The Outlook for Childhood Obesity

As obesity rates among American children continue to rise, researchers and other pediatric health care professionals are reporting dire results - and predicting drastic consequences. With effects that include a lowered quality of life, an increased likelihood of contracting several serious disorders, and a potential reduction in life expectancy, obesity and youth are proving to be a disastrous combination.

The immediate and long-term consequences of the childhood obesity epidemic have drawn the attention of the nation's premier pediatricians and public health experts. For example, in several of the speeches he has given since being named acting surgeon general of the United States, Steven K. Galson has referred to childhood obesity and overweight as "among the foremost health challenges of our time" and has stated that the increased development of chronic diseases associated with obesity has become "a catastrophe."

THE EPIDEMIC

The past three decades have seen a dramatic increase in the prevalence of overweight and obesity among American youth. According to the ChildTrends Data Bank, an analysis of data collected between 2003 and 2004 discovered that more than 17 percent of American adolescents ages 12 to 19 were overweight, which is more than triple the 5-percent rate found by researchers from 1976 to 1980. Among children ages 6 to 11, the rate rose from 6.5 percent to 18.8 percent.

On May 17, 2008, The Washington Post cited the following statistics in the inaugural entry of its five-part series on overweight youth:

• In 1963, the average 10-year-old girl weighed 77 pounds and the average 10-year-old boy weighed 74 pounds. By 2008, both of those averages had increased by 11 pounds.
• Only 2 percent of American children eat what the U.S. Department of Agriculture defines as a healthy diet.
• Consumption of soft drinks - the leading source of added sugars for adolescents in the United States - has increased 300 percent since 1988.

As the nonprofit Institute of Medicine of the National Academies has noted, childhood obesity is on the rise among both boys and girls, and weight increases in U.S. children have been observed across all age, race, and ethnic groups. The IOM is one of many agencies and organizations that continue to report on the significant immediate and long-term health effects associated with childhood overweight and obesity.

THE EFFECTS

The experts have not been shy in their attempts to express the enormity of the challenges that have resulted from the continuing prevalence of overweight and obesity among American youth.

As William H. Dietz of the Centers for Disease Control and Prevention told The Washington Post, "There's a huge burden of disease that we can anticipate from the growing obesity in kids."

With more of their patients developing overweight and obesity, pediatricians are diagnosing more children with weight-associated conditions that were previously found almost exclusively in adults. Hypertension, type-2 diabetes (once referred to as "adult onset diabetes"), and high cholesterol are among the most serious disorders that are affecting younger and younger children.

Various studies have also indicated that overweight and obese youth are at risk of developing the following conditions:

• Asthma - Though researchers have yet to clarify the cause-effect relationship between asthma and obesity, they have established a clear association between the two. The American Obesity Association has noted that children who suffer from moderate-to-severe asthma are significantly more likely to be overweight, and several studies have determined that asthma-related emergency room visits by overweight and obese children are more likely to result in hospitalization than are similar visits by children with lower body mass indices. As Jeffrey Fredberg of the Harvard School of Public Health told Medical News Today, "Obesity has the capacity to impact lung function in a variety of ways. None of them are good and all of them are poorly understood."
• Liver disease - As recently as the mid-1990s, fatty liver disease (one of the primary causes of cirrhosis of the liver), wasn't seen in children. Today, it is the most common liver disease among American youth, according to Dr. Miriam Vos of the Emory University School of Medicine, who was quoted in an Oct. 19, 2006, article in the Atlanta Journal-Constitution. Often associated with alcoholism, cirrhosis is a potentially life-threatening condition that can lead to fatigue, nausea, jaundice, mental confusion, and, ultimately, liver failure.
• Metabolic syndrome - Associated with abdominal obesity, elevated blood pressure, and insulin resistance, metabolic syndrome puts individuals at greater risk of coronary heart disease, stroke, and other disorders related to the buildup of plaque on artery walls.
• Precocious puberty - A number of studies have associated obesity and overweight with the rising rate of "precocious puberty," the onset of puberty in girls younger than age 8. According to Krista Hopkins, a spokesperson for the University of Michigan Health System, studies have indicated that starting puberty and beginning to menstruate at too young of an age can result in "higher rates of behavioral problems and psychosocial stress, as well as earlier initiation of alcohol use, sexual intercourse, and increased rates of adult obesity and reproductive cancer."
• Sleep disorders - As with asthma and obesity, researchers have yet to pin down the exact nature of the cause-effect relationship between being overweight and not sleeping properly, but they have noted a compelling connection. For example, a study that was published on the February 2008 edition of the research journal Obesity found that children whose sleep duration fell short of their age-recommended amount by at least two hours were twice as likely to be overweight than were their properly sleeping peers. As reported on the WebMD website, the researchers noted that the likelihood that a child was obese was reduced by an average of 9 percent for each extra hour of sleep.

