Positive parenting can reduce the risk that children develop obesity
Children with positive, early interactions with their caregivers — characterised by warmth, responsiveness, and a stimulating home environment — were at reduced risk of childhood obesity according to new research from Pennsylvania State University in the United States.
The study, “Family Psychosocial Assets, Child Behavioral Regulation, and Obesity,” appeared in the journal Pediatrics. In the article, Brandi Rollins, assistant research professor of biobehavioural health and Lori Francis, associate professor of biobehavioural health, analysed data from over 1,000 mother-child pairs and found that children’s early exposures to family psychosocial assets — including a quality home environment, emotional warmth from the mother, and a child’s ability to self-regulate — reduced the risk of developing childhood obesity.
“A lot of the discussion around childhood obesity and other health risks focuses on identifying and studying the exposure to risk,” said Rollins, “We took a strength-based approach in our analysis. We found that a supportive family and environment early in a child’s life may outweigh some of the cumulative risk factors that children can face.”
An especially encouraging aspect of the study found that these factors were protective even when children faced familial risks for obesity, including poverty, maternal depression, or residence in a single-parent home.
“Research on parenting has shown that these types of family assets influence children’s behaviour, academic success, career, and — not surprisingly — health,” Rollins said. “It is significant that these factors also protect against childhood obesity because the family assets we studied are not food or diet-specific at all. It is heartening to know that, by providing a loving, safe environment, we can reduce the risk that children will develop obesity.”
Children are deemed to have obesity when their body mass indices (BMIs) are greater than 95% of other children their age and gender. There is a great deal of variance, however, in the BMIs of children who exceed the obesity threshold. Children whose BMI is 20% higher than the obesity threshold are considered to have severe obesity.
The researchers found that children who had early-onset severe obesity did not face greater levels of family risk than children who were not obese. Children with severe obesity, however, did have fewer family assets than children who were not obese or who displayed moderate levels of obesity. More research is needed to understand which factors contribute to the development of severe obesity and which factors reduce the risk.
“Though the findings on severe obesity may seem discouraging, they offer some hope,” Rollins explained. “Some risk factors, like household poverty, can be very difficult to change. Assets, on the other hand, may be easier to build. People can learn to parent responsively. It is encouraging that parenting really matters, that family matters.”
Read MoreEurope set to miss global heart health targets as obesity skyrockets
According to a paper published in European Heart Journal, the flagship journal of the European Society of Cardiology, the prevalence of obesity in Europe has more than doubled over the past 35 years, with over one in five adults affected.
The third report from the ESC Atlas Project updates and expands upon the previous edition with cardiovascular disease (CVD) statistics to 2019, or the latest available year, for the 57 ESC member countries.
CVD is the most common cause of death in the region, accounting for 45% and 39% of fatalities in women and men, respectively. Unfortunately, the report paints a picture of ageing populations and low birth rates. Between 1970 and 2019 the proportion of individuals aged over 65 years increased from a median 9.2% to 17.2%, and the median age increased from 29.6 to 41.1 years. Alongside this, between 1970 and 2018 fertility rates fell from 2.6 to 1.6, below the average of 2.1 live births per woman needed for population replacement.
Each year, an estimated 48,000 new cases of coronary heart disease occur across Europe due to environmental noise pollution.
Professor Adam Timmis, chair of the report writing team, said, “Sociodemographic and environmental risk factors receive relatively little attention from cardiologists but make a substantial contribution to the risk of CVD. Europe now has top-heavy populations and this will exacerbate the growing burden of CVD. The situation is compounded by increasing urbanisation which threatens heart health due to dirty air, noise, social deprivation and stress. It is estimated that up to 40% of people living in the EU are exposed to noise levels beyond the region’s residential limits.”
