Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

Archive for the ‘children’ Category

The Junk Food Gene

Posted by Colin Rose on December 10, 2008

After $many billions spent on looking for genetic causes of common diseases like obesity we now have the answer in the latest NEJM that was obvious without spending all that money. The most common SNP (single nucleotide polymorphism) associated with obesity tends to influence people to eat high-fat, energy dense food, commonly known as junk food. We already knew that obesity was not caused by “slow metabolism”. So, no junk food, no junk food addiction, no obesity. Junk food addiction is like any addiction. If an alcoholic has a bottle in the house s/he will drink it. So don’t buy junk food and you won’t eat it.

To quote from the Discussion in the paper:

“This study indicates that there is no defect in the “output” side of energy balance, which constitutes energy expenditure…Our study tested satiety by directly measuring food intake from a test meal after ingestion of one of three preloads, and the results show a robust effect of genotype on energy intake but not on the weight of food ingested. This increase in energy intake was independent of body weight. Thus, the children carrying the A allele ingested more energy-dense foods than did the children who were not carrying the A allele, indicating a preference for energy-dense foods….In conclusion, variation within the FTO locus appears to confer a risk of obesity through increased energy intake, suggesting that moderate and controlled restriction of energy intake may prevent FTO genotype–associated obesity.”

nejm-fto-obesity-abs

Another Ice Cream Cone

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Disastrous Epidemic of Type 2 Diabetes in Children

Posted by Colin Rose on November 7, 2008

Many more children on medication, study says

‘Surprising’ rise targets diabetes, other obesity-related diseases

November 3, 2008

Baltimore Sun

Hundreds of thousands more children are taking medications for chronic diseases, with a huge spike over a four-year period in the number given drugs to treat conditions once seen primarily in adults and now linked to what has become an epidemic of childhood obesity.

In a study appearing today in the journal Pediatrics, researchers saw surges in the number of U.S. children taking prescription medicines for diabetes and asthma, with smaller increases in those taking drugs for high blood pressure or high cholesterol. All of those conditions, to varying degrees, have been associated with obesity.

Though doctors have been seeing the trend in their practices, “the rate of rise is what’s surprising,” said Dr. Donna R. Halloran, a pediatrician at St. Louis University in Missouri and one of the study’s authors.

The study found a doubling in the number of children taking medication for type 2 diabetes, with the largest increases seen among pre-teen and teenage girls. The number of asthma prescriptions was up nearly 47 percent.

The findings come from a study of 3 million privately insured children that was designed to be a nationally representative sample. The researchers used the sample to measure increases from 2002 to 2005 in the number of children taking various medicines but did not estimate how many youngsters nationally were on the medications.

There is nothing inherently wrong with giving medication to children with chronic diseases, doctors say, especially when the drugs are shown to be safe and effective. The increase in children receiving asthma medication appears to be partly because more children have asthma, but also because new guidelines recommend using medication in more cases.

The use of cholesterol medication for children appears to have become more accepted as well. The American Academy of Pediatrics recommended last summer the use of statins to lower cholesterol in children as young as 8.

Meanwhile, the federal Centers for Disease Control and Prevention say the number of children with type 2 diabetes is on the rise, but officials do not have estimates for how much. Type 2 diabetes, which used to be called adult-onset diabetes, begins when the body develops resistance to insulin and can no longer use it properly. Eventually, the body can no longer produce sufficient amounts of insulin to regulate blood sugar.

Still, there is an increasing unease in some circles that doctors are prescribing medication without exhausting nonpharmacological options.

“There are concerns that we’re moving too quickly to drug therapy,” said Emily R. Cox, a researcher at Express Scripts, a St. Louis-based pharmacy benefits management company, and lead author of the study. “We don’t know that drug therapy is best for some of these conditions.”

Cox and her colleagues looked at the rates of medication among children ages 5 to 19. They did not look at all medication use, but focused on drugs for high blood pressure, diabetes, cholesterol, asthma, depression and attention-deficit disorders.

