BMI found outdated for childhood obesity measurement in Bristol study
A groundbreaking study hailing from Bristol has shed new light on the efficacy of current methods used to assess childhood obesity, proposing a shift towards a more precise alternative. This research scrutinises the longstanding reliance on Body Mass Index (BMI) for evaluating obesity in children, suggesting that the waist-to-height ratio (WHtR) could serve as a superior metric.
The comprehensive analysis spanned over 15 years and delved into the health metrics of 7,237 children, each nine years of age, revealing significant insights. These findings challenge the existing guidelines that favour BMI as the standard obesity measure, underlining the urgent need for more accurate obesity detection in paediatric health.
Published in the prestigious journal Paediatric Research, this study is a component of the expansive Children of the 90s project, drawing attention to the escalating obesity rates amongst 10 and 11-year-olds in England, a surge notably exacerbated by the Covid pandemic and yet to recede to pre-pandemic figures.
Professor Julian Hamilton-Shield, a consultant paediatrician at the Bristol Royal Hospital for Children and a leading figure in the study, voiced concerns over the increasing prevalence of severe obesity and its complications observed in his weight management clinic. “The uptick in severe obesity levels and its attendant severe complications underscores the necessity for reliable measures that offer a clearer insight into an individual’s health status,” stated Prof Hamilton-Shield.
The research team scrutinised BMI data sourced from the government’s National Child Measurement Programme, which annually assesses approximately a million Year 6 students across England. While BMI has been a cornerstone in determining healthy weight parameters, offering a simple and quick assessment method based on height and weight, its limitations are becoming increasingly apparent. Specifically, BMI fails to account for body frame variations or muscle mass, rendering it an incomplete measure of body fat.
This limitation is particularly poignant when considering that BMI might categorise individuals with significant muscle mass, such as rugby players, as having obesity, highlighting its outdated nature. In contrast, the study, conducted in collaboration with researchers from the University of Bristol, the University of Exeter, and the University of Eastern Finland, advocates for the WHtR as a viable replacement for BMI. This method promises a more accurate assessment of excess fat mass in children and adolescents.
Professor Andrew Agbaje, the lead author of the study, emphasised the practicality and effectiveness of the waist circumference-to-height ratio. “Utilising just a measuring tape, we can accurately identify eight out of ten children who genuinely have obesity. Furthermore, this method allows us to correctly recognise 93 out of 100 individuals who, despite being muscular, would be mistakenly classified as overweight or having obesity by BMI standards,” Prof Agbaje explained.
He further highlighted that unlike BMI, which fluctuates with age and sex, the waist-to-height ratio remains consistent, irrespective of these variables. This finding underscores the potential of WHtR to revolutionise how childhood obesity is measured, offering a more nuanced understanding of body composition and facilitating the identification of true obesity, thus enabling more targeted and effective interventions.
Read MoreStudy highlights higher incidence of musculoskeletal issues in young girls with obesity
Recent research indicates a concerning trend among young girls aged 4 to 11 who are overweight or have obesity, showing they are more frequently visiting GPs for musculoskeletal problems compared to their counterparts of a healthy weight.
The study reveals that girls in their first year of school (reception year) with a Body Mass Index (BMI) classified as overweight have a 24% increased likelihood of attending a GP appointment for a musculoskeletal issue at least once. This probability soars to 67% for girls identified as living with obesity. Furthermore, by the time they reach year 6, girls with obesity are 20% more likely to consult a GP for similar problems. Conversely, boys in the same age bracket with a BMI categorised as underweight were found to be 61% less likely to seek such medical advice compared to their peers of a normal weight.
The most frequently reported problems were related to knee and back pain, as outlined in the results published in the “Archives of Disease in Childhood” journal, focusing on a specific London area.
Nicola Firman, the study’s lead author and a health data scientist at Queen Mary University of London, emphasised the scarcity of longitudinal studies examining the link between obesity and musculoskeletal health outcomes during childhood. Despite a systematic review revealing a general lack of substantial evidence, this study aims to bridge that gap by investigating these health outcomes in an ethnically diverse population within the UK, known for its high rates of childhood obesity and social deprivation.
