Complexity around childhood obesity

January 6, 2020

Science Daily/University of Notre Dame

In a new study, researchers examined how various psychological characteristics of children struggling with their weight, such as loneliness, anxiety and shyness, combined with similar characteristics of their parents or guardians and family dynamics affect outcomes of nutritional intervention.

The World Health Organization has estimated more than 340 million children and adolescents ages 5-19 are overweight or obese, and the epidemic has been linked to more deaths worldwide than those caused by being underweight.

The Centers for Disease Control recently reported an estimated 1 in 5 children in the United States, ages 12-18, are living with prediabetes -- increasing their risk of developing type 2 diabetes as well as chronic kidney disease, heart disease and stroke.

Efforts to stem the crisis have led clinicians and health professionals to examine both the nutritional and psychological factors of childhood obesity. In a new study led by the University of Notre Dame, researchers examined how various psychological characteristics of children struggling with their weight, such as loneliness, anxiety and shyness, combined with similar characteristics of their parents or guardians and family dynamics affect outcomes of nutritional intervention.

What they found was a "network effect," suggesting a personalized, comprehensive approach to treatment could improve results of nutritional interventions.

"Psychological characteristics clearly have interactional effects," said Nitesh Chawla, the Frank M. Freimann Professor of Computer Science and Engineering at Notre Dame, director of the Center for Network and Data Science and a lead author of the study. "We can no longer simply view them as individualized risk factors to be assessed. We need to account for the specific characteristics for each child, viewing them as a holistic set for which to plan treatment."

The Notre Dame team collaborated with the Centre for Nutritional Recovery and Education (CREN), a not-for-profit, nongovernmental nutritional clinic in São Paulo, Brazil, where patients participate in a two-year interdisciplinary treatment program including family counseling, nutritional workshops and various physical activities. Researchers analyzed the medical records and psychological assessments of 1,541 children who participated in the program.

The study's key takeaway points to the significant impact parents and guardians have on their child's health when it comes to nutrition. Strong family dynamics, such as concern for behavior and treatment and a sense of protectiveness for the child, led to improved outcomes of nutritional interventions. A lack of authority, however, led to minimal changes in results.

"This is quantitative evidence of the success and failure of interactions as they relate to the characteristics and interactions between the child and the parent or guardian," Chawla said.

The study also highlights the need for clinics to expand their views on patient populations. For example, while treatment programs that incorporate development of interpersonal relationship -- familial and otherwise -- may improve outcomes of nutritional interventions, the same treatment plan may not have the same result for children experiencing loneliness coupled with anxiety.

"For the group without anxiety, this makes sense when you consider a treatment plan focused on strengthening a child's social circle and address issues stemming from loneliness, such as poor social network, bullying or self-imposed isolation," said Gisela M.B. Solymos, co-author of the study, former general manager of CREN and former guest scholar at the Kellogg Institute for International Studies at Notre Dame and at the Center for Network and Data Science. "But patients feeling loneliness and anxiety actually showed minimal changes to nutritional interventions, and may be more likely to benefit from additional services at clinics like CREN."

https://www.sciencedaily.com/releases/2020/01/200106161935.htm

Factors that predict obesity by adolescence revealed

October 16, 2019

Science Daily/Murdoch Childrens Research Institute

Three simple factors that predict whether a healthy weight child will be overweight or obese by adolescence have been revealed in a new study led by the Murdoch Children's Research Institute (MCRI).

The research shows three factors -- a child's and mother's Body Mass Index (BMI) and the mother's education level -- predict the onset or resolution of weight problems by adolescence, especially from age 6-7 years onwards.

Each one-unit higher BMI when the child is aged 6-7 years increased the odds at 14-15 years of developing weight problems by three-fold and halved the odds of resolution.

Similarly, every one-unit increase in the mother's BMI when the child is aged 6-7 years increased the odds at 14-15 years of developing weight problems by 5 per cent and decreased the odds of resolution by about 10 per cent.

Mothers having a university degree was associated with lower odds of a child being overweight and obese at ages 2-5 years and higher odds of resolving obesity issues by adolescence.

Study author MCRI's Dr Kate Lycett said the prevalence of being overweight/obese at the age of 14-15 years was 13 per cent among children with none of these three risk factors at age 6-7 years, compared with 71 per cent among those with all risk factors.

Dr Lycett said identifying these three factors may help clinicians predict which children will develop and resolve excess weight with about 70 per cent accuracy.

"In the case of BMI, it is an objective measure that is easily measured and reflects diet and exercise choices, but is free from the challenges of assessing physical activity and diet in a standard clinical appointment such as recall bias," she said.