Since the study used figures from commercial insurance providers, it did not include the uninsured or those covered by programs for low-income children. Other studies have shown that the urban poor have some of the highest rates of childhood obesity in the United States.

According to the study, antidepressant use was essentially flat, though the numbers have gone down significantly among children under 10. Attention-deficit medication, the proper use of which has long been debated, rose 40 percent, with the largest increase among girls taking medicine for a set of disorders traditionally seen more in boys.

In raw numbers, the number of children on diabetes medication is relatively small, but the findings included one of the more surprising trends, a large number of girls on the drugs. The number of girls ages 10 to 14 on the medication rose 166 percent, and the figure for those ages 15 to 19 rose 133 percent.

One expert said those numbers cannot by accounted for by rises in child diabetes or by a secondary use of one of the drugs, metformin, to treat polycystic ovary syndrome.

“It’s definitely not due to a doubling of type 2 diabetes in children, because type 2 diabetes has not doubled in children and we have data on that,” said Dr. Silva Arslanian, an endocrinologist at the Children’s Hospital of Pittsburgh, who was not involved in the study.

She said overweight children regularly come into the hospital’s Weight Management and Wellness Center on metformin, having been told that they have diabetes, but tests of their blood sugar turn out normal. Arslanian said she believes that some doctors are using metformin, which can lead to appetite loss, as a diet pill – an “inappropriate” use.

“Management of obesity is very frustrating,” she said. “We talk about lifestyle changes, but how many of us are successful in changing lifestyle when the environment is so toxic? When you give somebody a medication, the psychology of the patient is, ‘The medication is doing the job, so I don’t need to change the way I’m eating or moving or drinking.'”

Dr. Debra R. Counts, head of pediatric endocrinology at the University of Maryland School of Medicine, said she does not think that diabetes drugs are being improperly prescribed. She said more children are taking diabetes medication because more children have diabetes. And even though more boys are becoming obese than girls, she said, studies show that girls are more likely to develop diabetes.

“Most pediatricians try not to prescribe medication unless it’s indicated,” she said.

Another reason that more children are being given medications could be that more drugs have been approved for pediatric use in recent years. In the past, doctors in some cases had prescribed the drugs anyway, but many feel more confident now, knowing that proper studies have been done in children.

Medication is not by itself a solution in many cases, especially when it comes to diseases like type 2 diabetes and hypertension, which are most closely linked to obesity, doctors said. Lifestyle changes have to begin as early as possible, Counts said, sometimes even in toddler years.

She noted recent recommendations that overweight 1-year-olds be given low-fat milk as opposed to whole milk. Doctors used to believe that babies needed the fat in whole milk for their brains to properly develop and recommended whole milk until a child’s second birthday.

“We get a lot of kids referred to us. The problem is, we have no magic,” Counts said. “The whole family needs to eat healthier and get more active and turn off the TV. … By the time people are teenagers, it’s hard to change them.”

Posted in addiction, children, cholesterol, diabetes, Type 2, diet, drugs, moral hazard, obesity | Tagged: , , , , | Leave a Comment »

Child obesity and trans fat, a politically correct scapegoat

Posted by Colin Rose on March 28, 2007

Here is a classic example of politicians trying to deflect responsibility for a problem away from the average voter, whom they are loath to antagonize, to a politically powerless scapegoat. You will never hear a politician say that eating TOO MANY CALORIES because of food addiction is the cause of pandemic obesity. That would upset the whole food supply industry and rural voters whose votes are worth twice a much as city dwellers. So, politicians blame trans fat and recommend building more gyms, changes that will make ABSOLUTELY NO difference but will not injure an delicate voter sensibilities.

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Child obesity an epidemic, Ottawa told

25% OVERWEIGHT: COMMONS COMMITTEE For first time, Canada’s younger generations are expected to live shorter lives than parents

OTTAWA – More Canadian children are overweight and for the first time the country’s younger generations are expected to live shorter lives than their parents because of obesity, says a new Commons committee report made public yesterday.

