Children and Obesity: The Diabetic Connection: What has been suspected for many years is proven true in new research delivered by the New England Journal of Medicine – obese children are more likely to die at a young age.
According to the New England Journal of Medicine (NEJM), “The lifetime risk of type 2 diabetes is now more than one in three in the general U.S. population, and one in six adolescents is now obese, suggesting that prevention should start in childhood. Many consider diabetes and obesity to be ‘common-source’ epidemics that are rooted in our culture, as evidenced by national trends toward larger portion sizes and more meals built around calorically dense fast food, sugar-sweetened drinks, and sedentary behavior. Fighting such a powerful wave with purely clinical and adult-based approaches to prevention may seem like pasting a small bandage on a gaping wound. Rather than focusing on adults who may be set in their ways, we should perhaps target our youth, who may represent a better hope for changing the norms, habits, attitudes, and preferences that define our culture’s collective energy balance.”
The primary struggle with targeting young people is the lack of perceived reward for the effort. Because the risk of Type 2 diabetes among young people is relatively low there would need to be improved lifestyle changes in adulthood in order to justify the expense associated with youth intervention. The NEJM report states, “Impaired glucose tolerance, impaired fasting glucose, and elevated glycated hemoglobin levels are practical targets among adults not only because they indicate a high risk of diabetes but also because structured lifestyle interventions can be highly effective. Segregated interventions may not work as well among youths because the long incubation period from risk factor to disease and unclear positive-predictive value for the development of diabetes and its complications make for inefficient risk stratification and allocation of intervention resources.”
There are other studies being conducted to help determine the actual benefit of childhood intervention with respect to Type 2 diabetes. A secondary study will follow 6,000 children through, “a unique, rigorous test of a model intervention to reduce glucose levels and other risk factors that incorporates thoroughly integrated nutritional, physical-activity, behavioral, and social-marketing components. Other experts suggest that we must reach far outside the schoolhouse to find out whether focusing policies on culturally embedded risk factors — sugar-sweetened beverages, calorically dense foods, excessive television and video watching, the high price and limited availability of healthy foods, and community designs that discourage physical activity — can be as fruitful as targeting tobacco, saturated fat, and trans fats has been for the prevention of cardiovascular disease, “ according to the NEJM.
WebMD suggests, “The American Academy of Pediatrics has a tool parents can use called 5210…It stands for:
- 5 servings of fruits and vegetables daily
- 2 hours or less of television viewing daily
- 1 hour of exercise daily
- 0 or nearly zero sugar-sweetened beverages daily (Source: WebMD)
What this new research seems to tell us is that obesity in childhood is a problem that can lead to diabetes and premature death. However, because these ‘problems’ can be decades away there may be a problem in developing support to address the issue in childhood since the risk of imminent death is not typically an issue. There are those who believe these findings may be used as a foundation for a long-range plan to enable better choices among the world’s youth.