Teenage Girls Obesity and MS Link

Teenage girls are often obsessed with weight, and a lot of emphasis naturally has been put on the fight against anorexia and false body image. However, the reverse is also flagging up a problem as recent research has shown that girls who were obese at age 18 faced double the risk of developing multiple sclerosis as adults.

The study is part of a very long running research project by the Nurses’ Health Study in the USA and found a much higher relative risk of MS among those girls who had a body mass index value of 30 or more at age 18. They have speculated that it could be related to inadequate levels of vitamin D or the systemic inflammation that is also associated with obesity. Those who are obese are often found to have very low levels of vitamin D.

Interestingly being overweight in childhood did not carry a similar risk, it was the weight as they reached 18-20 that was significant so it’s worth keeping an eye on teenage girls weight as they reach mid teens, if they will let you.

Eating for two can predict daughter’s future obesity

As a society we are increasingly overweight, and pregnant women are not immune. However, there is now evidence that the mother’s weight and the amount she gains during pregnancy can have a serious impact on her daughter’s risk of obesity decades later. Eating for two is not an option, and Alison Stuebe, M.D., assistant professor of obstetrics and gynaecology at the University of North Carolina who carried out the study, analysed data on more than 24,000 mother-daughter pairs.

She found that the heavier a mother was before her pregnancy, then she was twice as likely to have a daughter who was obese as an adult. Daughters whose mothers gained 15 to 19 pounds during pregnancy had the lowest risk of obesity whereas daughters whose mothers gained more than 40 pounds were almost twice as likely to be obese at age 18 and later in life.

Obviously diet through childhood and eating patterns picked up in the family will have played their part, but she stressed that women should aim for a healthy weight before they get pregnant, and then gain only a moderate amount.

Prebirth link to cause of childhood obesity

You must have noticed the strenuous efforts the Government is making to get our children healthier. It is a real cause for concern as being overweight is now much more common in the under 10′s than ever before. There are probably many factors that influence this, including lack of exercise and a high-fat diet, but a new study has shown that there is also a factor that comes into play before birth.

It was reported this month in the Environmental Health Perspectives Journal that a study done in Flanders in Belgium has revealed that when a woman is pregnant there is a link between how many environmental pollutants she is exposed to and the weight of her baby, right up to the first three years of life.

Certain chemicals are known to disrupt the endocrine system, but it hasn’t been realised that even brief exposures early in life can be a problem. Body weight may be increased if mother and baby are exposed to like pesticides, chemicals such as dichlorodiphenyl dichloroethylene (DDE), hexachlorobenzene, dioxin-like compounds and polychlorinated biphenyls (PCBs) – the ones found in aerosols. Children between one and three years of age were found to have a higher BMI (Body Mass Index) if exposed to these chemicals and more so if their mothers also smoked. For babies they tested blood from the umbilical cord to measure and identify any chemical pollutants at birth.

Reading helps overweight girls

I am a fan of reading, whatever the reason given, but when it can actually help overweight girls then it seems a win-win situation. New research on obesity at Duke University in the USA has found reading, if the material is right, actually encouraged weight loss in girls aged from 9-13 who took part in their study.

Getting children to lose weight is not something they can do alone, so Duke Children’s Hospital, has a family-focused weight loss programme that addresses the patients’ medical, dietary and behavioural needs. As part of the study, 31 girls who took part were given a novel called Lake Rescue (Beacon Street Girls). It’s the 6th in a series about the Beacon Street Girls by US author Annie Bryant, and in it the main character is an overweight preteen girl who struggles with low self-esteem, feelings of isolation and teasing because of her size. Another group of 33 girls read a different book called Charlotte in Paris, which did not have an overweight heroine, and another group of 17 girls read neither book.

They were all assessed after six months, and ALL the girls who read books had lost weight, but the girls who read Lake Rescue lost more.

The idea behind the study was to find a way to motivate the girls without resorting to the usual carrot and stick approach of so many dietary approaches and avoiding the often authoritative voice that goes with that. Lake Rescue was the perfect instrument, because it presents a likable character the girls could relate to and whom they could emulate. As the book progresses, its heroine learns to make healthier lifestyle choices and finds a mentor to help keep her on track. In other words, she learns that she can become healthier, and through her actions and the, ‘I can do it’ attitude really resonated with the preteen girls in the study.

The amount of weight lost was not huge, but the positive effect on the girls’ self-esteem would, the researchers believe, have a long-lasting effect that would help them maintain the weight loss. Healthy 9-13-year-old girls typically have a BMI between 16 and 19; the BMI of the girls in the study group was on average between 27 and 28. Without intervention, if these overweight girls were to continue to increase their BMI at their old rate, then in six months they would probably be at 28. Now, instead of going from 27 to 28, they are now going from 27 to 26.3, which would put her in the normal BMI range by time she is 13. If the weight is left unchecked, these girls would have a BMI of over 30 by the time they are 13, which would be obese even by adult standards.

Other Options?

The only viable option for obese pre-teens at the moment is a combination of lifestyle and behaviour-modification programmes, combined with counselling, which can be effective but unpredictable. There are some drugs available to counter severe weight-loss, but these are not suitable for anyone under the age of 15 – and used with caution by anyone over that age. The other newer option for obesity is to have a gastric bypass operation, but again this is far too risky for this younger age group.

