Behavioural Problems in Children

Americans buy more soft drinks per capita than people in any other country. 

These drinks are consumed by individuals of all ages, including very young children. 

Image Credit: © sfmthd / Fotolia

Although soft drink consumption is associated with aggression, depression, and suicidal thoughts in adolescents, the relationship had not been evaluated in younger children.

A new study scheduled for publication in the Journal of Pediatrics finds that aggression, attention problems, and withdrawal behaviour are all associated with soft drink consumption in young children.

Shakira Suglia, ScD, and colleagues from Columbia University's Mailman School of Public Health, University of Vermont, and Harvard School of Public Health assessed approximately 3,000 5-year-old children enrolled in the Fragile Families and Child Wellbeing Study, a prospective birth cohort that follows mother-child pairs from 20 large U.S. cities.

Shakira Suglia

Mothers reported their child's soft drink consumption and completed the Child Behaviour Checklist based on their child's behaviour during the previous two months.

The researchers found that 43% of the children consumed at least 1 serving of soft drinks per day, and 4% consumed 4 or more.

Aggression, withdrawal, and attention problems were associated with soda consumption.

Even after adjusting for socio-demographic factors, maternal depression, intimate partner violence, and paternal incarceration, any soft drink consumption was associated with increased aggressive behavior.

Children who drank 4 or more soft drinks per day were more than twice as likely to destroy things belonging to others, get into fights, and physically attack people.

They also had increased attention problems and withdrawal behaviour compared with those who did not consume soft drinks.

According to Dr. Suglia, "We found that the child's aggressive behaviour score increased with every increase in soft drinks servings per day."

Although this study cannot identify the exact nature of the association between soft drink consumption and problem behaviors, limiting or eliminating a child's soft drink consumption may reduce behavioural problems.

Journal Reference: Shakira F. Suglia, Sara Solnick, and David Hemenway. Soft Drinks Consumption Is Associated with Behavior Problems in 5-Year-Olds. The Journal of Pediatrics, 2013 DOI: 10.1016/j.jpeds.2013.06.023

Obese Fathers pass on Obesity and Metabolic Disorders to their Children

If you are obese and hope to be a father, here's another reason to lose weight: your children and grandchildren may inherit your waistline or metabolic disorders.

That's because scientists have discovered in mice that obese fathers, even those who did not show any signs of diabetes, passed this negative trait on most frequently to their daughters.

Sons don't entirely dodge this genetic bullet either—both sons and daughters of obese fathers have increased risks of developing metabolic diseases, such as diabetes.

"If these findings hold true in humans, then a father's diet and body composition at the time of conception is likely to affect his future child's health and risk of lifelong disease," said Tod Fullston, Ph.D., a researcher involved in the work from the Department of Obstetrics & Gynaecology at the Robinson Institute, Research Centre for Reproductive Health at the University of Adelaide in South Australia.

"Fathers should aim to be as healthy as possible at the time of conception to give future generations the best possible chance of good health."

To make this discovery, Fullston and colleagues used two groups of male mice. One was fed a high-fat diet that resembled a "fast food" diet and the other was fed a nutritious control diet.

When compared to the control group, the group fed the "fast food" diet gained weight and had an increase in fat (obesity) without any indications of diabetes.

The two groups of male mice were then mated to normal weight control diet-fed females to produce first generation mice, which were also mated to normal weight control diet-fed mice to produce the second generation.

Both generations of mouse offspring had metabolic disorders and obesity, with the only difference being their father's/grandfather's diet, although male/female offspring had different health problems.

By comparing small RNA molecules (microRNAs) in sperm from the obese mice as compared to the control mice, researchers deduced that changes in these molecules might be partly responsible for the transmission of these conditions from father to offspring.

This suggests that diet changes the molecular makeup of sperm, which in turn, program embryos and their risk of metabolic and reproductive health problems.

Gerald Weissmann

The research also suggests that these adverse health outcomes may be transmitted into the second generation as well.

"We've known for quite some time that obesity is a serious problem for children of expectant mothers," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal, "and now we see that obesity is likely a serious problem for children of obese fathers as well. Hopefully as more research emerges to support these findings, future fathers will find ways to slim down, if not for themselves, then for their children and grandchildren."

