Showing posts with label BMI. Show all posts
Showing posts with label BMI. Show all posts

Monday, May 11, 2015

Why Would an Article on Alzheimer Disease Appear in Pediatrics?


By: Lewis First, MD, MS; Editor-in-Chief   

          Hopefully the headline for today’s blog caught your attention.  What’s our interest in Alzheimer Disease in a pediatric journal? Believe it or not, two markers of insulin resistance have been associated in adults with an increased risk of developing Alzheimer Disease and dementia, and Luciano et al. (doi:10.1542/peds.2014-2391) opted to look for these markers early by measuring them in normal, overweight, and obese preschoolers and adolescents.  
      Correlations of the Alzheimer biomarkers were significantly associated with elevated body mass index (BMI) in conjunction with insulin resistance suggesting that perhaps seeing these markers early on may signal a later risk of developing the cognitive abnormalities associated with Alzheimer Disease and dementia.  How these markers in childhood might result in the brain changes that cause this disease of adults and what we might do about this while our patients are still young raises perhaps more questions than answers—but that’s what reading our journal is all about.  
     Hopefully an article like this will raise awareness enough to trigger other studies to confirm these findings, follow the cohort of overweight and obese children with insulin resistance and see if reducing the level of resistance also improves mentation as these children age.  Read this study and you’ll see yet another example of how the prevention work we strive to do as pediatricians pays off not just in childhood but throughout our patients’ lives.

Related Links: 

Tuesday, December 2, 2014

Two Breastfeeding Studies Provide New Information Worth Sharing with Parents

By: Lewis First, MD, MS; Editor-in-Chief 

Breastfeeding icon.
Public domain via Wikimedia Commons
There are many evidence-based reasons to exclusively breastfeed newborns and infants. Yet despite the evidence, mothers opt to not exclusively breastfeed for the recommended one-year duration, let alone six months or even a shorter time period. Yet each addition to the body of breastfeeding literature hopefully further convinces an expectant mother or one that has just given birth to choose exclusive breastfeeding as the best way to ensure the growth and development of her newborn.

Thus this week, we provide two additional studies that we found well worth sharing in our journal.

The first, by Abbass-Dick et al. (doi: 10.1542/peds.2014-1416), involved a randomized controlled trial to see if co-parenting breastfeeding support resulted in increases in breastfeeding duration and mothers feeling more supported by paternal partners.

The study involved more than 100 couples randomized to get either usual care or an intervention involving both parents’ involvement in understanding and supporting breastfeeding. The results of the co-parenting intervention are most impressive and may further enhance a mothers desire to continue to exclusively breastfeed for as long as she can.

The second study by Carling et al. (doi: 10.1542/peds.2014-1392) was a prospective observational study of mothers in rural and central New York of weight gain trajectories for the first two years of life in almost 600 infants.

The authors controlled for a number of possible confounders and found that the trajectories most worrisome for obesity risk were associated with the shortest duration of breastfeeding—especially if an infant breastfed for less than two months.

Since other studies have demonstrated that an overweight or obese younger child means increased risk of obesity up the road, this study should weigh heavily in your discussion with families of the importance of breastfeeding –especially if that family has a history of being overweight or obese.

Check out both studies—and then share what you learned with families of your infant patients. If they were on the fence about breastfeeding, these two studies may tip the balance in support of this important method of feeding.

Related Reading:

Tuesday, November 11, 2014

BMI Changes Between Fifth and Tenth Grades

By: Lewis First, MD, MS; Editor-in-Chief 

School lunch. Photo by US Dept. of Agriculture via Flickr
We have certainly published studies on overweight or obese toddlers and preschoolers with the hope of intervening as early as possible to attenuate the increasing weight gain—but what happens to weight gain and BMI in pre-adolescent children as they enter and move through adolescence? Does weight gain get worse or better? Can you influence the trajectory of that weight gain in this age group as much as if you altered things in early childhood?

Schuster et al. (doi: 10.1542/peds. 2014-2195) studied the factors that can result in progression to obesity as well as BMI reduction factors in a cohort of fifth graders followed through tenth grade. Those fifth graders who already had a negative body image due to their being overweight or obese, lower socioeconomic status, and/or an obese parent had the most difficulty lowering their BMI as they moved through adolescence.

What’s worse—fifth graders who were not yet overweight but had a negative body image of themselves, combined with an obese parent and/or a sedentary television-watching lifestyle were on a pathway to increasing their BMI trajectory unless intervening actions could be taken.