THE OUTLOOK

Perhaps the most startling effect of the childhood obesity epidemic is the estimated impact on the life expectancy of American youth. A study cited in the May 18, 2008, edition of The Washington Post indicates that, for the first time in U.S. history, the average lifespans of today's children may be shorter than those of their parents, "unless aggressive action manages to reverse obesity rates."

S. Jay Olshansky, lead author of the 2005 study that predicted a two-to-five-year reduction in average life expectancy, told the Post that in the time that has passed since his findings were released, he has grown even less optimistic about the lasting damage inflicted by childhood obesity. "Five years [reduced life expectancy] might be an underestimate," Olshansky said.

Research performed at the Harvard School of Public Health supports Olshansky's conclusions. As reported in the Annals of Internal Medicine, a study of 102,400 women indicated that those who were overweight or obese by age 18 had a greater likelihood of dying of cancer or heart disease by middle age than did women who entered adulthood with a body mass index in the normal range. The study, which was conducted over a 12-year period, involved women who were ages 24 to 44 and cancer-free when the research began.

Dr. Pavel Bence, a chiropractor from Sterling Heights, Michigan, was quoted in The Source News saying that the findings of the Harvard research indicate that "childhood obesity is a death sentence."

In addition to enduring the health consequences associated with excess weight, obese and overweight children are also likely to engage in other activities that negatively impact their health. "Obese youth were found less likely to exercise, and more likely to have smoked and consumed alcohol," he said. "Let me be the master of the obvious: This is a recipe for a shorter life."

Sources

ChildTrends Data Bank. "Overweight Children and Youth." Accessed May 23, 2008. (http://www.childtrendsdatabank.org/indicators/15OverweightChildrenYouth.cfm)

Hitti, Miranda. "More Sleep, Less Childhood Obesity." WebMD. Feb. 12, 2008. (http://children.webmd.com/news/20080212/more-sleep-less-childhood-obesity)

Hopson, Krista. "Childhood obesity may lead to early puberty for girls." Updated March 5, 2007. (http://www.ur.umich.edu/0607/Mar05_07/01.shtml)

Levine, Susan and Stein, Robert. The Washington Post. "Obesity Threatens a Generation." May 17, 2008. (http://www.washingtonpost.com/wp-dyn/content/story/2008/05/09/ST2008050900425.html?sid=ST2008050900425)

Mayo Clinic Staff. "Childhood Obesity." Posted March 28, 2008. (http://www.mayoclinic.com/health/childhood-obesity/DS00698/DSECTION=1)

Washington Post. "Facts You Should Know." Posted May 17, 2008. (http://www.washingtonpost.com/wp-dyn/content/article/2008/05/17/AR2008051702426.html?sub=AR)

White, Gayle. "Obesity Puts Children At Risk." Atlanta Journal-Constitution. Oct. 19, 2006. (http://www.futureofchildren.org/newsletter2861/newsletter_show.htm?doc_id=422826)