More information: Tod Fullston, E. Maria C. Ohlsson Teague, Nicole O. Palmer, Miles J. DeBlasio, Megan Mitchell, Mark Corbett, Cristin G. Print, Julie A. Owens, and Michelle Lane. Paternal obesity initiates metabolic disturbances in two generations of mice with incomplete penetrance to the F2 generation and alters the transcriptional profile of testis and sperm microRNA content. FASEB J, doi:10.1096/fj.12-224048

Explosive Rise in Teenage obesity and obesity-related admissions in England

Doctors in the NHS in England and Wales have seen a four-fold increase in the number of children and teenagers admitted to hospital for conditions linked to obesity.

The explosive rise in admissions from 872 to 3,806 occurred in the space of a decade between 2000 and 2009.

Over the whole 10-year period, a total of 20,885 young people were treated in hospital for obesity-related conditions.

Nearly three-quarters of cases involved problems complicated by being overweight, such as asthma, breathing difficulties during sleep, and pregnancy complications.

Teenage girls accounted for the biggest rise in obesity-related hospital admissions. In 2009, obesity is believed to have contributed to complications in 198 pregnant girls.

The number of bariatric surgery procedures conducted to help children and young people lose weight also saw a sharp rise, from one per year in 2000 to 31 in 2009.

Three-quarters of the patients were teenage girls. Bariatric surgery is a drastic obesity remedy that involves shrinking the stomach with a gastric band, removing part of the stomach, or re-routing the small intestine to a small stomach pouch.

Researchers from England's Imperial College London analysed NHS statistics for children and teenagers aged five to 19 who had a written record of obesity. Their findings are reported in the online journal Public Library of Science ONE.

Sonia Saxena

Study leader Dr Sonia Saxena, from the school of public health at Imperial College, said:

"The burden of obesity is usually thought to have its serious consequences in adulthood, but we now see it manifesting earlier, in childhood." 

"It's clear that rising obesity levels are causing more medical problems in children, but the rise we observed probably also reflects increasing awareness among clinicians, who have become better at recognising obesity."

Surveys suggest that around 30% of English children aged two to 15 are overweight and up to a fifth are obese.

Children who are obese are more likely to suffer health problems such as Type-2 diabetes, asthma, and sleep apnea - a condition that causes interrupted breathing during sleep - researchers said.

In their paper, the scientists wrote:

"Our findings support emerging evidence that the childhood obesity epidemic may lead to substantial problems of obesity-related disease much sooner in children and young people's lives than previously expected." 

"With levels of admissions for obesity-related diagnoses rising, there is likely to be increasing demand on health services and also greater use of more radical interventions, such as pharmacological or surgical treatment, as part of efforts to address the increasing trend of obesity that threatens the lives of many children and young people in England and globally."

Tam Fry

England's National Obesity Forum member Tam Fry, who chairs the Child Growth Foundation charity, said:

"I'm not surprised by this leap, and I won't be surprised if in five years we're talking about another significant rise." 

"When it comes to obesity we have taken our eyes off children to such an extent that they are now completely unmonitored and left to get on with it." 

"The medical profession is not really paying too much attention to them. A lot of these young people are completely unaware that piling on the pounds will not only make them fat but give rise to these other conditions."

He said the "real tragedy" was obese schoolgirls becoming pregnant. "Girls are not only getting fat, but getting pregnant," said Mr Fry.

"The result is not only distressing for the girls but threatening for their children." Pregnancy complications linked to obesity included gestational diabetes, high blood pressure, the dangerous condition pre-eclampsia, and neural tube defects.

Obese girls gave birth to overweight babies, who started life "on the back foot" and were predisposed to obesity, Mr Fry said.

He added:

"We've got a substantial number of our children going into their secondary school life ill-equipped to know what the consequences of fatness and obesity are." 

"If we're going to see the end of this problem we need to be addressing it from the word go to ensure we do all we can to stop children becoming fat in the first place." 

"We need a thorough reappraisal of the way we allow the food industry to get away with stuffing unhealthy levels of fat and sugar into their food." 

"We need to ban fizzy drinks and sugar-laden drinks entirely. We need to take really radical steps."

