Obese mothers have babies with more belly fat, study findsJune 24, 2014|By Shereen Lehman|ReutersBabies of obese mothers tend to be born with more fat, especially around their middles, than babies with leaner mothers, according to a new study."There are differences in body composition, already at birth between obese women's babies and normal weight women's babies," Emma Carlsen told Reuters Health in an email.

She led the study at Hvidovre Hospital at the University of Copenhagen in Denmark."It is important to notice that our study does not examine if there are any long term implications of these findings, and, therefore, follow-up studies are needed," Carlsen said.Among adults, having more belly fat is linked to a greater chance of developing high blood pressure, type 2 diabetes and heart disease."We don't know if fat location in infants is important, although our finding is interesting," Carlsen said.She and her colleagues recruited 231 obese and 80 normal-weight mothers who had participated in a prior study on obesity in pregnancy.They measured the women's newborns and assessed their body composition using so-called dual-energy X-ray absorptiometry, or DXA scanning.The researchers found that infants born to obese mothers were on average more than 6 ounces heavier at birth with 2.5 percent more body fat than infants whose mothers were of a healthy weight.What's more, babies born to obese mothers had about half an ounce more fat around their bellies, according to findings published in Acta Paediatrica.Babies whose mothers gained more weight during pregnancy also tended to be born with more fat, regardless of the mother's pre-pregnancy weight."This is a relatively small study, and it can be hard to extrapolate findings - however it adds to a growing body of evidence that shows differences in body composition in babies born to obese mothers," Sian Robinson told Reuters Health in an email.Robinson, who has studied infant and childhood obesity at the University of Southampton in the UK, wasn't involved in the current research."To date there have been relatively few studies of body composition determined using DXA and we don't yet know what the differences described in babies signify in later life," she said.

Robinson's own work has suggested that children's body composition may change more over the first few years of life than later in childhood. But longer-term research is needed, she said.Currently there is a lot of interest in whether excess weight gain during pregnancy can be prevented, Robinson added.But, Carlsen said, "Our study indicates that it might be more effective to lose weight before becoming pregnant than to restrict gestational weight gain, if you want to affect offspring body composition."According to the American College of Obstetricians and Gynecologists, doctors should encourage obese women to lose weight through diet, exercise and behavioral changes before becoming pregnant.SOURCE: http://bit.ly/1iBKiaR Acta Paediatrica, online June 18, 2014.

Obesity prevention programs might help lower kids' blood pressureMarch 19, 2014|Shereen Jegtvig|Reuters

NEW YORK (Reuters Health) - Programs designed to prevent obesity in children may help lower kids' blood pressure, according to a new review of past studies.Researchers found that programs targeting both diet and physical activity were more effective than programs that focused on one or the other.

Although it's generally thought of as a disease of middle-aged and elderly people, children can also develop high blood pressure, or hypertension. The American Heart Association recommends that children have yearly blood pressure checks, saying that detecting high blood pressure early will improve a child's health.Dr. Bonita Falkner told Reuters Health that in the U.S., at least 3.5 percent of children and adolescents have hypertension and another 3.5 percent are at risk because of slightly elevated blood pressure.Falkner studies hypertension at Jefferson Medical College at Thomas Jefferson University in Philadelphia and was not involved in the new review.High blood pressure is more common among children who are overweight and obese, so the authors of the review wanted to see if obesity-prevention programs also improved blood pressure in kids."Blood pressure during childhood can track into adulthood, and when kids have elevated blood pressure they are more likely to have hypertension when they become adults," coauthor Dr. Youfa Wang told Reuters Health in an email.Wang, from the University at Buffalo, State University of New York, said the new review is part of a larger comprehensive study on childhood obesity funded by the Agency for Healthcare Research and Quality (AHRQ). The project also includes researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore.Wang and his colleagues analyzed data from 23 studies of obesity interventions, including almost 19,000 kids in total. The interventions targeted diet, physical activity or both and lasted at least one year, or six months for school-based programs.Studies compared children who received a particular intervention with those who did not. In the majority of studies, children were randomly assigned to go through the obesity-prevention program or to be in a comparison group.The 23 studies tested a total of 28 different interventions. Most of them were done in schools or in combined school and home settings.Four of the interventions showed positive effects on both body fat and blood pressure. Eleven suggested a beneficial effect on blood pressure, but no effect on body fat.