Among the youngest participants, knee pain was reported by 46% of boys and 41.5% of girls, with these figures slightly decreasing among year 6 students to 40.4% for boys and 36% for girls. In terms of back pain, 22% of reception year boys and a higher 32% of girls experienced this issue, which increased to 30% for boys and an alarming 45% for girls by year 6.
Interestingly, the study noted that reception year girls with obesity were significantly more inclined to consult their GP over musculoskeletal issues than their healthy weight female peers, a trend not observed among boys.
Firman also referenced studies from Spain and the USA, noting an observed rise in back pain incidents among girls, not boys, highlighting the global need for more longitudinal research to fully understand the relationship between childhood obesity and musculoskeletal health.
The research sample included primary school children from four ethnically diverse local authorities in north-east London.
Katharine Jenner, Director of the Obesity Health Alliance, responded to these findings with concern, stressing that primary school-aged children should be enjoying their youth actively rather than facing the physical limitations and pains leading to GP consultations. She criticised the government’s lack of action on its obesity strategy, pointing out that the goal to halve childhood obesity by 2030 is becoming increasingly unattainable without significant policy changes and implementations.
Research indicates higher likelihood of midlife obesity in individuals whose parents had obesity
In the midst of growing concerns regarding global health, a pivotal study poised for presentation at the esteemed European Congress on Obesity (ECO) in Venice, from 12th to 15th May 2024, sheds light on the intergenerational transmission of obesity, revealing profound insights into how parental obesity significantly influences the likelihood of obesity in their offspring during middle age.
This groundbreaking research, led by Mari Mikkelsen from the Department of Community Medicine at UiT Arctic University of Norway in Tromsø, embarks on a novel investigation into the persistence of obesity from one generation to the next, particularly extending beyond adolescence and well into adulthood—a period often overlooked in previous studies. Mikkelsen’s team delved into the intricate relationship between the Body Mass Index (BMI) of parents and their adult children, employing data meticulously gathered from the Tromsø Study, a comprehensive, ongoing population-based health study.
The analysis encompassed 2,068 parent-offspring trios, focusing on individuals aged 40-59 years who participated in the seventh wave (2015-2016) of the Tromsø Study, with their parents’ data drawn from the fourth wave (1994-1995). The findings illuminate a compelling correlation between the BMI of parents in their middle years and that of their children at a similar stage in life, underscoring a pronounced genetic and environmental legacy of obesity.
Specifically, the study reveals that when both parents had a BMI indicating obesity (BMI ≥ 30 kg/m²) during their forties and fifties, their offspring were six times more likely to experience obesity at the same age compared to those whose parents were within a normal weight range (BMI 18.5-24.9 kg/m²). Moreover, the presence of obesity in just one parent still significantly elevated the likelihood of the offspring living with obesity, with the odds being over three times higher.
An intriguing aspect of the research was the quantification of the BMI transmission effect: an offspring’s BMI increased by 0.8 units for each 4-unit rise in the mother’s BMI and by 0.74 units for every 3.1-unit increase in the father’s BMI. These findings persisted even after adjustments for several variables, including the sex, age, education, and physical activity levels of both parents and offspring.
Mikkelsen’s team provides a nuanced understanding of the multifaceted factors contributing to this familial trend in obesity. Genetic predispositions play a crucial role by influencing susceptibility to weight gain and shaping reactions to an increasingly obesogenic environment. Additionally, shared family behaviours concerning diet and exercise, established during childhood and adolescence, may further perpetuate similar BMI statuses within families.
This profound research not only reinforces the enduring impact of familial obesity patterns but also emphasises the critical need for effective obesity prevention and treatment strategies. By highlighting the long-lasting consequences of parental obesity on their children into middle age, the study paves the way for future research aimed at identifying and mitigating the factors responsible for the intergenerational transmission of obesity. In doing so, it offers hope for breaking the cycle of obesity and fostering a healthier future for subsequent generations.