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Life-threatening disease in Children: Danish researchers expose new cause and understanding

Lars Allan Larsen

Danish researchers have just published findings that explain a previously unknown mechanism used by cells to communicate with one another.

The research significantly contributes to understanding why some children are born with malformations and why children and adults may develop life-threatening diseases.

Søren Tvorup Christensen

Dr. Søren Tvorup Christensen (Department of Biology) and Professor Lars Allan Larsen (Department of Cellular and Molecular Medicine) at the University of Copenhagen, in collaboration with colleagues in Denmark and France, have spearheaded the recent discovery which sheds new light on the causes of a range of debilitating diseases and birth defects.

Antennae-like structures on the surface of cells
Over the years, the research group has been a leader in primary cilium research.

Primary cilia are antennae-like structures found on the surface of nearly all cells in the human body.

These antennae are designed to receive signals, such as growth factor and hormones, from other cells in the body and then convert these signals to a response within individual cells.

Defective formation or function of these antennae can give rise to a range of serious maladies including heart defects, polycystic kidney disease, blindness, cancer, obesity and diabetes.

However, there remains a great deal of mystery as to how these antennae capture and convert signals within cells. The groundbreaking results have been published in Cell Reports, a prestigious scientific journal.

"We have identified an entirely new way by which these antennae are able to register signals in their midst, signals that serve to determine how cells divide and move amongst one another. This also serves to explain how a stem cell can develop into heart muscle," explains Søren Tvorup Christensen.

Dr. Søren Tvorup Christensen
"What we have found is that the antennae don't just capture signals via receptors out in the antennae, but they are also able to transport specific types of receptors down to the base of the antennae - where they are then activated and might possibly interact with a host of other signalling systems.

The receptors include the so-called Transforming Growth Factor beta (TGFβ) receptors which have previously been associated with birth defects and cancer.

Therefore, the base of the antennae can serve as a sort of control centre that coordinates the cell's ability to manage foetal development and the maintenance of organ function in adults."

TGFβ signalling and development of the heart 
Lars Allan Larsen has numerous years of experience in heart development research.

He adds "we know TGFβ signalling is very important during heart development and that a failure in this system can lead to the congenital heart defects that affect roughly 1% of all newborns.

Therefore, our discovery is a significant step towards demystifying the causes of congenital heart defects."

Professor Lars Allan Larsen
The two researchers also point out that defective TGFβ-signalling has been associated with neuro-degenerative diseases such as Alzheimers, Parkinsons disease and mental retardation.

Subsequently, the research group has begun studies on how these antennae - the primary cilia - regulate TGFβ-signalling during, among other processes, the transformation of stem cells into nerve cells.

"It's definitely an area that will be attracting lots of attention in years to come. Globally, there is a great deal of interest in understanding why the antennae are so important for our health," concludes the pair of researchers.

Parents with heavy TV viewing more likely to feed children junk food

If your preschooler thinks a cheeseburger is healthy, you may want to reconsider how you watch TV. A recent study by researchers at the University of Michigan found commercial TV viewing, as opposed to commercial-free digitally recorded TV or other media without food advertising, in the home was related to greater junk food consumption.

Kristen Harrison

Kristen Harrison and Mericarmen Peralta, both of the University of Michigan, will present their findings at the 63rd Annual International Communication Association conference in London.

Harrison and Peralta interviewed over 100 parents about a wide variety of home and family characteristics, including child and parent media exposure, and child dietary intake.

They conducted separate interviews with children in preschools to get a sense of what children thought made up a healthy meal.

The goal was to see how family characteristics were associated with children's dietary intake and perceptions of healthy meals.

Using food security as a marker, Harrison found that the media-junk food link is very strong among food-secure people, and almost zero among food-insecure people.

Since food insecurity is associated with limited income, it sets limits on how much people can spend on junk food.

Food-secure people, on the other hand, can afford to give in to cravings when watching food advertising.

People in this category were more likely to consume junk food, and their children had distorted views on what constitutes a healthy meal.

Past research has linked child TV viewing to obesity in childhood, but not during the preschool years. It has also combined commercial TV with digitally-recorded TV, so there was no way to separate the two.

Little research has investigated the development of ideas about healthy-meals in the preschool years.