As I said, I am all for encouraging reading, and buy Lake Rescue (Beacon Street Girls). If anyone knows of a similar story from a UK author that also features an overweight girl in a similar situation then I would be very happy to hear about it.

Yet Another ‘would you believe it’

Let’s hear it for Robert McMurray, Ph.D., and colleagues at the University of North Carolina, who managed to get a grant to show that teenagers who lounge about watching television and undertake very little physical activity probably developed the habit when they were younger. I wish I had thought of applying for a grant to study that, who would have guessed that kids who were couch potatoes at age 7-10 were unlikely to turn into star athletes when they hit their teens?

It is actually a serious subject as lack of physical activity and poor aerobic fitness is usually combined with poor eating habits to produce a child at risk of metabolic syndrome. That is a cluster of risk factors that in combination certainly appear to increase the risk of heart disease and other chronic illnesses later in life.

According to Dr Murray, “This is the first study to examine the importance of childhood fitness levels on your metabolism as a teenager. Previously we didn’t know if low fitness levels were an influence. It’s obvious now that there is a link and this is something which we need to pay attention to by encouraging our kids to keep fit, or suffer the consequences later in life.”

The study showed that the unfit kids already had a higher body mass index, higher blood pressure, and a greater total cholesterol level than the children who undertook more exercise and that second group would not go on to develop metabolic syndrome risk factors. In fact the unfit teenagers were six times more likely to have had poor aerobic fitness as children and five times more likely to have had overall low levels of physical activity.

I would guess that if you asked most adults if there was link between low physical activity in children and how they behaved as teenagers, then certainly most parents would not be surprised at the findings.

Anyone know the contact details for the National Lottery Research Funding Applications? I have a great idea for studying the health benefits of breathing on a daily basis, as opposed to only once a week, and I am sure I could show some benefit from it.

Tape Measure Predictor

Identifying children most likely to have an early form of metabolic syndrome needs only a scale and a tape measure, researchers at the University of Verona in Italy have recently discovered during a long study of just under 1500 Italian children. Metabolic syndrome is the term they used to describe the combination of excess weight, hypertension, and high cholesterol and plasma glucose found in children and adolescents.

We know that childhood obesity is a growing problem, but if parents were to monitor the waist-to-height ratio of those aged 5-15 they could help prevent their child developing serious conditions later in life that are linked to obesity such as cardiovascular disease and risk of diabetes.

The significant figure is when a child has a waist-to-height ratio greater than 0.5 and may seem overweight, but not obese so that warning signals are not raised in time. Such children were found to have a 95% chance of meeting the criteria for metabolic syndrome. As with adults, having a high waist measurement is a red flag, although of course there are more high-tech tools available to assess the risk in such children.

The chief researcher, Dr. Maffeis, says that waist-to-height ratio is easier for parents to monitor and interpret before the stage of intervention may be required.

The hidden factor in childhood obesity

Childhood, and adult, obesity is a topic of real concern and although much of the emphasis is on diet and exercise there could be a third, hidden, factor. A recent study done in Auckland, New Zealand, has revealed that young children who sleep less than nine hours a night have triple the risk of being overweight and have about 3% more body fat than children who get nine hours or more.

Although duration of sleep changes with the seasons, we sleep more in winter than summer for instance, but the New Zealand findings from a study of 519 seven-year-olds showed a definite link year-round between lack of sleep and obesity. On average, children in the study slept just over 10 hours a night, and those who went to bed after 9 p.m. were likely to sleep less. Again, on average, they had up to 40 minutes less sleep per night than children who went to bed earlier. These children’s weight gain is not because they are up raiding the refrigerator to pile on the pounds, but because the time the body needs for important maintenance processes has been reduced. The study also saw a link between lack of sleep and emotional instability such as mood swings or surliness, and indeed it can be seen in adults who don’t get enough sleep too.

Diabetes and the Younger Generation

First the bad news: the onset of type 2 diabetes appears to be rapidly increasing for people in their twenties. This is an age group that most doctors traditionally wouldn’t think about diagnosing for diabetes, but the evidence shows that it is now a serious factor.

Diabetes Care magazine this week ran a report from the University of Michigan study that showed there had been a 40 per cent increase in hospitalisations related to diabetes among those aged 20 to 29. Joyce Lee, M.D. and her colleagues studied data from the period 1993 to the end of 2004 and one of the conclusions they reached was that this huge increase probably was reflecting the physiological connection between obesity and type 2 diabetes. Throughout the Western world, and particularly in the USA and UK, there has been an unprecedented rise in childhood obesity. This is due to the change in diet, which has many youngsters consuming far more empty calories from snacks such as crisps and carbonated soft drinks, and this has unfortunately been mirrored by a corresponding decrease in physical exercise and activity.

Interestingly the rate of increase of childhood diabetes has remained fairly stable, leading to the possible conclusion that damage done in childhood from diet takes some time to take effect, and that most people on leaving school undertake far less exercise than they did when younger.

Now the good news: do you know anyone under the age of 30 without a mobile phone? Texting is as automatic as breathing to most young people, so some health practices are taking advantage of this to track individuals with acute and chronic medical conditions such as asthma and diabetes. This group may not respond well to conventional follow up methods, but they always check their messages so this one way to ensure that the message about medication and specific health practices is getting through. For example, in one study in Scotland, young diabetics could send a text message to their doctor to check how to modify their insulin treatment after eating certain foods, or drinking alcohol at a party.