Read MoreAI breakthrough improves eye exam rates in youth with diabetes
In a ground-breaking study conducted by the Johns Hopkins Children’s Center, researchers have demonstrated a significant leap forward in the field of diabetic eye care through the implementation of autonomous artificial intelligence (AI) for eye examinations. This innovative approach has markedly improved the rate of screening completions among children and adolescents with diabetes, thereby offering a promising avenue to combat the incidence of diabetes-related eye diseases (DED), which can lead to blindness if left unchecked.
The study, which has been a focal point of attention in a recent Johns Hopkins news release, utilises a non-intrusive method whereby images of the retina are captured without the necessity for pupil dilation. Following this, AI technology analyses the images to provide instantaneous results, distinguishing this method from traditional screening procedures which often require an additional appointment and dilation of the eyes.
The significance of this research cannot be overstated, especially considering its potential to bridge healthcare disparities. Historically, minority and economically disadvantaged youth, who are at a heightened risk of developing DED, have faced substantial barriers in accessing regular eye screenings. The AI-driven method heralded by this study not only promises to close these care gaps but also to enhance adherence to screening protocols among these populations.
Published in the esteemed journal Nature Communications, the study analysed eye exam completion rates among individuals under 21 years of age suffering from type 1 and type 2 diabetes. Remarkably, it was found that all participants who underwent the AI-based screenings completed their eye assessments, a stark contrast to traditionally lower adherence rates.
Diabetic retinopathy, a condition affecting 4% to 9% of youth with type 1 diabetes and 4% to 15% of those with type 2 diabetes, underscores the urgency for regular screenings. The American Diabetes Association estimates that approximately 238,000 individuals under the age of 20 are living with diagnosed diabetes, making early detection and treatment of eye conditions critical to preventing the advancement of DED.
Despite the general recommendation for annual screenings, traditional methods have seen a participation rate of only 35% to 72% among young diabetic patients, with even lower rates observed in minority and economically disadvantaged groups. Barriers such as confusion over the necessity of screenings, inconvenience, and lack of accessibility have all contributed to this shortfall.
The Johns Hopkins study introduced a novel solution to these challenges by incorporating autonomous AI screening into routine visits to the endocrinologist, thereby eliminating the need for separate appointments and the discomfort of eye dilation. This method, which involves taking four images of the eye to assess for diabetic retinopathy, has not only streamlined the screening process but also facilitated immediate follow-up actions when necessary.
This research initiative enrolled 164 participants from the Johns Hopkins Pediatric Diabetes Center, with a demographic makeup that was both gender and ethnically diverse. The findings revealed a 100% completion rate for eye exams among the group subjected to AI screenings, a significant improvement over traditional methods.
The study’s lead, Dr. Risa Wolf, emphasised the dual benefits of this approach: increased screening rates and the potential to enhance health equity. By making screenings more accessible and convenient, the researchers hope to prevent the progression of diabetic eye disease across all demographics.
However, it is important to note the study’s limitations, including the current FDA approval status of the autonomous AI for individuals under 21 and the potential bias due to some participants’ prior familiarity with AI screenings from a previous study.
Funded by the National Eye Institute of the National Institutes of Health and the Diabetes Research Connection, this study represents a pivotal step forward in diabetic eye care. It not only underscores the transformative potential of AI in healthcare but also highlights the critical need for innovative solutions to improve access and outcomes for vulnerable populations.
Read MoreHealth experts raise alarm over ‘appalling decline’ in UK child health
In a stark warning to the nation, leading health experts have highlighted an ‘appaling decline’ in the health and wellbeing of the UK’s children, attributing this trend to increasing instances of obesity and tooth decay among the youth. The Academy of Medical Sciences has released a report urging immediate intervention to halt the decline of physical and mental health in children under five years of age across Britain.
