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Once seen only among an older population, adult diseases such as fatty liver disease, hypertension and osteoporosis are being diagnosed more and more in children. And you can add to that sleep apnea, Type 2 diabetes and high cholesterol levels. The culprits? Unhealthy diets and growing waistlines, experts say.
Recognizing obesity early and appreciating the cardiovascular decline it can pose for young children has become so important that the American Academy of Pediatrics established guidelines and recommendations for pediatricians, typically not accustomed to seeing the resulting cascade of health issues in their patients.
“Parents in general tend to think they will outgrow it. It also depends on the ethnic group they’re coming from. In some cultures, being overweight is actually a sign of prosperity. So they may actually not even consider that as a problem.”
Kumar’s observations ring true with a study by the New York University Langone Medical Center that was published online in April in the journal Childhood Obesity. While rates of childhood obesity have risen over the last several decades, the study showed, a vast majority of parents perceive their kids as “about the right weight.”
Dr. James J. Maciejko, a lipidologist and director of the Adult and Pediatric Lipid Clinics at St. John Hospital in Detroit, is concerned by how few Americans in general understand the grave dangers of overeating. Maciejko sees kids eating 3,000 calories a day and reminds them and their parents that young bodies cannot handle that load. In general, he said, pre-pubescent children should be consuming about 2,000 calories per day; if they are quite active, maybe 200 to 300 calories more. After puberty, most boys should consume about 2,000 calories a day and girls about 1,500 to 1,600 daily.
Why? Here’s the list:
Heart disease: With obesity comes the risk of cardiovascular disease. Developing risk factors in childhood can greatly increase the likelihood of heart disease in adulthood. For that reason, guidelines sponsored by the U.S. National Heart, Lung and Blood Institute, part of the National Institutes of Health, recommend that all children be screened for high cholesterol at least once at ages 9 to 11 and again at 17 to 21.
Diabetes: Overweight children can develop “adult-onset” diabetes, or Type 2, as young as age 8, and the U.S. Centers for Disease Control and Prevention points out that the loss of insulin sensitivity can develop at any age, especially among overweight children.
Hypertension: “There are enough studies that have shown that . . . an overweight child is two to three times more likely to have high blood pressure compared to a child that is normal weight,” Kumar said. Hypertension can cause a range of health problems, from the heart to the brain to the kidneys.
Fatty liver: Maciejko said he is noticing more children being diagnosed with hyperlipidemia, or high fat levels in the blood. Part of the reason simply may be that doctors now are testing children for this.
The pediatrics association “now recommends all kids, by the age of 9, have a lipid profile,” he noted. As a result, when kids come in for their wellness visit when they’re 9, 10 or 11, the pediatrician orders a cholesterol profile. “And so, because of that, we’re starting to identify cholesterol issues in kids,” he said.
“When a child (or adult) eats excessive amounts of calories (particularly from refined carbohydrates), the blood sugar rises,” he explained. “The liver attempts to reduce the blood-sugar level by taking sugar up from the bloodstream. The liver converts this extra sugar to glycogen and stores it. However, when the storage capacity of the liver is full, the extra sugar the liver takes out of the blood is converted to fatty acid and triglycerides. The fatty acid tends to accumulate in the liver, causing fatty liver disease (also called nonalcoholic steatohepatitis, or NASH), while the triglycerides are deposited into the blood, raising the blood triglyceride level.”
Fatty liver disease can lead to depleted liver function, and the consequence of high triglycerides is cardiovascular disease, among other things.
Osteoporosis: Just as important as what kids are putting into their bodies is what they’re not. Eating disorders among very young children are contributing to the increase of osteoporosis, according to Dr. Ellen Rome, head of the Cleveland Clinic Children’s Center for Adolescent Medicine and professor of pediatrics at the Cleveland Clinic Lerner College of Medicine at Case.
“So many of the problems we see in adulthood have their roots in childhood,” Rome said. “A classic example is osteoporosis. That’s now seen as a pediatric disease.”
“If a kid from childhood isn’t getting three calcium or dairy servings a day with vitamin D, they can, in their early years, not be putting on the bone they’re supposed to have put on,” Rome said. By not depositing bone during those early years in life, when they’re supposed to be adding 40 to 60 per cent of their bone mass, they’re increasing their risk of osteoporosis later in life. “That means that kid is way behind on what they should have been depositing in their “bone bank” by the time they are in their 20s. If they’re five to 10 times lower in their bone density, they’ve doubled or tripled their fracture risks.”
What can parents do?
Children’s diets should consist of healthy sources of protein such as low-fat dairy products, lean cuts of meat and eggs; fresh vegetables and fruit, and healthy beverages such as water and skim milk, according to Maciejko. He advises against excess starch such as pasta, potatoes and white bread, favoring whole-grain pasta, rye or whole-grain bread and vegetables as replacements