The family

People are always asking me for posts about helping with kids and obesity.  And trust me, I struggle with my group as well.  Don’t believe me?  Just read this and you’ll see.

New report came out this week that says that family meals and veggies (this is a duh?) to help curb childhood obesity.

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1 in 5

On February 6, 2010, in Uncategorized, by Andrea

That’s the number of kids that abnormal lipid numbers.

I’ll wait for some of you to, you know, wake up.  Need some smelling salts?

20% of kids have abnormal lipid numbers.  That’s scary, folks.  These are kids just waiting for RNYs, DS’s, VSG’s, and AGB’s — plus anything else we can think up and guinea pig on ourselves.  We need to get all of this down and understand it cause the next generation isn’t looking too healthy.

From Medscape:

One in Five Kids With Abnormal Lipids

Michael O’Riordan

February 3, 2010 (Atlanta, Georgia) — New data from the Centers for Disease Control and Prevention (CDC) shows that one in five youths aged 12 to 19 years has abnormal lipid levels [1]. Also, nearly one-third of these youths are obese or overweight and based on their body-mass index (BMI) are candidates for lipid screening, according to investigators.

In an editorial accompanying the new report [2], the CDC urges clinicians to be aware of the lipid screening guidelines so that interventions for overweight or obese children and youths can be recommended. “Healthcare providers can refer eligible youths to nutritional counseling, community fitness programs, and school-based lifestyle programs,” writes the CDC.

The new report, from a combined sample of four National Health and Nutrition Examination Survey (NHANES) surveys taken from 1999 to 2006, includes data on 9187 youths, of which 3733 provided fasting blood samples for lipid testing.

Among the sample, 20% had at least one abnormal lipid measurement, such as elevated LDL cholesterol (>130 mg/dL), reduced HDL cholesterol (<35 mg/dL), or elevated triglyceride levels (>150 mg/dL). Researchers also showed that compared with normal-weight youths, those who were overweight or obese were significantly more likely to have at least one abnormal lipid measurement.

In addition to these findings, the CDC report also showed that boys were more likely than girls to have low HDL cholesterol, while older youths, those aged 18 to 19 years, were more likely to have low HDL and elevated triglyceride levels than kids aged 12 or 13 years.

The researchers point out that, based on the American Academy of Pediatrics (AAP) screening recommendations, 32% of youths would be eligible for lipid screening based solely on their BMI. The AAP recommends screening based on family history of high cholesterol or premature cardiovascular disease or an unknown family history of high cholesterol or premature disease, as well as the presence of at least one major cardiovascular disease risk factor, including overweight/obesity.

New Risk Factor in Childhood Obesity?

On February 6, 2010, in Uncategorized, by Andrea

As a mother of a tall 3 1/2 year old, I hope not.  I hope she got her skinny papa’s genes.  Really hoping she keeps her, get this, BMI of 14.5.  Her brother isn’t far off with a BMI of 16.

From Medscape:

Children Tall for Their Age Are More Likely to Be Obese

By Sue Mulley

HONG KONG (Reuters Health) Feb 03 – Children who are tall for their age are more likely to be apple-shaped (abdominally obese) than their counterparts, according to a British study presented at the First International Congress on Abdominal Obesity.

These tall-for-age children also are more likely to be generally overweight or obese, and have higher body fat percentages, said Dr. David McCarthy of the UK’s London Metropolitan University.

Dr. McCarthy and his colleagues studied 2,298 Caucasian children aged 5-14 years, measuring their height, weight, percent body fat and waist circumference, and calculating their body mass index (BMI).

The children were given a statistical score based on their height adjusted for age and divided into four groups from shortest to tallest.

Rates of high BMI, high body fat percent and bigger waistlines ranged from 8-13% in the shortest group of children and from 33-52% in the tallest group.

“These findings suggest that being tall for age is not only a risk factor for general overweight/obesity in children, but particularly for abdominal obesity,” the researchers emphasized.

“Height and central fat reserves are related, and this has been overlooked in the obesity field,” Dr. McCarthy told Reuters Health in an interview.

He continued, “In any population of children, those who are overweight or obese classified by BMI tend to be taller than normal weight children. How did they become that tall in the first place? And what’s the link between that height and the accumulation of central fat?”

“As obese children grow taller, they tend to grow fatter and even more centralized in their fat distribution. Somehow their growth trajectory is taking off more than you would expect from looking at the height of their parents,” he said.

Dr. McCarthy and his colleagues have data on roughly 8,000 children in London and the surrounding areas. They are in the process of analyzing information on South Asian and Afro-Caribbean children.

“We see children who are at greater risk of developing abdominal obesity related to ethnic background and level of income, but we don’t know what is driving the accumulation of central fat in these children,” he said.

“I think it could be related to the postnatal diet, perhaps artificial feeding, and very early growth patterns.”