Committee MPs said they were “shocked” to learn about the increase in overweight children, from 12 per cent to 18 per cent, and obese children, from three per cent to eight per cent, between 1978 and 2004.

That makes about one in four Canadian children overweight or obese.

The report said parents must be in denial, as a Canadian Medical Association survey found only nine per cent report they have a child who is at least somewhat overweight.

The health committee called yesterday for aggressive measures to halt child obesity, and said they share fears of experts that “today’s children will be the first generation for some time to have poorer health outcomes and a shorter life expectancy than their parents.”

Highlights of recommendations are a ban on trans fats as advised by a federal task force; use of a mandatory, simplified, standardized food labelling system; and designation of federal funds to build or replace aging playgrounds, sidewalks, rinks, pools and other community exercise spots across the country.

The report said most Canadian children spend too much time in front of TV and computer screens; don’t get the expert-recommended 90 minutes a day of exercise; eat too much fat and junk food; consume too many sugary drinks and don’t eat the recommended five daily servings of fruit and vegetables.

The committee also reported the “distressing” and “most alarming” number of 55 per cent of First Nations children living on reserves, and 41 per cent off reserves, are overweight or obese.

There is so much poverty among First Nation and Inuit people that many people cannot afford nutritious food, especially in remote northern communities, the report said.

And of more than 500 First Nations schools, only half have a gym.

The health committee proposed Canadians take up a national challenge to halt a 30-year rise in overweight children in just three years – by the 2010 Olympic games in Vancouver. Then targets to reverse the trend could kick in.

“It is ambitious but it is doable,” committee chairperson Rob Merrifield, an Alberta Conservative MP, told a news conference.

“For the first time in recorded history, our younger generations are expected to live shorter lives than their parents due to obesity,” he said in a prepared statement.

“New and aggressive action is required to address this complex and, ultimately, very costly problem.”

The report was welcomed by the Heart and Stroke Foundation, which has long warned “fat is the new tobacco,” and by the Canadian Medical Association.

Foundation chief Sally Brown said overweight children are on “a fast track” to developing hypertension, heart disease and stroke.

New Democratic Party MP Penny Priddy said by chronicling links between poverty, poor diet and lack of exercise, the report busts a myth that overweight children all sit around playing on computers and watching TV. She cited the example of children in poor families being fed Kraft Dinner instead of going to bed hungry.

Kraft Dinner is a brand of macaroni and cheese, an inexpensive food.

Expressing concern that the committee would get into trouble with the Kraft corporation, Merrifield said “I love Kraft Dinner.”

The report said on average, adolescents in Canada spend almost 35 hours a week in front of a TV or computer screen – more time than in the classroom over the course of a year. Studies had shown the less time in front of a screen and the more activity, the less weight.

The committee also postponed a decision on a possible ban on food advertising to children, saying it would assess the impact of self-regulation in Quebec, Sweden and other jurisdictions in a year before deciding on the issue.

Bloc Québécois MPs issued a dissenting report, saying the Quebec government already has a well-defined strategy to deal with juvenile obesity and that the federal government should stick to its own jurisdiction in health, which is confined to First Nations and Inuit people.

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According to studies conducted at the University of Guelph, Canadians consume an average of eight to 10 grams of trans fats per day. At 9 kcal/gm for fat, trans fat account for at most 90 kcal/day. This is the cause of the obestiy pandemic? One pound of fat is about 3500 kcal, so it would take about 40 days to gain or lose one pound of fat if one adds the trans fat or eliminates it respectively. But that trans fat is always REPLACED with another form of fat with the same calories. A gram of trans fat has the same caloric value as a gram of oil or other fat. So one has to reduce the TOTAL FAT and TOTAL CALORIE intake to make any difference.

Here is what is often used to replace trans fat. No cholesterol, no trans fat, omega-3. These slogans are now used by food manufacturers to market even more junk calories. I predict the pandemic will only worsen. Nobody wants to deal with the fundamental problem, food addiction. See my photo essay on food addiction.

Health Food in Costco

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