Kids vulnerable to grown-up diseases
By Graziella Steele
More and more children are being diagnosed with diseases usually found in older people, such as high blood pressure, fatty liver disease, type 2 diabetes, high cholesterol and sleep apnea. The culprit behind these conditions is being overweight.
“We’re definitely seeing more children with these conditions,” said Dr. Jennifer Squires of Novant Health Walker Pediatrics in Charlotte, North Carolina. “The primary cause is poor diet, lack of exercise and genetics. Children will replicate what their parents do so it’s important for parents to set an example.”
The matter is so dramatic that the American Academy of Pediatrics has developed and issued guidelines for pediatricians to recognize and manage these health issues in children.
Some parents in denial
Part of the problem is recognition that a child is obese. One study published by NYU Langone Medical Center found parents are subject to misperceptions about their child’s weight. Researchers said the majority of parents perceived their children as “about the right weight,” even as rates of obesity rose during the last couple of decades.
The findings are critical, according to researchers, because parents with accurate perceptions of their children’s weight are more likely to implement behavior changes that could lead to weight reduction.
“Many parents don’t recognize there is a problem,” Squires said. “Depending on the age of the child, we’ll develop a strategy. Children who are overweight and heading into puberty, we might closely monitor but not take an action plan. For a 5 year-old who is overweight, I’d take a different strategy.”
Help for meal planning
Squires said caloric intake recommendations for children can vary due to a child’s age, sex, physical size and activity level. She said the U.S. Department of Agriculture has some general guidelines that can help parents. She recommended ChooseMyPlate.gov as a resource for parents for meal planning and nutrition. For children who are overweight, Squires said she tries to engage them in creating goals for weight management. “I don’t want to use the ‘D’ word,” she said. “I want the parents to be appropriately concerned, but I don’t the children to feel ashamed.”
If children drink soda or juice, she encourages them to limit the juice drink to one a week and to give up soda. “I try to get them to come up with the idea because they are more likely to stick to the goal,” she said.
Squires added that she aims to make the goals attainable. “Ultimately, it’s the parents who are responsible for the child’s weight loss since they are buying the food,” she said.
Some of the adult diseases pediatricians are seeing in children include:
Heart disease: Cardiovascular disease develops over time and obesity can greatly contribute to risk factors causing heart disease. Children should get tested to identify possible health risks.
Guidelines developed by the National Heart, Lung and Blood Institute recommend that all children get screened for high cholesterol at least once between the ages of 9 to 11 and again at 17 to 21.
Diabetes: Type 2 diabetes is on the rise among children, according to the American Diabetes Association. Most at risk are children from certain ethnic and racial groups, including African-Americans, Latinos, Asians and people of Pacific Island descent. The nonprofit says children at risk can prevent or delay the onset of diabetes by making small changes. Even a small loss in weight can make a big impact on developing diabetes.
Hypertension: According to the American Heart Association, teens, children and even babies can have high blood pressure. High blood pressure in children can be caused by a number of factors including obesity.
The association recommends changes in diet and physical activity to improve blood pressure. It said obese teens with high blood pressure can develop thickening of the arteries, a condition that leads to stroke and heart disease, as young as age 30.
Fatty liver: Fatty liver disease is rapidly increasing among children due in large part to obesity. One study estimates half of obese children have the disease, which can progress to an inflamed liver that ultimately stops functioning properly.
“Fatty liver disease is intermingled with some components of obesity, some lipid issues and possibly some early insulin resistance,” Squires said. “We call this metabolic syndrome. When there is extra sugar in the blood stream, the body will store that sugar in the liver. Eventually the sugar will change to fatty acids.”
Fatty liver disease is associated with a number of medical problems that can cascade into insulin resistance, metabolic syndrome and obstructive sleep apnea.
Changes in diet and physical activity are effective in lowering liver enzymes and improving the condition, according to another study.
Early intervention is key in treating these conditions in children, according to Squires. “If the disease is caught early, it is reversible. But if it’s left untreated, it can cause organ damage. For instance, blood pressure will go down if managed appropriately,” she said.