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Obesity in the Young

As the prevalence of childhood obesity has increased, more and more children and teens are at risk for early cardiovascular problems and metabolic dysfunction.  At a recent forum of the American Academy of Pediatrics Institute for Healthy Childhood, new research showed that there are metabolic measures that can be used in children and adolescents to predict health risks in adulthood–and hopefully help to prevent them.

One study on 754 children and teens found that waist-to-hip ratio was correlated with factors that normally are associated with the metabolic syndrome in adults.  Waist-to-hip ration was correlated positively with triglycerides in 597 patients, LDL in 596 patients and insulin in 414 patients. Further, they found that in all 754 patients there also was a significant effect of waist-to-hip ratio on body mass index (BMI) percentile—all of which suggest that the measurement may be a useful tool to indicate risk for developing metabolic syndrome and diabetes in children and adolescents.

Another study found that among young teens, a high-risk atherogenic index (AI) was associated with abdominal obesity, high blood pressure, and insulin resistance.  The AI represents the ratio of triglycerides to HDL cholesterol and has been shown to predict cardiovascular disease in adults. One of the key findings was that boys with high-risk AI had 13 times greater risk of being hypertensive compared with patients who had low-risk AI, while girls had 34 times greater odds.

The forum also covered recent research on weight loss surgery in children and teens–a controversial topic, despite studies showing its safety and efficacy. One study compared the results of sleeve gastrectomy with a comprehensive weight management program, and found that the sleeve provides significant short-term BMI decrease as compared with medical management. A second study looked at the results of Roux-en-Y gastric bypass in 11 adolescents (10 girls, 1 boy), with median BMI of 48.2 before surgery. Nearly half of the patients had insulin resistance, and all showed symptoms of depression and anxiety before surgery. One year post-op, the patients had lost an average of 66.7 percent of their excess BMI and insulin resistance resolved in all cases.

Research aimed at addressing the risks of childhood obesity and the most effective and safest ways to treat excess weight in childhood is critical to curbing the obesity epidemic in the United States.  A 2013 report from the CDC showed that childhood obesity rates in many states have declined, but sill as much as 1 in 8 preschoolers are obese. You can read more here.

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