According to the World Health Organisation (WHO), noncommunicable diseases kill 41 million people each year, equivalent to 71% of all deaths globally. CVD accounts for most of these deaths (17.9 million annually), followed by cancer (9.3 million). The WHO has set targets for noncommunicable diseases to be met by 2025 but the evidence in today’s report suggests that, across ESC member countries, most goals relating to heart health are unlikely to be achieved. For example, the WHO has called for a halt (with reference to 2010) to the rise in obesity. But between 2010 and 2016, the prevalence of obesity rose from 20.4% to 22.7% in women and from 19.2% to 22.2% in men.
Healthcare professionals will need to be properly trained to deal with the ever-increasing strain of this problem.
Read MoreBariatric surgery may reduce cancer risk in patients with obesity and type 2 diabetes
Research findings derived from a Swedish Obese Subjects (SOS) study, published in Diabetes Care, found that in people with obesity and type 2 diabetes (T2D), bariatric surgery may play a role in cancer prevention. “Durable” remission of T2D is often achieved after weight-loss surgery, further associating it with a reduced cancer risk.
The study examined long-term outcomes after bariatric surgery versus usual care in people with obesity. Researchers examined outcomes of 701 patients with obesity and T2D at baseline. A total of 393 of these patients (mean age, 48.6 years) underwent bariatric surgery while 308 patients (mean age, 50.5 years) received conventional obesity treatment. The investigators analysed cancer events, reported in the Swedish National Cancer Register, over the median follow-up of 21.3 years.
In patients treated with bariatric surgery, the incidence rate for first-time cancer during the follow-up period was 9.1 per 1,000 person-years (95% CI, 7.2–11.5). In contrast, the incidence rate for first-time cancer in patients treated with usual obesity care was 14.1 per 1,000 person-years (95% CI, 11.2–17.7). The incidence rate for first-time cancer diagnosis was significantly lower in the patients treated with bariatric surgery (adjusted hazard ratio [HR], 0.63; 95% CI, 0.44–0.89; P =.008).
Compared with the control group, bariatric surgery was associated with a significantly reduced incidence of cancer in women, (HR, 0.58; 95% CI, 0.38–0.90; P =.016). However, with bariatric surgery in men, there was no similar association (HR, 0.79; 95% CI, 0.46-1.38; P =.0413). Diabetes remission at 10 years follow-up was also associated with a reduction in cancer incidence (HR, 0.40; 95% CI, 0.22–0.74; P =.003).
The ascertainment of diabetes diagnoses was a limitation of the study, which were based on a single time point measurement and/or the use of a diabetes medication. Additionally, the majority of participants in the surgery group had received vertical banded gastroplasty or banding, which is rarely used today. High postoperative mortality following bariatric surgery was reported during the original SOS study.
“In conclusion, with increasing rates of obesity and diabetes worldwide, a greater emphasis on cancer prevention strategies is needed,” the researchers wrote. “Bariatric surgery may greatly reduce the risk of cancer among patients with obesity and diabetes. Durable diabetes remission seems imperative for cancer prevention in patients with obesity and diabetes.”
Read MoreResearch finds weight loss in boys with obesity improves testosterone levels
A study, published in the European Journal of Endocrinology, and conducted by researchers at both Saint Louis University School of Medicine and University of Buffalo has found that adolescent boys with obesity who lose weight following bariatric surgery improve their testosterone levels.
Sandeep Dhindsa, M.D., a SLUCare endocrinologist and the director of SLU’s Division of Endocrinology, Diabetes and Metabolism, and first author on the paper stated, “Boys with obesity do not achieve sufficient testosterone levels at puberty and weight loss can theoretically improve testosterone. We checked the testosterone levels in boys with obesity who underwent bariatric surgery. Those who lost weight had increased testosterone levels. Those who regained weight had a lowering of testosterone again.”
In the study, researchers evaluated the changes in sex hormones following bariatric surgery in 34 male patients between the ages of 14 to 19. These participants were part of a long-term multi-centre study, the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS). Teen-LABS is the first large study to systematically document the outcome of metabolic bariatric surgery for treatment of adolescents with severe obesity in the United States.
