Early Intervention Key to Combating Childhood Obesity

Childhood obesity is an epidemic in the United States, and one that not only endangers the health of children, but also costs our healthcare system a great deal of time, money, and resources when considering the comorbid conditions that often present as a result. This past weekend at the American College of Cardiology 62^nd Annual Scientific Sessions & Expo, Geetha Raghuver, MD, MPH, FAAP, FACC, FAHA, Children’s Mercy Hospital, University of Missouri, Kansas City, spoke about obesity interventions and what every pediatric cardiologist should know.

Childhood obesity has been linked to an overwhelming number of other conditions, including non-alcoholic fatty liver disease, joint disease, sleep apnea, depression, dyslipidemia, hypertension, gastroesophageal reflux, and even cancer. There is also existing data indicating that the prevention of obesity and atherosclerotic disease should begin in the first decade of life. Early formative years are crucial to imparting proper dietary and activity regimens for children.

Therapeutic lifestyle changes are also imperative to obese children, and Dr Raghuver mentioned a number of changes to modify their behavior:

• Have them drink water instead of ingesting liquid calories.
• Make sure that they eat breakfast (preferably one that has good fat and fiber). This is also importance for metabolic purposes.
• Have them eat “colorful” foods (ie, fruits and vegetables).
• Maintain a source of calcium, such as skim milk or low fat cheese.
• Ensure that there are after school activities and that they are exercising regularly (30-45 minutes/day).

These instructions may seem like common sense, but the truth is that childhood obesity is so prevalent that this information must be disseminated. Dr Raghuver made a point to mention that it is necessary to include all caregivers whenever making lifestyle changes; this will help to make sure that all parties are on the same page so that there is a consistent diet and exercise regimen. With the proper amount of physical activity, children will improve their insulin sensitivity and reduce their blood pressure, among many other benefits. Conversely, if left untreated, childhood obesity can become a burden. Dr Raghuver mentioned what she called the “Tragedy of Triads,” which refers to the correlation between sugar, salt, and fat with poverty, obesity, and tobacco.

Dr Raghuver also touched on the various societal components that can influence the prevalence of childhood obesity, such as taxes, regulations, subsidies, incentives, bans, and mandates. She then presented a chart outlining the increased cost of certain foods and drinks since 1980 so that attendees could visualize the steady rise in the cost of milk, fruits, and vegetables while simultaneously viewing the consistently low prices of soda and other carbonated drinks.

There are many concerns related to childhood obesity; however, intervention in children does work. It reduces risk factors and improves vascular health. Caregivers must take responsibility and recognize early warning signs of childhood obesity and react accordingly with behavior modifications. Although this can be challenging, intervention earlier can prevent deteriorating healthcare and complications later.