Wang and his colleagues then combined the findings of 19 studies that reported on systolic blood pressure (the top number in a blood pressure reading) and 18 that reported on diastolic blood pressure (the bottom number).They found that obesity prevention programs reduced blood pressure among children, by an average of 1.64 millimeters of mercury (mm Hg) in systolic blood pressure and 1.44 mm Hg in diastolic blood pressure.The reduction was more pronounced in the studies that used a combined approach with both diet and physical activity interventions, the authors wrote in Circulation."It's not a huge impact, but the totality of the data that they looked at with the analysis of multiple projects seemed to be optimistic," Falkner said."So it's hopeful that some impact can be achieved," she said. "No one really lost a lot of weight but at least with the efforts there was some decrease in blood pressure."Falkner said measuring blood pressure has become a standard part of children's medical care, just like measuring height and weight. But deciding what's normal and what's high blood pressure is more complicated than it is in adults."In adults, generally, there is an accepted standard of 140/90 (mm Hg), which is the cut-off point," she said. "If blood pressure goes beyond that it becomes a risk factor for cardiovascular diseases."For kids, on the other hand, assessments are based on how their blood pressure compares to other children of their age, height and gender.Treatment depends on how high the blood pressure is, Falkner said."If it's markedly elevated then the doctors generally do some testing to see if there's some underlying cause for the high blood pressure," she said.She said there are things parents can do that are beneficial for kids' blood pressure, such as helping them lose weight if they're overweight or obese.Dietary changes such as reducing sodium or following the DASH diet could help, she added. DASH stands for Dietary Approaches to Stop Hypertension."The DASH diet is kind of like the Mediterranean diet," Falkner said. "It's rich in fruits and vegetables, fiber and low-fat dairy.""The idea behind this is that there are multiple nutrients that are beneficial for the cardiovascular system," she said.SOURCE: http://bit.ly/1j1j3Gy Circulation, online February 19, 2014.

Obesity may disturb bone growth during teen yearsDecember 18, 2013|Shereen Jegtvig|Reuters

NEW YORK (Reuters Health) - Obese teens might not develop sufficient bone mass relative to their body weight, according to a new study from Brazil.Both body fat and lean body mass have an impact on bone growth, but it's not clear if the bones of the heaviest teens are strong enough for their weight and that could have long- and short-term consequences.

Bone mineral acquisition "rises exponentially in both genders" during the growth spurt following puberty, the researchers write in the journal Nutrition.Previous studies examining whether obesity interferes with bone development have shown conflicting results - some indicate bone density is fine when compared just to the adolescent's lean mass (muscle).But others have suggested bone density doesn't increase enough during this important period to support the heavier weight of obese teens, potentially putting them at increased risk for bone fractures.Since obesity rates in children and teens are high in many parts of the world, the researchers wanted to explore the subject further."The study was conducted with Brazilian adolescents where the prevalence of overweight/obesity is around 30 percent, similar to the American teenager population," Dr. Tamara Goldberg told Reuters Health in an email.Goldberg, a physician and professor in the Department of Pediatrics at the Botucatu School of Medicine of So Paulo State University, was part of the team that worked on the new study."In the last decades, an increase in obesity has been observed in developed countries as well as in developing countries," she said.The new study involved 377 adolescents aged 10 to 19 years old. The researchers excluded kids who took calcium or iron supplements, were taking certain medications or were vegetarians or ate high-fiber diets.The adolescents were all non-smokers and non-drinkers, and none of them participated in any types of regular physical activity.The researchers used body mass index to categorize the participants into one of four categories. Most - about 42 percent - fell into the normal weight category. Another 13 percent were overweight, 38 percent were obese and 7 percent were classified as extremely obese.The researchers used dual-energy X-ray absorptiometry, or DEXA testing, to determine total body composition and bone mineral content and bone mineral density of the thigh bones and lower-back vertebrae.