Following surgery the participants were followed for five years. Total testosterone, estradiol, luteinizing hormone, follicle stimulating hormone, sex hormone binding globulin, insulin and glucose were all measured before surgery, six months’ post-operative and annually thereafter.
The study showed that bariatric surgery, in addition to treating obesity and reversing Type 2 diabetes, reversed low testosterone levels.
“Males usually achieve their peak testosterone concentrations at puberty, followed by a gradual decline for the rest of their life. Adolescent males with obesity start off with a lower testosterone. We do not know the long-term effects on fertility and sexual function. Testosterone is also important for muscle and bone growth. Our study provides strong evidence that weight loss can restore normal testosterone concentrations in these boys,” Dhindsa said.
73% of participants had subnormal free testosterone levels prior to surgery. Only 20% had subnormal free testosterone concentrations two years later. That percentage rose to 33% due to regained weight among some participants five years later.
Common causes of low testosterone in adults are ageing, obesity and diabetes. Male adults with obesity have lower testosterone levels than adults who are of a lean weight.
Read MorePicture warnings on fizzy drinks? A promising tool to fight childhood obesity
A study published in the journal PLOS Medicine is the first to examine whether pictorial health warnings on sugary drinks, like juice and fizzy drinks, influence whether or not parents purchase these types of beverages for their children.
The study’s results found that these warnings reduced parental purchases of sugary drinks for their children by 17%.
Researchers at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health ran the study in a unique laboratory by creating the “UNC Mini Mart”. This space was set up to mimic a convenience store and simulate a realistic setting for a shopping experience.
“We created this store because we saw a major need for research that tests the impact of policies in a food store setting that is much more realistic,” said senior author Lindsey Smith Taillie, PhD, assistant professor in the Department of Nutrition at the Gillings School and a member of UNC’s Carolina Population Center (CPC). “When people make choices about what food to buy, they are juggling dozens of factors like taste, cost, and advertising and are looking at many products at once. Showing that warnings can cut through the noise of everything else that’s happening in a food store is powerful evidence that they would help reduce sugary drink purchases in the real world.”
Taillie’s and her co-authors’ positive findings about the effects of image-based warning labels highlight a recent approach to combating the global struggle with obesity. Children in the United States and many other countries, including the UK, consume more than the recommended amount of sugary drinks, which increases their risk for obesity and other diet-related chronic diseases, including Type 2 diabetes.
Taillie has conducted research on warning labels and taxes on sugar-sweetened beverages and junk food in Chile, Mexico and South Africa. Marissa G. Hall, PhD, one of the study’s co-authors, researches the impact of warnings on tobacco and food as well as effectiveness of obesity prevention policies.
In their study, 326 parents of children between the ages of 2 to 12 years old participated in a randomised trial with 1) a pictorial warning arm (in which drink labels had images representing heart damage and Type 2 diabetes), and 2) a control arm (in which drinks labels displayed a barcode).
Participants were instructed to choose one drink and one snack for their child, along with one household good, the latter being added to the shopping list to potentially mask the purpose of the study. After shopping, participants completed a survey about their selections and left with their drink of choice and a cash incentive.
The picture warnings led to a 17% reduction in purchases of sugary drinks, with 45% of parents in the control arm buying a sugary drink for their child compared to 28% in the pictorial warning arm.
The warnings also reduced calories purchased from sugary drinks and led to parents feeling more in control of healthy eating decisions and thinking more about the harms of sugary drinks.
“We think the paper could be useful for policymakers in the U.S. and globally,” Hall says. “This evidence supports strong, front-of-package warnings to reduce sugary drink consumption in children.”
Read MoreIrish government steps up plans to tackle nation’s growing obesity crisis
The Irish government has stepped up its plans to tackle the nation’s growing obesity crisis through the establishment of a task force that will look at the ways saturated fat, salt, sugar and calories can be reduced in processed food that is prevalent in Ireland.
Along with the task force a ‘Roadmap for Food and Product Reformation in Ireland’ was also published by the Minister for Health Stephen Donnelly and the Minister of State for Public Health Frank Feighan.