If you are interested in learning more as to what factors enhance or inhibit a child from becoming overweight or obese between fifth and tenth grade so you can better counsel your patients accordingly, this study weighs in admirably for your consideration.

You would be a pound foolish not to read it—if you want to work with your overweight or obese teens to lower elevated BMIs. And speaking of lowering BMIs in teens—have you found some ways to do this that yield success in your practice? Share your thoughts: leave a comment below, send us an eLetter on our journal website, or find us on Facebook or Twitter.

Related Reading:

Monday, August 25, 2014

Parental Perceptions of Overweight 20 Years Ago and Today: The Times (and BMIs) They Are a Changin’!

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by epSos.de via Flickr
Part of the problem of trying to get a family to help their overweight child lose weight is getting parental buy-in—and that begins when parents agree that their child is medically perceived to be overweight. One would think that parents would view their child as being overweight quite easily—and while that may have been true 20 years ago—it is not as easily perceived today—at least according to a study we are sharing this week by Hansen et al. (doi: 10.1542/peds.2014-0012).

The authors looked at survey data from parents on close to 3,000 children (ages 6-11 years) enrolled in the National Health and Nutrition Examination Survey in 1988 through 1994 and another cohort enrolled in 2005 to 2010 and found some substantive differences. Parents today are less likely to perceive their child as overweight: They did not view weight gain above the 85th percentile but below the 91st percentile as concerning, whereas 20 years ago it was.

What does this shift in social norms mean for the health of children who are showing increased body weight and crossing high percentiles on a growth curve? Weigh in on the information contained in this study and then perhaps share it with parents of overweight patients and see if it can’t help them realize that their child’s increasing BMI over time really is a problem.

Related Reading:

Tuesday, March 18, 2014

Weighing the Ups and Downs of ADHD and Stimulant Use on BMI Trajectory

Photo by Nemo via Pixabay
Prior studies in our journal and others have suggested that attention deficit/hyperactivity disorder (ADHD) in the absence of stimulant use is associated with an increased risk of childhood and adult obesity. But what happens when stimulants are started, and does the duration of their use influence BMI trajectory?

Schwartz et al. (doi: 10.1542/ peds.2013-3427) release their findings this week gathered from longitudinal electronic health record data on more than 164,000 children aged 3-18 years. The role that stimulants play during childhood and how the BMI trajectory can change during adolescence is a study you should pay attention to if you follow patients with ADHD—and there are few pediatricians practicing primary care who do not. Read this study and learn more.

Related Reading:

Thursday, February 6, 2014

Parental Misperceptions of Their Child’s Weight: Implications for Obesity Prevention and Treatment

As pediatricians, one of the challenges we face is when a family does not see their child as being as overweight or obese as the growth chart might indicate. Why does this occur and what can we do about it?

Photo by PublicDomainPictures via Pixabay
Lundahl et al. (doi: 10.1542/ peds.2013-2690) weigh in with a large meta-analysis involving 69 articles and 78 samples of almost 15,800 overweight children to understand how often underestimation of weight status occurs and what contributes to this problem.

The researchers identified significant risk factors that can lead to underestimating a child’s weight that may be useful to help parents better acknowledge the rising trend in their child’s weight so that appropriate healthy strategies can be better implemented to tackle this problem.

Do you find parents in your practice do not grasp the import of a child becoming overweight or obese? Have you found ways to convince parents to see the reality of the situation? Leave a comment below, or share your thoughts via an eLetter, Facebook or Twitter. We’d love to hear from you.

Monday, September 16, 2013

Adolescent Obesity-Related Behaviors: What Do the Trends Show?

Given the high prevalence of teen obesity that we have observed over the past decade, one wonders whether adolescent physical activity, sedentary behaviors, and dietary behaviors have gone up or down during the same time period.  Well stop wondering, and read the article by Iannotti and Wang (doi: 10.1542/peds.2013-1488) we are early releasing this week.  The authors looked at nationally representative samples of students in grades 6 to 10 at three different time points between 2001 and 2009 and administered a national survey assessing their physical activity, sedentary and dietary behaviors, and body mass index (BMI) during the school year.

The results may surprise you and even make you smile when you see that the trend direction of obesity-related behaviors appears to be changing for the better, although BMI does not.  So maybe all those articles and studies we have been publishing indicating the benefits of physical activity, nutrition, and less sedentary behaviors such as TV watching and video-game playing are having an effect and it’s just too early to see that effect play out in BMI itself.  Weigh the data for yourself and then keep educating your teen patients so they too become part of the positive trends that will hopefully decrease the prevalence of obesity in this country.