Current status of the war against child obesity

Robin Wulffson MD's picture
child obesity, Vitamin D, low income children, minority children
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In addition to a number of armed conflicts taking place around the globe, an ongoing battle against child obesity is being waged in the US. A new study by the Centers for Disease Control and Prevention (CDC) published on December 25 in the Journal of the American Medical Association (JAMA) reported that we have made some progress in the war against child obesity; however, child obesity is still of epidemic proportions. A study published on December 24 in the journal Pediatrics has unearthed another weapon that may aid in this obesity battle. Researchers affiliated with the University of Texas Southwestern Medical Center (Dallas, Texas) and the Children’s Medical Center (Dallas, Texas) reported a strong association between child obesity and Vitamin D deficiency.

The Texas researchers noted that adequate Vitamin D is essential for skeletal health in developing children. They explained that excess body weight is associated with risk of Vitamin D deficiency; however, the national prevalence of and risk factors associated with vitamin D deficiency in overweight and obese children are unknown. Therefore, they designed a study to determine the prevalence of Vitamin D deficiency (defined as a 25-hydroxyvitamin-D level of less than 20 ng/mL) in a sample of 6- to 18-year-old children. The children were enrolled in a cross-sectional study (the 2003–2006 National Health and Nutrition Examination Survey) in which body weight and height were measured directly. The children were classified as healthy-weight, overweight, obese, or severely obese by using recommended age- and gender-specific BMI-percentile cutoff points. Associations between BMI-percentile classification and Vitamin D deficiency were examined after adjustment for relevant confounders. Sample weights were used to generate nationally representative estimates.

The researchers found that the prevalence of Vitamin D deficiency for the different groups were: healthy-weight (21%); overweight (29%); obese (34%); and severely obese (49%). They also found racial differences. The prevalence of Vitamin D deficiency in severely obese Caucasian children was 27%; the prevalence was 52% for Latino children; and the prevalence for African American children was 87%. Compared with healthy-weight children, overweight, obese, and severely obese children had significantly greater adjusted odds of vitamin D deficiency. Modifiable factors associated with vitamin D deficiency in overweight/obese children were identified.

The researchers concluded that Vitamin D deficiency is highly prevalent in overweight and obese children. They noted that the particularly high prevalence in severely obese and minority children suggests that targeted screening and treatment guidance is needed.

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The CDC noted that low-income preschoolers are known to be at higher risk of obesity than their more affluent peers, in part because access to healthy food is often limited in poorer neighborhoods. The agency’s new study found that the number of these children who qualify as obese or extremely obese has decreased over the last decade.. However, the researchers cautioned that the decline was only modest and may not apply to all children. Despite that, the researchers noted that the findings were encouraging because the new findings are the first national data to show obesity and extreme obesity may be declining in young children

The investigators reviewed data on routine clinic visits for about half of all US children eligible for federal nutrition programs, including 27.5 million children between age two and four. They found that 13% of those preschoolers were obese in 1998. That rose to just above 15% in 2003, but dropped slightly below 15% in 2010, the most recent study year included. Similarly, the prevalence of extreme obesity increased from nearly 1.8% in 1998 to 2.2% in 2003, then fell to just below 2.1% percent in 2010.

The CDC noted some reasons for the decrease in child obesity. Between 2003 and 2010, an increase in breastfeeding of low-income infants occurred. Breastfeeding has been linked to a healthier weight in early childhood. In addition, states and communities have started working with child care centers to ensure that children have time to run around and that healthy foods are on the lunch menu, she added. The CDC researchers noted that parents can encourage better eating by having fruits and vegetables available at snack time and allowing their young children to help with meal preparation. Other recommendations include making sure preschoolers get at least one hour of activity every day and keeping television sets out of the bedroom.

References:
Pediatrics
JAMA

See also:
Low Vitamin D levels increase risk of type 1 diabetes
Vitamin D reported to lower the risk of multiple sclerosis
Health advocacy organization PHA combatting child obesity with Play Streets

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