Mr Donnelly highlighted the links between diet and non-communicable diseases and noted that it was “particularly evident in economically disadvantaged areas, where people tend to eat more processed food”. He also suggested that the new task force would work with the food industry “to combat inequality by improving the quality of the food available”.
Mr Feighan suggested that modern lifestyles were having a negative impact of people’s health and said that people were “living very busy lives and it’s not always easy, even with the best of intentions, to eat or buy the healthiest option”. He then suggested that the task force and road map were “important and positive steps forward for all of our health and wellbeing and will help to improve the nutritional quality of the processed food available to consumers and will have tangible benefits for public health”.
The Food Reformulation Task Force will sit within the Food Safety Authority of Ireland (FSAI) and will provide “a dedicated resource to work with all levels of industry to ensure progress and to address the difficulties that may arise in the highly technical process of reformulation”. FSAI chief executive Dr Pamela Byrne said the reformulation of foods has been proven to have a “positive impact on the quality of the diet and reducing salt, sugar and saturated fats in food products will positively contribute to a healthier population”. She said the FSAI would be engaging “with the food industry and other stakeholder” over the next four years.
The move comes as more retailers and producers move to make their products less harmful.
Read MoreObesity raises risk of gum disease
According to new research from the University of Buffalo, chronic inflammation caused by obesity may trigger the development of cells that break down bone tissue, including the bone that holds teeth in place. The study sought to improve understanding of the connection between obesity and gum disease.
The study also found that excessive inflammation resulting from obesity raises the number of myeloid-derived suppressor cells (MDSC), a group of immune cells that increase during illness to regulate immune function. MDSCs, which originate in the bone marrow, develop into a range of different cell types, including osteoclasts, a cell that breaks down bone tissue. This research was published in October in the Journal of Dental Research
Also known as periodontal disease, gum disease affects more than 47% of adults 30 years and older, according to the Centers for Disease Control and Prevention. Bone loss is a major symptom of gum disease and may ultimately lead to tooth loss.
Keith Kirkwood, professor of oral biology in the School of Dental Medicine at the University of Buffalo said the following about the study, “although there is a clear relationship between the degree of obesity and periodontal disease, the mechanisms that underpin the links between these conditions were not completely understood.”
“This research promotes the concept that MDSC expansion during obesity to become osteoclasts during periodontitis is tied to increased alveolar bone destruction,” says Kyuhwan Kwack, postdoctoral associate in the Department of Oral Biology. “Taken together, this data supports the view that obesity raises the risk of periodontal bone loss.”
The findings may shed more light on the mechanisms behind other chronic inflammatory, bone-related diseases that develop concurrently with obesity, such as arthritis and osteoporosis, Kirkwood says.
Read MoreExperts warn of obesity “pandemic” in Spain
On November 17, 2021, the Spanish Obesity Society (Seedo) launched a campaign asking for a new national multidisciplinary and transversal plan aimed at addressing Spain’s growing obesity epidemic.
According to recent data, more than 60 percent of Spanish adults are considered overweight, 24% of which have obesity and 40 percent of children between 6 and 9 years old are considered overweight, and this is unlikely to have improved during the pandemic. These figures have led specialists to predict what’s been described as a “tsunami of cases” in the coming decades.
“Obesity is a problem that will accompany us in the coming years if strong measures are not taken now,” warned the president of Seedo, Francisco Tinahones. “Strategies must be proposed to prevent and fight obesity because it is not an aesthetic problem but one of the most important diseases facing our health systems.” Tinahones clarified the need for a global plan to tackle obesity, and that the small specific actions taken so far had been merely “drops in the ocean of obesity,” and not useful.
Tinahones proposes that this new strategy include financing from the health system for obesity medication, a tax policy that penalises unhealthy food products and encourages healthy ones, food labelling that clearly reflects how healthy or unhealthy a product is, regulations that prohibit certain advertisements, urban planning that creates spaces for exercise, and the promotion of physical activity.