Professor Helen Minnis, co-chair of the report and a distinguished academic from the University of Glasgow, has painted a grim picture of the current state of child health in the UK. “We are witnessing a disturbing increase in child mortality rates, with the UK lagging in infant survival compared to its peers. A plethora of preventable physical and mental health issues is afflicting our youngest, which demands prompt and decisive action,” Minnis stated.
The report sheds light on alarming statistics, revealing that over 20% of children aged five have either obesity or overweight. Furthermore, tooth decay has emerged as a prevalent concern, affecting one in four children. The financial repercussions of this health crisis are staggering, with the report estimating the cost to exceed £16 billion annually.
A particularly concerning trend noted in the report is the decline in vaccination rates across the UK, which now fall below the safety benchmarks established by the World Health Organization. This decline poses a significant threat to the nation’s capability to fend off future outbreaks of severe childhood illnesses.
This call to action resonates amid a growing chorus among medical professionals advocating for enhanced access to childhood vaccinations and addressing the rising vaccine hesitancy within certain communities.
The report also forecasts that the issue of child health, particularly the increasing rates of obesity and declining stature compared to international standards, will become a focal point in the forthcoming general election.
The Labour Party has pointed fingers at the current government’s policies for exacerbating health issues among children, particularly highlighting tooth decay as the leading cause of hospital admissions for children between six and ten years of age.
“The evidence is unequivocal: we are failing our children. If we do not place the health of infants and young children at the forefront of our priorities, we risk consigning many to a future of diminished health and unfulfilled potential. The moment to act is now,” Professor Minnis stated emphatically.
The Royal College of Paediatrics and Child Health has backed the report’s findings, describing them as “alarming evidence that the UK is failing too many of its children.”
In response, a government spokesperson defended the administration’s track record, highlighting several measures aimed at improving child health. “Significant steps have been taken, including substantial reductions in sugar content in children’s food, investing over £600 million to enhance the quality of children’s sports, and promoting healthy diets among lower-income families through initiatives like Healthy Start,” the spokesperson noted.
Additionally, the government underscored its investment of an extra £2.3 billion annually into mental health services and pointed to a 14% increase in the number of children seen by NHS dentists in the previous year as evidence of its commitment to reversing the decline in child health.
Read MoreStudy finds some 40% of Chinese children face obesity by 2030
A comprehensive study recently unveiled alarming projections that nearly 40% of Chinese children and adolescents are on track to have overweight or obesity by the year 2030 if current upward trends persist. This pressing issue has prompted calls from experts for immediate action to mitigate the looming health crisis, with proposed strategies including the implementation of a 20% levy on sugar-laden beverages.
The research, which was published in The Lancet Regional Health last month and conducted by a collaborative team from the School of Public Health at Peking University and the United Nations Children’s Fund, highlights the swift rise in obesity rates among the youth in China, pinpointing significant consequent health and financial repercussions.
The study’s forecasts paint a grim picture, estimating a staggering lifetime economic toll of 218 trillion yuan (approximately $31.6 trillion) from 2025 to 2092, attributable to the prevailing rates of obesity among children and adolescents in the absence of intervention strategies.
Zhou Maigeng, Deputy Director of the National Center for Chronic and Noncommunicable Disease Control and Prevention at the Chinese Center for Disease Control and Prevention, stressed that the economic strain posed by the increasing prevalence of children with overweight and obesity is often overlooked, as many related health complications have yet to manifest.
Alarm bells have already been sounded by data concerning adult obesity, which forewarns of the annual costs of chronic diseases linked to excess weight reaching 49 billion yuan by 2030, according to Zhou.
The upward trajectory of childhood and adolescent obesity in China has been startling, with prevalence rates soaring from a relatively modest 8.8% in 2000 to an estimated 37.9% in 2020—an increase of 400% over two decades. This surge has not only eclipsed the global average but also surpassed rates observed in certain Western and upper-middle-income nations. Without decisive action, researchers warn that these figures could exceed 60% by 2030.
In response to this growing public health concern, China has initiated several national interventions aimed at curbing the trend, focusing primarily on enhancing nutrition and physical activity within schools. The proposed introduction of a 20% tax on sugar-sweetened beverages, coupled with tighter restrictions on marketing unhealthy food products to children, has been identified as the most effective course of action.