Harrison and Peralta's research aimed to address these less-studied topics to get a better sense of what children are learning about eating before they begin to make their own food choices.

"Even though parents and other caregivers are the primary gatekeepers regarding young children's food intake, children are still learning about food as it relates to health from family, media, and other sources, and may use this knowledge later on to inform their decisions when parents or other adults aren't there to supervise them," Harrison said.

"The preschool years are especially important, because the adiposity rebound in kids who grow up to be normal weight tends to be around age 5 or 6, whereas for kids to grow up to be obese, it happens closer to 3. We need to know as much as we can about the factors that encourage obesogenic eating during the preschool years, even if that eating doesn't manifest as obesity until the child is older."

More information: 
"Parent and Child Television Exposure, Preschooler Dietary Intake, and Preschooler Healthy-Meal Schemas in the Context of Food Insecurity: A Pilot Study," by Kathleen Harrison and Mericarmen Peralta; To be presented at the 63rd Annual International Communication Association Conference, London, England 17-21 June

More TV time equals higher consumption of sweetened beverages among children

Stina Olafsdottir

More time in front of the TV set and higher exposure to TV adverts may lead to increased consumption of sweetened beverages among children.

This is the conclusion of a new study from the University of Gothenburg, Sweden.

The parents of more than 1,700 two- to four-year-olds in Sweden responded to questions about their children's TV and screen habits and consumption of sweetened drinks.

About one parent in seven indicated that they tried to reduce their children's exposure to TV adverts; the same parents stated that their children were less prone to drink soft drinks and other sweetened beverages.

Children of parents who were less strict about TV adverts were twice as likely to consume sweetened beverages every week.

The study was conducted in 2007–2010 as part of the EU research project IDEFICS – Identification and Prevention of Dietary and Lifestyle -Induced Health Effects in Children and Infants.

It reveals a very clear link between children's TV habits and their consumption of sweetened drinks. 'The children who watched more TV were more likely to drink these beverages.

In fact, each additional hour in front of the TV increased the likelihood of regular consumption by 50 per cent.

A similar link was found for total screen time,' says Stina Olafsdottir, PhD student at the Department of Food and Nutrition, and Sport Science and one of the researchers behind the study.

The study also found that children with higher exposure to food adverts on TV were more likely to consume sweetened beverages on a regular basis in a follow-up study conducted two years after the initial study.

However, exposure to TV adverts could not explain the link between TV habit and beverage consumption entirely.

It is therefore likely that the TV programmes watched also matter or that children simply enjoy drinking these types of beverages while watching TV.

The article Young children's screen habits are associated with consumption of sweetened beverages independently of parental norms is published in the International Journal of Public Health.

More information: Olafsdottir, S. et al. Young children's screen habits are associated with consumption of sweetened beverages independently of parental norms, International Journal of Public Health. link.springer.com/… 8-013-0473-2

Obesity in Children: Overeating learned in infancy

In the long run, encouraging a baby to finish the last ounce in their bottle might be doing more harm than good. Though the calories soon burn off, a bad habit remains.

 Renata Forste

Brigham Young University sociology professors Ben Gibbs and Renata Forste found that clinical obesity at 24 months of age strongly traces back to infant feeding.

"If you are overweight at age two, it puts you on a trajectory where you are likely to be overweight into middle childhood and adolescence and as an adult," said Forste. "That's a big concern."

The BYU researchers analyzed data from more than 8,000 families and found that babies predominantly fed formula were 2.5 times more likely to become obese toddlers than babies who were breastfed for the first six months.

But, the study authors argue, this pattern is not just about breastfeeding.

Ben Gibbs

"There seems to be this cluster of infant feeding patterns that promote childhood obesity," said Gibbs, lead author of the study that appears in the journal Pediatric Obesity.

Putting babies to bed with a bottle increased the risk of childhood obesity by 36 percent. And introducing solid foods too soon -- before four months of age -- increased a child's risk of obesity by 40 percent.

"Developing this pattern of needing to eat before you go to sleep, those kinds of things discourage children from monitoring their own eating patterns so they can self-regulate," Forste said.

Forste said that the nature of breastfeeding lends itself to helping babies recognize when they feel full and should stop. But that same kind of skill can be developed by formula-fed infants.