Read MoreCan rye help reduce weight and obesity?
New research published in Clinical Nutrition has indicated that consuming whole grain rye products can benefit your health greater than refined wheat products. The new study was conducted at Chalmers University of Technology, Sweden. It examined how people lost more body fat and weight when eating a diet with high-fibre products containing whole grain rye, compared to those who ate refined wheat products.
This study is the biggest to look at the consequences of consuming specific grains on body weight and body fat, and the first to examine rye specifically. Scientists have also suggested that obesity is caused by what we are eating, and not by how much.
Researchers analysed 242 men and women with overweight aged from 30 to 70 for 12 weeks. Their weight, body composition, blood samples, and appetite was examined at the start, halfway through, and end of the study. The participants were given a specific daily quantity of either whole grain rye or refined wheat, both with the same energy value, and were given the same guidance from a dietician on how to eat healthily.
Although both the rye and wheat groups lost weight during the study, those who ate rye products lost an average of one kilogram more than those who ate wheat products, with the difference attributable to fat loss.
“Although we saw an overall difference in weight loss between the rye and the wheat group, there was also very large variation within those groups. Increasing our understanding of why different people respond differently to the same foods can pave the way for more specifically tailored diets based on individual needs,” says Rikard Landberg, Professor of Food and Health at Chalmers University of Technology.
Obesity and excess weight are among the biggest health challenges in the world and require many different measures. One idea is to develop foods that contribute to an increased feeling of fullness and have positive effects on metabolism, and previous studies had observed that those who eat rye, which has a very high content of dietary fibre, feel more full than those who eat the corresponding amount of energy in the form of refined wheat.
“But surprisingly,” says Kia Nøhr Iversen, “in this study, we actually never observed any difference in appetite. We think this may be simply because the method we used to measure appetite was not good enough. We are therefore working on evaluating and developing the method further.”
Read MoreChildhood Obesity: A Growing Pandemic
Reported in The Lancet, childhood obesity rates have increased substantially over the past year in the UK, according to a new report from the UK Government’s National Child Measurement Programme. The report details that this rise in prevalence is the largest single-year increase since the programme began 15 years ago and highlights a trend in obesity among children and adolescents not just in the UK, but worldwide. The trend now extends to both low-income and middle-income countries despite obesity once being seen as a problem mainly for high-income countries. Childhood obesity has long been a cause for concern, but the effects of the pandemic and national lockdowns has added to the issue, making childhood obesity an undeniable public health crisis and one that should be addressed imminently.
A different lifestyle brought about because of lockdown measures including school closures, restrictions on leaving the house, and limitations on meeting new people has meant children have seen a huge jump in screen time and have become more sedentary than they were previously. The CDC Morbidity and Mortality Weekly Report measured the effects of these lifestyle changes and it notes that the rate of BMI increase almost doubled in US children and adolescents aged 2–19 years during the pandemic compared to pre-pandemic. Children with overweight and obesity are more likely to become adults with obesity and to develop a host of non-communicable diseases including type 2 diabetes and cardiovascular disease, and have an increased risk of cancer, premature death, and disability later in life.
Read MoreMeet CCH PGDip Graduate, Shaimaa Alasfour!
Shaimaa graduated from CCH in 2020 with a Postgraduate Diploma (PGDip) in Obesity Care and Management (now Lifestyle Medicine). Since her graduation she has found fulfilment and happiness working at a health center, using her specialist training in obesity care to make a meaningful impact in the lives of her patients with obesity. Here we have interviewed her about the impact she is making with her postgraduate qualification from CCH.
Q: Hi, Shaima! Where do you work at the moment?
A: At the moment I work in the state of Kuwait, at the Al Nuzha Health Center.
Q: What profession do you work in?
A: I’m currently a consultant in family medicine at MRCGP International, and I specialise in obesity medicine and management as more of a subspecialty.
Q: Who are some of the patients you assist on a day-to-day basis?