This recommendation aligns with the World Health Organization’s guidance issued in December, urging nations to adopt or amplify existing taxes on sugary drinks as a measure to safeguard public health. The call to action is supported by evidence from countries like Mexico, South Africa, and the United Kingdom, where such fiscal policies have yielded positive outcomes.
Zhang Man, a researcher at Peking University, emphasised the importance of grounding policy decisions in scientific evidence and underscored the need for ongoing monitoring and evaluation of intervention impacts, suggesting adjustments based on observed results to enhance efficacy.
Read MoreCurbing fruit juice intake in childhood may reduce obesity risk, research indicates
Recent research indicates that reducing the consumption of 100% fruit juice in children could be a key strategy in addressing the growing concern of childhood obesity, especially in younger age groups.
Published in the journal JAMA Pediatrics, this study sheds light on a significant issue: children who have overweight or obesity are more likely to maintain this status into adulthood. The researchers, therefore, advocate for limiting fruit juice intake to avoid excess calorie consumption and subsequent weight gain.
A team from the University of Toronto in Canada spearheaded the research, analysing data from 42 previous studies to explore the relationship between drinking 100% fruit juice and weight gain in both children and adults. While the link with adult weight gain requires further exploration, the team observed a definitive correlation between juice consumption and weight gain in children.
The study defined 100% fruit juice as a drink with no added sugar, with a standard serving being 8 ounces. The researchers evaluated data for approximately 46,000 children aged between 1 and 15 years. Their findings pointed to a clear association between each additional serving of 100% fruit juice and an increase in body mass index (BMI), a standard metric for determining overweight and obesity status. The team highlighted that, unlike whole fruits, juice lacks significant fibre, potentially leading to high calorie intake without a corresponding feeling of fullness.
The American Academy of Pediatrics has set guidelines advising against fruit juice for infants under one year and recommending a daily limit of 4 ounces as part of a meal for toddlers and young children. For children aged 1 to 6 years, the intake should not exceed 6 ounces per day.
On its website, the Academy emphasises, “Fruit juice offers no nutritional benefits over whole fruit,” pointing out that whole fruits also contain fibre and other essential nutrients. It advises against giving fruit juice at bedtime and cautions against its use in managing dehydration or diarrhoea.
The urgency of addressing childhood overweight and obesity is underscored by alarming statistics from the U.S., where 1 in 5 children aged 2 to 19 years have obesity. Obesity in childhood carries the risk of serious health issues such as high blood pressure, high cholesterol, type 2 diabetes, asthma, sleep apnea, and joint problems, according to the CDC.
The study observed that children consuming fruit juice gained more weight than those drinking zero-calorie beverages, like water. This weight gain was most pronounced in children aged 8 years and younger when compared to their peers consuming non-caloric drinks.
The types of juice consumed included pomegranate, berry, tart cherry, apple, citrus, and grape, with no noticeable differences in BMI impact based on juice type. The researchers suggested that weight gain could be attributed to the high liquid calorie content in fruit juice and the rapid absorption of fructose, which can affect liver function and cholesterol levels.
In conclusion, the study supports public health recommendations to limit the consumption of 100% fruit juice as a preventative measure against overweight and obesity in children.
Read MoreExcessive school holiday downtime linked to rising health concerns in children
The extended school holidays, a period of relaxation and rest for educators and students alike, may be inadvertently contributing to health issues in children. Recent research highlights a worrying trend of increased weight gain during these leisure times, particularly among children.
In Australia, the prevalence of children and teenagers with overweight or obesity stands at one in four, reflecting a global issue where over 124 million children and adolescents have obesity. These alarming figures have spurred governments, educational institutions, and communities to advocate for enhanced physical activity and healthier eating habits among the younger demographic.