"You can still do things even if you are bottle feeding to help your child learn to regulate their eating practices and develop healthy patterns," Forste said. "When a child is full and pushes away, stop! Don't encourage them to finish the whole bottle."

Sally Findley

Breastfeeding rates are lowest in poor and less educated families. Sally Findley, a public health professor at Columbia University, says the new BYU study shows that infant feeding practices are the primary reason that childhood obesity hits hardest below the poverty line.

"Bottle feeding somehow changes the feeding dynamic, and those who bottle feed, alone or mixed with some breastfeeding, are more likely to add cereal or sweeteners to their infant's bottle at an early age, even before feeding cereal with a spoon," said Findley.

The next project for Gibbs and Forste is to re-evaluate the link between breastfeeding and cognitive development in childhood.

Forste has previously published research about why women stop breastfeeding.

"The health community is looking to the origins of the obesity epidemic, and more and more, scholars are looking toward early childhood," Gibbs said.

"I don't think this is some nascent, unimportant time period. It's very critical."

Journal Reference:

1. B. G. Gibbs, R. Forste. Socioeconomic status, infant feeding practices and early childhood obesity†.Pediatric Obesity, 2013; DOI: 10.1111/j.2047-6310.2013.00155.x

Sugary Soft Drinks: 180,000 Deaths Worldwide Each Year + Obesity, Diabetes, etc

Sugar-sweetened sodas, sports drinks and fruit drinks may be associated with about 180,000 deaths around the world each year, according to research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.

Sugar-sweetened beverages are consumed throughout the world, and contribute to excess body weight, which increases the risk of developing diabetes, cardiovascular diseases and some cancers.

Using data collected as part of the 2010 Global Burden of Diseases Study, the researchers linked intake of sugar- sweetened beverages to 133,000 diabetes deaths, 44,000 deaths from cardiovascular diseases and 6,000 cancer deaths.

Seventy-eight percent of these deaths due to over-consuming sugary drinks were in low and middle-income countries, rather than high-income countries.

"In the U.S., our research shows that about 25,000 deaths in 2010 were linked to drinking sugar-sweetened beverages," said Gitanjali M. Singh, Ph.D., co-author of the study and a postdoctoral research fellow at the Harvard School of Public Health in Boston, Mass.

Researchers calculated the quantities of sugar-sweetened beverage intake around the world by age and sex; the effects of this consumption on obesity and diabetes; and the impact of obesity and diabetes-related deaths.

Of nine world regions, Latin America/Caribbean had the most diabetes deaths (38,000) related to the consumption of sugar-sweetened beverages in 2010.

East/Central Eurasia had the largest numbers of cardiovascular deaths (11,000) related to sugary beverage consumption in 2010.

Among the world's 15 most populous countries, Mexico -- one of the countries with the highest per-capita consumption of sugary beverages in the world -- had the highest death rate due to these beverages, with 318 deaths per million adults linked to sugar-sweetened beverage intake.

Japan, one of the countries with lowest per-capita consumption of sugary beverages in the world, had the lowest death rate associated with the consumption of sugary beverages, at about 10 deaths due to per million adults.

"Because we were focused on deaths due to chronic diseases, our study focused on adults. Future research should assess the amount of sugary beverage consumption in children across the world and how this affects their current and future health," Singh said.

The Global Burden of Disease Study 2010 is an international, collaborative, systematic effort to quantify the global distribution and causes of major diseases, injuries and health risk factors.

The American Heart Association recommends adults consume no more than 450 calories per week, from sugar-sweetened beverages , based on a 2,000 calorie diet and offers tips on how Life's Simple 7™ can help you make better lifestyle choices and eat healthier.

The American Beverage Association, in a statement released on its website, disputed the findings of the study and said that they found this report 'hard to swallow.'

Obesity and Type 2 Diabetes: Tougher to Treat in Kids and Teens

Type 2 diabetes, the kind linked with obesity, progresses much faster and is harder to treat in children than in adults, according to the disappointing results of a new study that sought to determine the best treatment for the disease in obese teens.