The findings, published in the latest edition of the International Journal of Obesity, also found children who are overweight or obese at 2-5 years have a low chance of resolving their weight problems by adolescence when these three risk factors are present.

Data was sourced from 3469 participants at birth and 3276 participants at kinder from the Longitudinal Study of Australian Children. The child's height and weight were measured every two years.

Dr Lycett said until now most studies have overlooked the important questions around which children are likely to become overweight/obese and how it be resolved.

"Because clinicians haven't been able to tell which children will grow up to become teens with excess weight, it's been hard to target interventions for those most at risk," she said.

"The consequences of this are dire, with childhood obesity predicting premature death and being implicated in cardiovascular disease, diabetes and cancer."

The study examined how combinations of 25 potential short clinical markers such as time breastfeeding and amount of outdoor activity at various ages predict weight issues, as well as resolution, by ages 10-11 and 14-15 years.

Intriguingly, short questions about poor diet, low physical activity and other common lifestyle factors were not predictive of weight outcomes.

Lead author Professor Markus Juonala, from the University of Turku in Finland, said a simple risk score, which would be easily available to child health clinicians, could help target treatment or prevention.

"Combining data on these three easily obtainable risk factors may help clinicians make appropriate decisions targeting care to those most at risk of adolescent obesity," he said.

"The benefits of removing a focus on those unlikely to need clinical interventions for obesity has largely been ignored, despite an increasing policy emphasis on avoiding wasteful or unnecessary health care."

https://www.sciencedaily.com/releases/2019/10/191016094911.htm

Even in young children: Higher weight = higher blood pressure

June 13, 2019

Science Daily/European Society of Cardiology

Overweight four-year-olds have a doubled risk of high blood pressure by age six, raising the hazard of future heart attack and stroke. That's the finding of a study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

"The myth that excess weight in children has no consequences hampers the prevention and control of this health problem," said study author Dr Iñaki Galán, of Carlos III Health Institute, Madrid, Spain. "Parents need to be more physically active with young children and provide a healthy diet. Women should shed extra pounds before becoming pregnant, avoid gaining excess weight during pregnancy, and quit smoking, as these are all established risk factors for childhood obesity."

According to the World Health Organization, childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and the prevalence has increased at an alarming rate. In 2016, more than 41 million children under the age of five were overweight.

This study, based on the ELOIN cohort, examined the link between excess weight and high blood pressure in 1,796 four-year-olds who were followed up two years later. Blood pressure was measured at both time points, as was body mass index (BMI in kg/m2) and waist circumference.

Compared to children maintaining a healthy weight between ages four and six, those with new or persistent excess weight according to BMI had 2.49 and 2.54 higher risks of high blood pressure, respectively. In those with new or persistent abdominal obesity, the risks for high blood pressure were 2.81 and 3.42 greater, respectively. Children who lost weight did not have an increased risk of high blood pressure. The findings applied to all children regardless of sex or socioeconomic status.

"There is a chain of risk, whereby overweight and obesity lead to high blood pressure, which heightens the chance of cardiovascular disease if allowed to track into adulthood," said Dr Galán. "But the results show that children who return to a normal weight also regain a healthy blood pressure."

The best way to maintain a healthy weight and lose excess kilos is to exercise and eat a healthy diet, said Dr Galán. In addition to the central role of parents, the school curriculum needs to include three to four hours of physical activity every week. Teachers should supervise activities during breaks, while schools can offer games and sports after classes and provide nutritionally balanced meals and snacks.

Doctors should routinely assess BMI and waist circumference at early ages, added Dr Galán. "Some paediatricians think the harms of overweight and obesity begin in adolescence but our study shows they are mistaken," he said. "We need to detect excess weight as soon as possible so the damaging impact on blood pressure can be reversed."

Overweight children should have their blood pressure measured. Three consecutive elevated readings constitute high blood pressure. In young children, the most common cause is excess weight, but doctors will rule out other reasons such as heart defects, kidney disease, genetic conditions, and hormonal disorders. If the cause is overweight, more activity and dietary improvements will be advised. If lifestyle changes don't help, blood pressure lowering medication may be prescribed.

Dr Galán noted that overweight in children is most accurately assessed using both BMI and waist circumference. In the study, using either measurement alone would have missed 15% to 20% of cases.

https://www.sciencedaily.com/releases/2019/06/190613095224.htm

Despite common obesity gene variants obese children lose weight after lifestyle changes

November 28, 2018

Science Daily/University of Copenhagen The Faculty of Health and Medical Sciences

Children who are genetically predisposed to overweight, due to common gene variants, can still lose weight by changing their diet and exercise habits, according to a new study.