The groundbreaking ‘Life on Holidays‘ study, spearheaded by the University of South Australia’s Alliance for Research in Exercise, Nutrition and Activity team, is the first to explore this phenomenon outside the United States. It specifically examined the impact of holiday periods on children’s fitness levels and body composition.
The study’s findings revealed a concerning pattern: children’s body fat accumulates more rapidly during school holidays than during academic terms. Notably, children in Years 4 and 5 exhibited a decrease in physical activity and an increase in sedentary behaviours during their holidays.
Key observations included children sleeping an average of 12 minutes less, engaging in 12 fewer minutes of physical activity daily, and spending an additional 70 minutes on screens each day during holiday periods. Consequently, there was a marked acceleration in body fat accumulation and a more pronounced decline in aerobic fitness compared to term time.
Professor Tim Olds, lead researcher from UniSA, suggests that promoting physical activities during school holidays could be crucial in combating these negative health trends. He notes that while children and their parents rightly deserve holiday downtime, the lifestyle shift during these periods often negatively impacts children’s health.
“On school holidays, kids are significantly less active than when they’re at school, leading to higher body fat percentages and lower levels of fitness,” Professor Olds remarked. He expressed concern over the rapid rate of weight gain and fitness loss during holidays, pointing out the potential long-term health risks such as cardiovascular disease and Type 2 diabetes.
The study, which spanned two years, focused on children aged 9-10 years and involved over 150 participants. Data were collected at the start and end of Terms 1 and 4 across Grades 4 and 5.
Co-researcher Dr Dot Dumuid highlighted that the unstructured nature of school holidays contributes significantly to these trends. She pointed out that children have unrestricted access to food and are prone to increased screen time due to the lack of structured activities.
Dr Dumuid contrasted this with the structured environment of school days, where meals are planned, and physical education lessons and playtimes are scheduled. She suggested that adopting American-style summer camps and holiday programs could be an effective way to address the issue in Australia. These programs, she noted, have been successful in providing children with physical activities in a more structured setting.
“Summer camps and holiday programs have shown positive results in America and could offer a valuable solution during Australian holidays,” Dr Dumuid said. She emphasised the need for a balance between leisure and physical activity, questioning the reliance on devices and TV for child care at the expense of children’s health.
The study underlines the importance of finding a healthy balance between relaxation and physical activity during school holidays. As societies grapple with increasing rates of childhood obesity and associated health problems, initiatives like summer camps and structured holiday programs could play a pivotal role in ensuring the health and well-being of the younger generation.
Read MoreStudy shows early breastfeeding mitigates child obesity, regardless of maternal weight
A recent study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health has revealed a significant correlation between early breastfeeding and reduced childhood obesity risks. This relationship holds true irrespective of the mother’s pre-pregnancy body mass index (BMI).
The ECHO Cohort study delved into the impact of breastfeeding practices in women who had overweight or obesity before pregnancy and its influence on their children’s BMIz scores. BMIz scores are used to compare a child’s height and weight against their peers, whereas BMI assesses body weight relative to height.
The research discovered that any consistent breastfeeding during the first three months of an infant’s life was linked with lower BMIz scores at ages 2 to 6, regardless of the mother’s pre-pregnancy BMI. This association was particularly pronounced in children whose mothers had obesity before pregnancy, compared to those whose mothers were merely overweight.
Dr. Gayle Shipp from Michigan State University, who led the study, emphasised the importance of each additional month of breastfeeding, whether exclusive or combined with other foods, in contributing to lower childhood weights. This effect was notably significant for mothers who had overweight or obesity before pregnancy.
The study analysed data from 8,134 mother-child pairs across 21 sites in 16 states and Puerto Rico. It examined BMI and BMIz scores obtained from study visits, medical records, or self-reported information. The research particularly focused on two aspects of breastfeeding: whether the mother ever breastfed and if she was exclusively breastfeeding at three months. The definition of continuous breastfeeding included any breastfeeding duration with the allowance of formula or other food, and the duration of exclusive breastfeeding without formula feeding or other food.