The study, the largest to examine Type 2 diabetes treatment in youth, looked at the effectiveness of several methods to manage blood sugar in newly diagnosed teens aged 10 to 17. The researchers found that nearly half of all participants failed to maintain stable blood sugar over the four-year study, and 1 in 5 suffered serious complications as a result.

The findings are troubling for teens’ health since obesity and diabetes rates are increasing nationwide. Uncontrolled diabetes can increase the risk for serious health problems, including heart disease, vision loss, nerve problems, amputations and kidney failure.

Type 2 diabetes — once referred to as adult-onset diabetes — was rarely seen among children before the 1990s. But as American children and teens started getting fatter, related cases of diabetes began to rise. Today, Type 2 diabetes is still uncommon in children (Type 1, or juvenile, diabetes affects more youths), but the disease continues to increase at an alarming rate: between 2002 and 2005, there were about 3,600 new cases of Type 2 diabetes in children and teens a year.

For the new study, released Sunday by the New England Journal of Medicine, researchers followed 699 overweight and obese teens who had been recently diagnosed with diabetes. Most of the participants were from low-income families; 40% were Hispanic, 33% black, 20% white, 6% American Indian and fewer than 2% were Asian.

All of the participants were started off on metformin, the standard oral medication for Type 2 diabetes, to normalize their blood sugar levels. They were then divided into three treatment groups to maintain blood sugar control. One group continued to use metformin alone; another used metformin along with an intensive diet, exercise and weight-loss program; the third used metformin plus another drug, rosiglitazone (Avandia).

Failure rates were high for all three treatment groups. About half of the teens in the metformin group failed to keep their blood sugar down, 39% failed in the group using metformin plus Avandia, and 47% failed in the diet and exercise group.

“It’s frightening how severe this metabolic disease is in children,” study author Dr. David M. Nathan, director of the diabetes center at Massachusetts General Hospital, told the New York Times. “I fear that these children are going to become sick earlier in their lives than we’ve ever seen before

The authors could only speculate why diabetes is so hard to treat in children and teens, but it could be due to rapid growth and hormonal changes during puberty.

To read the whole article click here

Sorry but Parents' diet choice knowledge doesn't prevent Child Obesity

A study of the families of 150 preschoolers suggests that parents of healthy-weight and overweight preschoolers are generally well aware of dietary risk factors that fuel childhood obesity.

The research, conducted by the Johns Hopkins Children's Center and the All Children's Hospital in Florida, suggests that awareness alone is not enough to effect meaningful weight change, and that pediatricians should help parents with specific and tailored guidance on how to apply their knowledge in daily practice, the researchers said.

The study, published ahead of print on April 11 in the journal Clinical Pediatrics, also illuminates the gap between what parents know about the root causes of obesity and what they can actually do to maintain healthy diets for preschoolers, a group generally overlooked in obesity research and prevention.

"When it comes to obesity prevention, the focus tends to be on school-age children and teens, but a growing body of research has found a link between poor life-long health and being overweight as early as 2 years of age," said lead investigator Raquel Hernandez, M.D. M.P.H., a pediatrician at Johns Hopkins.

The Centers for Disease Control and Prevention define children with a body-mass index at or above the 85th percentile for their age as overweight. One-third of the 150 children in the current study were overweight, most from low-income urban homes, and more than 90 percent African-American.

"Childhood obesity is a complex, multi-factorial phenomenon but our findings reveal that, for the most part, lack of parental awareness of nutritional risk factors is not one of the drivers behind it," Hernandez said.

The investigators set out to identify parental perceptions of risk factors for childhood obesity and barriers to healthy weight and to determine whether the parents of healthy-weight preschoolers viewed such risks and barriers differently from the parents of overweight children. They didn't. The study found minimal to non-existent differences between the two groups.

One important risk factor remained seriously overlooked by parents in both groups: physical activity. Only 7 percent of parents in the healthy-weight group and 8 percent in the overweight group cited lack of physical activity as a top driver of unhealthy weight.

Recent studies have shown that few preschoolers achieve healthy levels of activity, and most remain sedentary 85 percent of the time, the investigators say. The results of the study suggest that parents undervalue physical activity in an age group often perceived as "active enough," and alerting parents to the risks of inactivity is critical in obesity prevention, according to Janet Serwint, M.D., of Johns Hopkins Children's Center.