A: On a day-to-day basis I deal with many different patients with a variety of diseases from acute to chronic, and also non-communicable conditions which affect all different age groups and ethnicities.
Q: What percentage of your patients have overweight or obesity?
A: It is well known that Kuwait has the highest prevalence of obesity in comparison with other regions in the Gulf. Also, obesity has a significant association to other chronic conditions such as diabetes melitus, hypertension, and so on. I can’t say definitively what percentage of my patients have an abnormally high BMI, but I would say it is more than 75-80% of them that do, and 90% of those patients have some sort of chronic disease from obesity which is why they’re visiting the clinic.
Q: Why did you choose to study obesity care and management?
A: You will be surprised to know that my first choice was to study geriatric care, but luckily, God chose the right path for my career and that was to help and assist with many people, but especially those who have undergone bariatric surgery, and children with obesity, many of whom suffer in silence. During the Covid-19 lockdowns, everyone was affected either mentally or physically, but I felt that children were most significantly affected, especially with weight regain. That is why I have become more focused on children. I want them to live normal and healthy lives without the risk of cardiovascular disease that childhood obesity can bring about.
Q: Why did you choose CCH?
A: There were many important reasons behind my decision to study with CCH. Firstly, I knew CCH could really increase my knowledge in this area, but I also knew they could help enhance my clinical skills as well. Upon studying with CCH, I really noticed an improvement in my critical thinking skills, and also how significantly improved my writing skills became!
Q: How did gaining your PGDip at CCH enhance the care that you provide to your patients?
A: I noticed positive changes during my fellowship in obesity management with Imperial College London especially at the multi-disciplinary team meetings and daily clinic attendance. It also increased my interest in childhood obesity.
Q: What is one of the biggest takeaways you gained from your PGDip as a health professional?
A: My PGDip has made me a lot more confident when treating people with obesity, and it’s also given me a real passion to do it as well!
Q: Would you encourage other health professionals to pursue a PGDip with CCH?
A: Yes, definitely! I would encourage anyone who is interested to go ahead and learn about the mystery of obesity and enrol with the CCH. You’ll start with the basics, and believe me, you will never want to stop until you’ve covered all aspects of obesity!
The College of Contemporary Health, in partnership with the University of Central Lancashire Medical School, offers the first, and only, fully online postgraduate qualifications (PGCert/PGDip/MSc) in Lifestyle Medicine (Obesity Care) not just for UK based students, but for students across the world, like Shaimaa in Kuwait.
We offer 3 student intakes per year starting in January, May, and September.
Click here to apply: Apply for a Postgraduate Qualification in Lifestyle Medicine (Obesity Care).
What is Lifestyle Medicine?
Obesity, along with many other non-communicable diseases, is the result of a complex range of factors, many of which relate to lifestyle, and are underpinned by physical, emotional, environmental and social determinants.
Lifestyle medicine (LM) seeks to address these underlying issues to improve the health and wellbeing of individuals and societies. LM offers healthcare professionals and patients a powerful tool for obesity prevention and treatment. LM is not, on its own, the answer to the obesity crisis, but for most people it will be part of the solution.
Lifestyle medicine is an evidence-based approach to educating, guiding and supporting individuals and populations to make positive behaviour changes, with:
A focus on:
- healthy eating
- physical activity
- stress management and
- adequate sleep.
It also emphasises the importance of good mental health and interpersonal relationships, and the individual’s home and community environment.
Lifestyle medicine recognises the need for, and the continued importance of, other therapeutic interventions for obesity, including pharmaceutical and surgical, where appropriate.
The College of Contemporary Health, in partnership with the University of Central Lancashire Medical School, offers the first, and only, fully online postgraduate qualifications (PGCert/PGDip/MSc) in Lifestyle Medicine (Obesity Care) not just for UK based students, but for students across the world.
We offer 3 student intakes per year starting in January, May, and September.
Click here to apply: Apply for a Postgraduate Qualification in Lifestyle Medicine (Obesity Care).