The study found that exclusive breastfeeding at three months was linked to a lower child BMIz score primarily among women with a normal pre-pregnancy BMI. Each additional month of either any or exclusive breastfeeding correlated with a significantly lower child BMIz score, especially for mothers who had overweight or obesity before pregnancy.
Dr. Shipp highlighted the significance of this research for health professionals, suggesting it as an opportunity to promote breastfeeding among all women, particularly those with obesity. The study’s findings have been published in the journal Pediatrics.
Study confirms light exercise effectively counters childhood obesity
Childhood obesity, a growing concern worldwide, might have a surprisingly straightforward solution: light exercise. Recent research led by an international team of scientists from the Universities of Exeter, Eastern Finland, Bristol, and Colorado, underscores the profound impact of light physical activity in combating the rise of obesity in children.
Drawing from the University of Bristol’s Children of the 90s study, the research tracked 6,059 children (53% female) from age 11 to 24. Amid global reports revealing a worrying trend of inactivity among adolescents — with over 80% failing to meet the World Health Organization’s guidelines for daily physical activity — the study presents an urgent narrative. The lack of exercise is anticipated to contribute to 500 million new cases of noncommunicable diseases by 2030, costing an estimated $23 million annually.
What’s striking about the study is the revelation that light physical activity, rather than moderate-to-vigorous exertion, plays a crucial role in reducing fat mass gain in youth. Dr. Andrew Agbaje of the University of Exeter, a key contributor to the study, emphasises the overlooked benefits of light physical activities like walking, household chores, and leisurely swimming. He suggests shifting public health messages from an emphasis on 60 minutes of moderate-to-vigorous activity to encouraging at least three hours of light activity daily.
Participants were observed over 13 years, with physical activity levels and health markers meticulously monitored using waist-worn accelerometers and dual-energy X-ray absorptiometry. The results were startling: each additional minute of sedentary behaviour correlated with a 1.3-gram increase in total body fat mass. In contrast, each minute of light physical activity corresponded to a 3.6-gram decrease in total body fat mass, amounting to a significant reduction of 950 grams to 1.5 kilograms over the study period.
In comparison, moderate-to-vigorous physical activity showed a minimal effect, reducing total body fat mass by only about 0.7 to 1.7 percent. This finding challenges the prevailing public health guidelines, which predominantly advocate for higher-intensity exercise.
The study, published in Nature Communications, calls for a reevaluation of health guidelines and policy statements, urging public health experts, policymakers, and parents alike to promote light physical activity as a key strategy in preventing childhood obesity. As Dr. Agbaje concludes, sustaining light physical activity can be the much-needed antidote to the detrimental effects of a sedentary lifestyle in young populations.
Rates of severe obesity in young American children are escalating, study reveals
A recent study published in the journal Pediatrics presents alarming evidence that severe obesity is on the rise among young children in the United States.
This concerning trend was initially hoped to be an exception for children participating in a government food programme, as earlier research indicated a slight decline in obesity rates about a decade ago among these children. However, the updated findings from 2020 show a rebound in the rate, countering the previous optimism.
National data align with these findings, suggesting that approximately 2.5% of preschool-aged children across the U.S. were classified as having severe obesity during the same period.
“We were doing well and now we see this upward trend,” stated Heidi Blanck of the U.S. Centers for Disease Control and Prevention, one of the authors of the study. “We are dismayed at seeing these findings.”
The study focused on children aged 2 to 4 who were enrolled in the Women, Infants and Children (WIC) programme, which offers healthy food and additional services to preschool-aged children from low-income families. Measurements and weights of the children were recorded for the study.
The researchers observed that 2.1% of children in the WIC programme had severe obesity in 2010. By 2016, this percentage had decreased slightly to 1.8%. However, by 2020, the rate had risen to 2%, equating to about 33,000 of the more than 1.6 million children in the WIC programme.
Twenty states recorded significant increases, with California exhibiting the highest rate at 2.8%. Notable rises were also seen in certain racial and ethnic groups, with the highest rate of approximately 2.8% found among Hispanic children.