Bone mineral content is the amount of mineral found in a specific area, while bone mineral density is the bone mineral content divided by the size of that area.The researchers compared the changes in lean mass and fat percentages across the different weight groups - they found that lean mass stayed about the same while body fat percentage went up as weight went up.But bone mineral density and bone mineral content didn't necessarily increase as much as body fat percentage.In general, girls with the highest body fat percentages didn't show a comparable increase in bone densities of the thighbone and vertebrae.In boys, it appeared that bone density and mineral content didn't increase comparably with body fat percentage in any of the bones tested.While some excess body fat has been identified as a protective factor in women, extreme obesity is not associated with normal bone density, even in adults, Goldberg said."The prevention of obesity is the best protective way to decrease the incidence of metabolic cardiovascular events (high blood pressure, diabetes, dyslipidemia) and other factors which interfere with the increase of bone mass," Goldberg said.This study doesn't prove that excess fat has a negative effect on bone mass, only that they seem to go hand in hand.It's also important that the kids in this study did not participate in any regular physical activity, a pediatrician who was not involved in the study pointed out."Kids who are not obese are more physically active and physical activity, especially high impact activities like soccer, basketball, gymnastics and other sports which require sprinting and jumping, improve bone. Severely obese children are less likely to participate in these sports," Dr. Amanda Weiss Kelly told Reuters Health.Weiss Kelly is the division chief of pediatric sports medicine at University Hospitals Rainbow Babies and Children's Hospital of Case Western Reserve University in Cleveland, Ohio.Whereas the study authors speculate that hormones secreted by fat and inflammation related to adipose may contribute to decreased bone density in overweight kids, Weiss Kelly says that may well be true, but so far it has yet to be proven."In the end both physical activity and the fat itself may both play a role," she said."Parents of obese (and all) children should encourage regular (DAILY) weight bearing physical activity. Weight training is another good activity for improving bone density," Weiss Kelly wrote."Finally, making sure that all children are receiving adequate amounts of calcium and vitamin D for their age group is important," she added.SOURCE: http://bit.ly/18vsrgH Nutrition, online December 16, 2013.

Habits linked to obesity may differ for boys and girlsAugust 13, 2013|By Andrew M. Seaman|Reuters

NEW YORK (Reuters Health) - Some behaviors, such as TV watching and eating school lunches, were linked to obesity among sixth grade boys and girls in a new study, but other risk factors were gender specific.Involvement in sports, for example, was tied to a lower risk of obesity in boys but not girls and drinking milk was linked to lowered risk among girls but not boys, according to researchers from the University of Michigan Health System in Ann Arbor.

The study's authors, led by Dr. Elizabeth Jackson, write in the journal Pediatrics that understanding obesity risk factors for specific genders may help target programs aimed at weight loss or preventing weight gain in children.The U.S. Centers for Disease Control and Prevention estimates that about 17 percent of children and teens are obese.For the new study, Jackson and her colleagues used data collected between 2004 and 2011 from 1,714 sixth-grade students at 20 middle schools in and around Ann Arbor.Overall, about 18 percent of boys and 16 percent of girls were obese, which is defined as children who are in the top-fifth percentile of body mass index - a measurement of weight in relation to height.Among boys who were not obese, about 56 percent participated in at least 20 minutes of vigorous physical activity at least five times per week, compared to about 43 percent of boys who were obese.But there was no difference between the percentage of obese and non-obese girls who reported regular vigorous physical activity.Playing on at least one sports team was also linked to decreased risk of obesity for boys but not girls.The lack of an association between obesity and physical activity in girls may be explained by girls not reporting some activities like cheerleading or dance, because children may not consider those activities sports, the researchers write.They did find, however, that drinking two or more servings of milk per day was tied to about a 20 percent decreased risk of obesity among girls but not boys. One possible explanation is that milk is displacing sugary drinks in the girls' diets, Jackson's team writes.In addition to those gender-specific risk factors for obesity, the researchers found that heavy TV-watching and regularly eating school lunches were each tied to an increased risk of obesity for both boys and girls.Watching more than two hours of TV was linked to a 19 percent increased risk of obesity and almost always eating school lunches was linked to a 27-to-29 percent increased risk.The new study cannot prove that any of the children's habits caused their obesity. For example, the authors point out in their report, a child regularly eating school lunches might be eligible for the meals because of low family income - itself a risk factor for obesity."This isn't really showing that school lunches caused obesity, but it's appropriate to point out that the school lunch program hasn't had the effect we would have liked," Daniel Taber, assistant professor at the University of Texas School of Public Health in Austin, said.