“If you have a low birth weight baby, the natural response of the parents is to feed that child up, to get him to grow and catch up to where he should be for his age… maybe it’s a combination of being a small baby and rapidly growing in the first two or three years of life that seems to put you on a trajectory for storing fat centrally,” he noted.

10 year old undergoes WLS

On February 3, 2010, in Uncategorized, by Andrea

!!!

!!!!

VSG.

But still.  10!

I understand childhood obesity.  Not to this degree.  But 10?!?!

I weighed 320 at surgery at 25.  This kid weighed close to 280 at 10.  Yes, something had to be done, but OMG.

!!!

From Times of India:

10-year-old undergoes weight loss surgery

TNN, 23 January 2010, 05:31am IST
AHMEDABAD: At 10, Kshitiji Jindger from Chennai weighs 127 kg. Jindger used to be mostly confined to his home but after undergoing bariatric surgery, he is hoping to play his favourite sport cricket soon.

Jindger is Asia’s youngest patient to undergo bariatric surgery,” said city-based laparoscopic and obesity surgeon Dr Mahendra Narwaria who conducted the operation.

He added that Jindger had normal body weight at birth but started gaining excess weight after he turned two. “He was doubling his weight every other year, the body mass index was at 54.3, normally it should be 22 to 23. Jindger underwent laproscopoic sleeve gastrectomy over a month ago and already lost 13.5 kg,” said Narwaria.

Laparoscopic sleeve gastrectomy is a bariatric or weight loss procedure in which the surgeon removes approximately 80 per cent of the stomach, shaping the remaining stomach into a tube or sleeve’. The surgery is done through sophisticated medical instruments and using titanium clips.

Referring to a recent city survey, Narwaria said, “According to research, 16 per cent children going to private schools in Ahmedabad are obese. These are alarming figures.”

Explaining reasons for obesity in young children, he added, “Imbalance in energy intake, junk food, sedentary lifestyle aggravates the problem. Only less than five percent obesity is caused by abnormality like hormonal, genetic and syndromic causes,” added Narwaria.

According to him, obesity in children doubles the mortality rate and kids suffer from depression, hypertension, sleep apnea, diabetes and menstrual disorders in women.

Another tool for adolescent obesity — this is a study geared towards 13-18 year olds who were in the 95th percentile for their BMI.

From Medscape:

Metformin Extended Release May Be Helpful for Adolescent Obesity

Laurie Barclay, MD

February 2, 2010 — Metformin hydrochloride extended release (XR) with lifestyle intervention may be helpful for the treatment of adolescent obesity, according to the results of a multicenter, randomized controlled trial reported in the February issue of the Archives of Pediatrics & Adolescent Medicine.

“Metformin has been proffered as a therapy for adolescent obesity, although long-term controlled studies have not been reported,” write Darrell M. Wilson, MD, from Lucile Salter Packard Children’s Hospital, Stanford University School of Medicine in Stanford, California, and colleagues from the Glaser Pediatric Research Network Obesity Study Group. “Therefore, we conducted a 48-week randomized, double-blind, placebo-controlled trial of…XR metformin therapy in nondiabetic obese adolescents, followed by a 48-week monitoring period after completion of treatment.”

The goal of the study was to test the hypothesis that 48 weeks of daily metformin XR treatment would reduce body mass index (BMI) in obese adolescents vs placebo.

From October 2003 to August 2007 at the 6 centers of the Glaser Pediatric Research Network, 78 obese adolescents following a lifestyle intervention program underwent a 1-month run-in period and were then randomly assigned 1:1 to receive 48 weeks of treatment with metformin hydrochloride XR, 2000 mg once daily or an identical placebo. At baseline, BMI was at least in the 95th percentile, and age range was 13 to 18 years. The main study endpoint was change in BMI, after adjustment for site, sex, race, ethnicity, and age, and group assignment.

Mean adjusted BMI increased by 0.2 ± 0.5 in the placebo group and decreased by 0.9 ± 0.5 in the metformin XR group (P = .03) after 48 weeks of treatment, and this difference persisted for 12 to 24 weeks after cessation of treatment. There were no significant effects of metformin on body composition, abdominal fat, or insulin indices.

“Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program,” the study authors write.

Limitations of this study include study not specifically powered to evaluate the effect of metformin on insulin and lipid indices.

“Metformin was safe and tolerated in this population,” the study authors conclude. “These results indicate that metformin may have an important role in the treatment of adolescent obesity. Longer-term studies will be needed to define the effects of metformin treatment on obesity-related disease risk in this population.”

Bristol-Myers Squibb provided active drug (GlucophageXR) and placebos. The Glaser Pediatric Research Network is funded by the Elizabeth Glaser Pediatric Research Foundation, a program of the Elizabeth Glaser Pediatric AIDS Foundation. The study was supported by the Elizabeth Glaser Pediatric Research Foundation and the National Institutes of Health–supported Clinical Research Centers.

Arch Pediatr Adolesc Med. 2010;164:116-123.

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