Experts warn that severe obesity in early childhood is almost irreversible and is closely linked to chronic health issues and premature mortality.
The reasons for the increase in obesity rates remain unclear, according to Blanck. Some experts had previously attributed the decline in WIC obesity rates to policy changes in 2009, which included adjustments to food packages such as the removal of juice for infants, reduced saturated fat, and increased accessibility to fruits and vegetables.
Despite these policy changes remaining in effect, “the daily hardships that families living in poverty are facing may be harder today than they were 10 years ago, and the slight increases in the WIC package just weren’t enough,” suggested Dr. Sarah Armstrong, a Duke University childhood obesity researcher.
The study faced several challenges, including a decline in the number of children participating in the WIC programme over the past decade. Furthermore, the study period encompassed 2020, the year the COVID-19 pandemic began, leading to fewer parents taking their children for doctor visits and thus a reduction in the amount of complete data available.
Deanna Hoelscher, a childhood obesity researcher at the UTHealth Houston School of Public Health, commended the study despite its limitations, noting that “it gives you a hint of what’s going on.”
Post-2020 developments in childhood obesity rates are yet to be fully understood. Some smaller studies have indicated a significant increase in childhood obesity, particularly during the pandemic, when children were homebound from schools, experiencing disrupted eating and bedtime routines, and reduced physical activity.
“We are thinking it’s going to get worse,” Hoelscher added, highlighting concerns about the trajectory of childhood obesity in the wake of the pandemic.
Read MoreUS panel of health experts advocate early interventions for childhood obesity from age 6
A panel of U.S. health experts has put forth a draft recommendation advocating for children with obesity to begin receiving comprehensive counselling aimed at fostering healthy eating and exercise habits, starting at the age of 6. This guidance, issued by the U.S. Preventive Services Task Force (USPSTF), builds upon their 2017 recommendation which suggested that obesity screening should commence from the same age.
Recent research underscores the value of intensive behavioural interventions, defined as a minimum of 26 hours of counselling with one or more health professionals, in aiding children and adolescents to achieve and maintain a healthy weight and enhance their overall quality of life. However, the recommendation does not set a specific timeframe for these interventions.
The USPSTF’s updated advice does not delve into the use of weight-loss medications like Novo Nordisk’s Wegovy, approved for use in children aged 12 and above, nor does it address surgical options. The Task Force reviewed evidence surrounding weight-loss medications but noted that further research is needed to fully grasp the long-term health impacts of such treatments.
According to Dr. Katrina Donahue from the University of North Carolina School of Medicine and a member of the Task Force, the proposed behavioural interventions encompass a combination of physical activity, behaviour change support, and education on healthy eating. Recognising that available resources vary by location, Donahue acknowledged that the implementation of these interventions might differ across cities.
The recommendation is backed by data from 58 randomised controlled trials involving over 10,000 children, which demonstrated the effectiveness of these interventions when a child engages in at least 26 hours of professional contact. The evidence for these intensive interventions received a “grade B” from the USPSTF, indicating high certainty of at least moderate benefit. The children in these trials lost an average of 4 to 6.5 pounds (approximately 2 to 3 kilograms), with the reductions being sustained for at least a year.
Childhood and adolescent obesity, through the age of 19, is defined as having a body mass index (BMI) – a weight-to-height ratio – higher than that of 95% of peers of the same age and gender. Nearly one in five U.S. children and teenagers are categorised as having obesity, based on data from the U.S. Centers for Disease Control and Prevention (CDC).
The American Academy of Pediatrics (AAP) guidelines also endorse lifestyle support, including over 26 hours of face-to-face, family-based, multicomponent treatment spanning 3 to 12 months. Additionally, the AAP recommends paediatricians consider weight-loss drugs for children with obesity aged 12 and over and to refer adolescents aged 13 and older with severe obesity for metabolic and bariatric surgery evaluation.
The USPSTF’s draft recommendation is open for public comment until the 16th of January 2023, inviting a wider discourse on the proposed approach to tackle childhood obesity.
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