Overweight and obesity constitute an increasing global problem that may lead to serious sequelae such as heart attacks, diabetes and cancer. In 2016, 124 million children and adolescents worldwide suffered from obesity. Now researchers from the University of Copenhagen and the Children's Obesity Clinic, the Department of Paediatrics at Holbæk Hospital have examined how genetics affect children and young people's ability to lose excess weight.

'We are trying to understand the genetic driving force behind overweight and whether this force also makes it impossible for some to lose weight. We show that a high genetic predisposition to overweight during childhood in fact had no influence on whether the children reacted to lifestyle intervention compared to children with low genetic predisposition to overweight. The 15 genetic variants we have studied are common in the population and are the ones that in general increase a child's risk of becoming overweight,' says Postdoc at the Novo Nordisk Foundation Center for Basic Metabolic Research at UCPH Theresia Maria Schnurr, who is one of the authors of the study.

The new research results have just been published in the scientific journal Obesity. The researchers' aim was to determine the influence of specific gene variants on children and adolescents' ability to lose weight. Therefore, they studied the 15 specific gene variants implicated in childhood obesity and which are common in the population. In the study, the researchers demonstrate that these genetic variants did not predict whether children and adolescents' were able to lose weight when they changed their lifestyle. So far only children with a rare genetic mutation in the MC4R gene do not seem to lose weight when undergoing lifestyle intervention.

Lifestyle Intervention Led to Weight Loss

The researchers examined 754 children and adolescents with overweight and obesity. The median age was 11.6 years. The genetic profile of all participants was mapped, and the researchers then calculated a genetic risk score for childhood overweight for each participant based on the 15 genetic variants. They all carried one or more of the 15 genetic variants associated with increased risk for obesity and overweight during childhood. To determine whether a genetic predisposition for overweight affected the children and adolescents' ability to lose weight the children had to implement a series of lifestyle changes.

They followed a treatment protocol developed at Holbæk Hospital. The protocol centres around the family with behavioural lifestyle changes. For example, the children and adolescents had to change their diet, means of transportation, physical activity, sedentary activity, amount of sleep, consumption of snacks and sweet things and social activities. The intervention lasted six to 24 months. Subsequently, the researchers followed up on the treatment and found that the lifestyle changes had affected the weight of the participants, despite their genetic disposition for overweight and obesity.

'Large parts of the population believes that when you have problematic genes it is game over. That is why it is very important we send a clear message that even though you have a genetic sensitivity this treatment can help people. We have discovered that it does not matter whether the children and adolescents have an increased genetic risk score or not. They can respond to treatment just as well. This means our treatment is efficient despite carrying common obesity risk genes. It gives hope to people with obesity and obesity related complications such as high blood pressure, cholesterol and fatty liver that we can in fact help them,' says one of the study's authors Jens-Christian Holm, doctor and head of the Children's Obesity Clinic, Holbæk Hospital.

Genetic Markers

The genetic variants the researchers have examined are common in the population and turned out not to have an effect on the ability to lose weight during the intervention. So far, the researchers did not find any biological markers for a poor response on lifestyle intervention except for the rare gene MC4R associated with poor response in terms of weight loss following a lifestyle intervention.

'MC4R is a rare genetic mutation and thus the question remains why around 75 percent of children in a group of children receiving the exact same treatment react more positively to the treatment compared to the remaining 25 percent of children not responding to lifestyle treatment. Identifying additional common genetic markers would help us understand the biological pathways that affect obesity and a person's reaction to lifestyle changes -- and thus in the long term help us provide even better treatments,' says Professor at the Novo Nordisk Foundation Center for Basic Metabolic Research Torben Hansen, last author of the study.

https://www.sciencedaily.com/releases/2018/11/181128115006.htm

Childhood obesity linked to poor school performance and coping skills

November 2, 2018

Science Daily/American Academy of Pediatrics

Study suggests that childhood obesity, now at epidemic levels in the United States, may affect school performance and coping skills for challenging situations.

Researchers analyzed responses from 22,914 parents and caregivers of children aged 10-17 years who participated in the 2016 National Survey of Children's Health. The goal was to determine the independent association between body mass index (BMI) and five markers of "flourishing," or overall well-being as it relates to the development of positive psychosocial and coping skills.

