Overweight Children: An Emerging Epidemic

An increasing number of children and teenagers are now obese and are at risk for developing high blood pressure, heart disease and stroke, including diabetes, even as children and teenagers. This could be considered an emerging epidemic with significant impact upon the health of our nation and the world, says a physician at Washington University School of Medicine in St. Louis and St. Louis Children’s Hospital.

“There is an emerging epidemic upon us,” says Neil H. White, M.D., professor of pediatrics and of medicine at the School of Medicine and a pediatric endocrinologist at St. Louis Children’s Hospital, affiliated with the School of Medicine. “Over the past decade, it has become apparent that type 2 diabetes, previously a disorder primarily of adults, is developing at an alarming rate in teenagers and preteens.”

Diabetes mellitus is a disease in which the blood glucose (blood sugar) is elevated. It is often associated with long term complications, including vision loss, kidney failure, nerve damage and blood vessel damage resulting in heart attack, stroke and amputation. Diabetes is the second most common chronic childhood disease and is traditionally divided into two primary types.

Type 1 diabetes results from destruction of the cells in the pancreas that produce the hormone insulin. Insulin is responsible for regulating blood sugar and fuel metabolism. Type 1 diabetes is a disorder that usually starts in people under 30 years old. Although the number of children diagnosed with type 1 diabetes may be increasing, this increase has been gradual and the rates of this disease have been relatively stable over the last few decades.

However, the situation with type 2 diabetes is very different. Type 2 diabetes is a disorder associated with a need for more insulin to regulate metabolism, but the pancreas cannot produce the extra insulin. Type 2 diabetes is a very common disease and accounts for most of the estimated 19 million people with diabetes and a major portion of the morbidity, mortality and costs of diabetes.

Perhaps even more worrisome, however, is that the common association of insulin resistance, high blood pressure, High cholesterol or triglycerides and obesity leads to an increased risk for heart disease even before the diabetes is diagnosed. This constellation of symptoms has been called metabolic syndrome or Syndrome X, and is now considered to be a “prediabetic” state.

White said in some areas of the country, type 2 diabetes represents nearly half of all new cases of childhood diabetes.

Type 2 diabetes in children is clearly associated with obesity and it occurs more commonly in those with a family history of the disorder and in those of African-American or Hispanic background,” he says. “More and more children are now obese with recent estimates suggesting that at least 20 percent of children in the United States are obese. As obesity increases, so does the incidence of type 2 diabetes in children and teenagers, leading to considerable concern that these children will develop diabetes complications as well as metabolic syndrome and its complications, including heart disease, relatively early in life,” he says. “Prevention is the best medicine.”

White, a Certified Diabetes Educator, says there are many things families and communities can do to help prevent type 2 diabetes in children and teenagers.

“Individual, family and community-based interventions aimed at reducing obesity in children should be encouraged in hopes that this will curb the trend of increasing type 2 diabetes and reduce the risk of heart disease, high blood pressure and High cholesterol in this high-risk population,” he says. “Dietary counseling should be provided to encourage healthy eating and to reduce the intake of food high in calories and fat. Children should be encouraged and counseled to be more active and less sedentary.”

White says these interventions are best implemented at the family level and with professional behavioral support. Community interventions are also needed at the level of the school system to reduce the availability of unhealthy food choices and encourage physical activity.

Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Source: Washington University in St. Louis

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