"The importance of physical activity and age-appropriate exercise is one area where we could step up educational efforts," Serwint said. "Pediatricians should discuss specific and age-appropriate activity goals during well-child visits."

Nearly 40 percent of parents in both groups identified buying and preparing unhealthy food as the top contributor to weight problems at an early age. Similar numbers of parents in both groups (23 percent and 31 percent) cited using food as a reward for good behaviour as a risk factor for weight problems. A nearly equal proportion of parents in both groups (25 percent and 23 percent) said that asking the child to finish food on the plate was the most critical contributor to overweight or obesity.

Importantly, one-third of parents from both groups (35 percent and 33 percent) identified lack of control over the child's food choices as the top barrier to healthy weight -- a notable finding, the researchers say, given that most preschool children spend most of their waking hours in daycare or with alternate caregivers.

"Daycare providers, grandparents and others involved in a child's care are often just as important in achieving healthy-weight goals as the parents themselves, and parents should be encouraged to provide specific dietary and activity instructions to these influential caregivers," Hernandez said.

Co-investigators on the study included Tina Cheng, M.D. M.P.H., and Darcy Thompson, M.D. M.P.H., both of Johns Hopkins.

The research was funded by The Thomas Wilson Sanitarium for Children of Baltimore City.

Children's Sugar Consumption Too High

U.S. children and teens are getting too much sugar in their diets, mostly from processed and prepared foods, according to a new study.

Sugar consumption decreased since 1999, although added sugars make up 16 percent of youth diets and contribute to the ongoing problem of childhood obesity.

Researchers followed 7,100 children and teens between 1999 and 2008 and found the majority of them had unhealthy eating habits.

Boys consumed 362 calories and girls consumed 282 calories from added sugar daily, a number that increased as the children got older. Forty-one percent of calories from additional sugar came from soda and other beverages, according to the study.

"If you look at individual items, the one that has the biggest contribution [to added sugar consumption] is soda," Cynthia Ogden, lead study researcher and epidemiologist of the Centers for Disease Control and Prevention, said.

The U.S. Department of Agriculture recommends that between 5 and 15 percent of daily calories come from sugars and fats combined.

The National Center for Health Statistics Data Brief published the study on Wednesday.

Lessening the number of calories children consume is imperative to curb childhood obesity. Over 12.5 million children ages 2-19 are obese, according to the CDC. The number has tripled since 1980.

In addition, childhood obesity-related healthcare costs $3 billion annually, according to a 2009 study published in Nature.

Parents need to watch what they buy and cook more at home to curb the calories their children eat, one dietician said.

"Whoever is the gatekeeper for the family food supply needs to take a good, hard look at their choices. Obviously, junk foods, cookies, desserts and sodas are high in sugar and non-nutritive calories," Samantha Heller, a dietitian and nutritionist based in Connecticut, reported.

However, many unexpected foods are high in sugars. Parents need to check ingredient lists for hidden sugars such as brown rice syrup, dextrose, fructose, molasses, sucrose, corn sweetener, barley malt syrup, fruit juice concentrates, glucose, cane juice syrup and sorghum, reported.

Childhood Obesity: Dads more likely than moms to impact

A father’s use of restaurants and his perceptions of family meals carry more weight, so to speak, than mothers’, according to a Texas AgriLife Research study, published recently in The Journal of Nutrition Education and Behavior.

“Dads who think that dinner time is a special family time certainly do not see a fast-food restaurant as an appropriate place for that special family time, so this means that his kids are spending less time in those places."

"Dads who have no trouble eating food in a fast-food restaurant are going to be more likely to have kids who do so,” said Dr. Alex McIntosh, AgriLife Research sociologist.

Childhood obesity study points to father’s role

New research indicates that father’s are more likely than mother’s to have an impact on childhood obesity. A study by Texas AgriLife Research showed that lenient fathers allow their children more trips to fast-food restaurants which have been linked to obesity in children. (Texas AgriLife Research photo by Kathleen Phillips)

The study began as a 15-month look at parents’ use of time and how that impacted meal choices. It aimed at the difference between fast-food and full-service restaurants because numerous studies have shown a correlation between fast-food consumption and weight gain.