"It's pointing out that the school lunch program needed improvement because it wasn't preventing childhood obesity," Taber said.The U.S. Department of Agriculture (USDA) set new standards for school lunches in January 2012 that set maximums for calories offered during lunch and mandate that only skim or reduced-fat milk are offered to students.Prior to 2012, the USDA only set minimum calorie counts for school lunches. Now, the agency requires school lunches to fall between 550 calories and 850 calories - depending on a child's grade level.Earlier this year, Taber published a study that found stricter lunch standards - like the ones implemented in 2012 - were tied to healthier body weights among students (see Reuters Health story of April 8, 2013 here:.)"It's not that you want to steer kids away, you want to improve the school lunch program, which is exactly what they've been doing this past year," he said.Jackson and her colleagues write that more research is needed to find out how much children may benefit from improving school lunches and reducing TV time, while also learning more about gender-specific risk factors for obesity.SOURCE: http://bit.ly/17mwYMH Pediatrics, online August 12, 2013.

The Kid's Doctor: Family routines can reduce childhood obesityAugust 21, 2013|By Sue Hubbard, M.D|Premium Health News Servicehttp://www.kidsdr.comI just read an article published in the journal Pediatrics which once again validated the importance of family routines. In this study, researchers from Ohio State University looked at household routines as they related to childhood obesity, an ever-escalating problem.

The research, conducted in 2005 but published this year, analyzed over 8,500 four-year-old children. 18 percent of the children were identified as obese. Families were asked if 1) they regularly ate evening meals together, 2) did their children have a bedtime and receive adequate sleep, and 3) was TV time limited within the home? When looked at more closely, a little more than half of the children reported having family dinners 6 or 7 evenings a week.About 57 percent of the children who were reported to get 10.5 hours of sleep per weeknight. Only about 40 percent of the studied children were reported to watch less than 2 hours of television or movie viewing per weekday. When looked at in terms of those children who were exposed to all three routines, the prevalence of obesity was 14 percent, while those children not exposed to any of the three routines had a prevalence rate for obesity of 24.5 percent.The research also found that the number of household routines was a predicator of obesity, and that by adding a routine, there was a 17 percent reduction in the odds for obesity.These household routines seem to be fairly easy to initiate, in that they may be accomplished without cost, etc. Establishing good routines for family meals has repeatedly been shown to improve a child's academic success, attention, risk of using alcohol and drugs and overall well being. If it could also reduce the incidence of obesity what a win! Just one more reason to plan for a family to eat dinner together.This study did not even discuss healthy food choices, which might make the statistics even more compelling, and what about adding eating breakfast together? Bedtime routines are important for all children and the lack of sleep has been documented to cause numerous problems.We as parents all know children are "cranky" when they're sleepy, and as they get older lack of sleep impacts a child's school performance, alertness and focus, and may even be a factor in a teens driving safety. I think all children need to have a "bedtime," and even teens need to know when to go to bed!Lastly, the American Academy of Pediatrics has recommended that children under 2 years of age not watch TV, and for those older than 2, there should be no more than 2 hours of television/DVD/movie/computer time per day. I would add that children should not watch TV prior to their school day, and that includes watching movies in the car en route to school! I just don't get that.Start with one of these routines and as it becomes "routine," add another. See what you think!(Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show. Submit questions athttp://www.kidsdr.comathttp://www.kidsdr.com.)