Of particular interest for the research, funded by the U.S. Department of Agriculture, was parental choice of restaurants as a connection to childhood obesity, McIntosh said.

Almost as an afterthought, the researchers decided to ask children in these families also to record what they ate and whether it was at home or out. If a meal was eaten out, the name of the restaurant was not required.

“It never occurred to me that we would have data on them eating out and where they were eating out. But the kids — if they said they ate out, they always wrote down where they ate by the name of the restaurant,” McIntosh said. “So it was just a matter of tracking down information about the restaurant to find out if they were full-service or more like a fast-food place.”

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Child obesity growing in developing world: WHO

The number of overweight African children under five has tripled to 13.5 million in 20 years, the UN's health agency said Wednesday, warning of a child obesity problem in developing countries.

Poor diet, low rates of breastfeeding and a sedentary lifestyle were largely to blame for the sharp rise in overweight children in developing nations, the World Health Organisation said.

In Africa the jump was from four million in 1990 to 13.5 million in 2010, an increase from four percent of the total under-five population to 8.5 percent, it said.

In Asia the corresponding gain over the same period was from 3.2 percent to 4.9 percent.

"The reason why children become overweight is because they are becoming more sedentary or less active and the food they have is exceeding their needs," said Francesco Branca, WHO's director of nutrition for health and development.

Children are given high energy food that is low in essential vitamins and minerals but heavy with sugar and fat, he noted.

"What we have seen in developing countries is that the offer of food is moving towards highly refined, industrial food which often have very high content of sugar and fat," Branca said.

The problem was compounded by a trend of lower breastfeeding rates, he said.

Poor nutrition among mothers also often resulted in newborns with a low birth weight of under 2.5 kilogrammes (5.51 pounds) who were vulnerable to becoming overweight later in life, Branca said.

"Often we have the combination of children who have low birth weight who become more easily children who are overweight," he said, adding "children with very low birth weight are less able to handle high energy density food."

The UN health agency issued in January a series of recommendations aimed at cutting child obesity, including a call on governments to ban junk food from schools and playgrounds.

Lifestyle intervention reduces preschoolers’ body fat and improves fitness

Lifestyle intervention reduces preschoolers’ body fat, improves fitness — Science Blog

Migrant children are at increased risk of obesity, but a new study shows that a program teaching multiple lifestyle changes to predominantly migrant preschoolers and their parents helps the children reduce body fat and improve fitness.

Such interventions may be needed to help curb the global obesity epidemic, the study’s lead author Jardena Puder, MD, said. Puder, a senior resident at the University of Lausanne, Lausanne, Switzerland, said, “Even young children have high rates of obesity today.”

Statistics show that in the United States, about 14 percent of children ages 2 to 5 years are obese.

The public health program in this study attempted to reduce the risk of obesity among preschool children from areas of Switzerland with high migrant populations.

Specifically, it encouraged the children to increase their physical activity, improve nutrition, get more sleep and reduce audiovisual media use and stimulation, especially TV watching and video games.

Excessive exposure to stimulating media use can contribute to lack of physical activity, and insufficient sleep in early life may play a role in childhood obesity, according to the authors.

Compared with the control group, the group of children who participated in the program had significantly improved overall and aerobic fitness, according to the abstract.

Additionally, the intervention group had greater reductions in total and percent of body fat, waist size and appropriate or moderate media use. They also improved more than the controls in “some aspects of nutritional behaviour,” Puder said.

Obesity Lower at High Altitude

People who are classified as Obese may find it easier to lose weight at high altitudes, the results of a German study suggest.

Previous studies demonstrated weight loss in athletes and normal-weight subjects at high altitude, but this study focused on the impact of altitude on overweight people for whom weight loss is desirable.

Researchers from Germany took 20 obese men to a high altitude location for one week. No changes were made to limit their food or alter their exercise routines, in an attempt to isolate the impact of altitude on weight.

After one week, the participants were eating less, had lost weight and had a lower diastolic blood pressure.

Writing in Obesity, the researchers said that low levels of oxygen found at high altitude may cause a rise in the hormone leptin which is thought to suppress appetite. However, they say more research is needed.

- Obesity Online 2010
- American Obesity Association

- AOA Online Journal
- The Journal of the American Obesity Association