"Childhood obesity is one of the biggest public health challenges we face today," said Natasha Gill, MD, FAAP, a Pediatric Emergency Medicine Fellow at the Alpert Medical School of Brown University and Hasbro Children's Hospital. "We know that children with obesity are at a greater risk for long-term health conditions that can last into adulthood, and we wanted to see whether obesity affects a child's immediate well-being as it relates to development of psychosocial skills and other signs of flourishing."

Adjusting for several confounding variables, including gender, child depression status, average sleep hours per night, average digital media exposure per day, highest parental education level, and household poverty status, Dr. Gill and her colleagues analyzed parents' responses to questions about whether their child:

·     "Shows interest and curiosity in learning new things"

·     "Works to finish tasks he or she starts"

·     "Stays calm and in control when faced with a challenge"

·     "Cares about doing well in school"

·     "Does all required homework"

Researchers found that only 27.5 percent of children with obesity, defined as a BMI at or above the 95th percentile for children and teens of the same age and sex, were reported to have all five flourishing markers. This compares with 36.5 percent of those in the overweight range, with BMI at or above the 85th percentile, and 39 percent of children with normal BMI.

"The negative relationship between obesity and flourishing markers suggests that when compared to children with a normal BMI, obese youth may be less likely to develop healthy relationships, positive attitudes, a sense of purpose and responsibility, and interest in learning," Dr. Gill said. "Individual markers of flourishing have been shown to stay the same over time like a person's personality," she said, "so it may be important to monitor these markers in childhood to ensure optimal development into adulthood."

"We want all children to reach their maximum potential," she said. "If we can intervene early enough, we can promote positive physical, mental, and social development for these at-risk children and help them become responsible, hard-working members of society." She said her study's findings support the need for focused and coordinated efforts and resources from schools and health care providers that target obesity to improve overall well-being.

https://www.sciencedaily.com/releases/2018/11/181102083441.htm

Brain's appetite regulator disrupted in obese teens

November 30, 2017

Science Daily/Radiological Society of North America

Researchers using advanced MRI to study obese adolescents found disrupted connectivity in the complex regions of the brain involved in regulating appetite, according to a new study.

According to the Centers for Disease Control and Prevention (CDC), obesity has more than quadrupled in adolescents over the past 30 years. It is estimated that more than one-third of children and adolescents in the U.S. are overweight or obese. Obesity in adolescence is associated with a number of health risks, including cardiovascular disease and diabetes.

The study at the University of Sao Paulo in Brazil included 59 obese adolescents between the ages of 11 and 18 and 61 healthy control adolescents matched for gender, age, socio-economical classification and education level. The adolescents were classified by the World Health Organization criterion for obesity. They had no other known chronic diseases or conditions. The study participants underwent diffusion tensor imaging (DTI) of the brain to evaluate white matter integrity.

DTI is a type of MRI exam that measures functional anisotropy (FA), the microscopic motion, or anisotropy, of water molecules within and surrounding the brain's white matter fibers. Low FA values indicate greater disruption within the white matter.

"DTI is a relatively new MRI technique not widely used in clinical diagnosis," said study author Pamela Bertolazzi, a biomedical scientist and Ph.D. student in the neuroimaging laboratory at the University of Sao Paulo.

The results showed loss of white matter integrity in several brain regions in the obese patients. Compared to the healthy controls, the brains of the obese adolescents showed a decrease in FA values in areas of the brain including the amygdala, hippocampus, thalamus, cingulate gyrus, fornix, insula, putamen, orbital gyrus and bilateral hypothalamus. Several of these regions are involved in appetite regulation, impulse control, emotions and reward and pleasure in eating.

"The data reveal a pattern of involvement among brain regions that are important in the control of appetite and emotions," Bertolazzi said. "There was no region of higher FA in obese patients compared to the control group," she added.

The researchers hope that these findings will offer new tools to combat this global public health crisis.

"Childhood obesity has increased 10 to 40 percent in the last 10 years in most countries," Bertolazzi said. "If we are able to identify the brain changes associated with obesity, this DTI technique could be used to help prevent obesity and avoid the complications associated with the condition."

https://www.sciencedaily.com/releases/2017/11/171130090044.htm

Early weight gain in pregnancy correlates with childhood obesity, first study of its size shows

August 28, 2017

Science Daily/Obesity Society

Weight gain in early pregnancy has the greatest impact on infant size at birth, according to a new study. The study is the largest ever analysis of the effect that weight gain in early pregnancy has on infant size.

The study examined 16,218 pregnant mothers throughout the first, second and third trimesters in Tianjin, China to determine the risk of infants' size at birth. Results found weight gain early in pregnancy, before 24 weeks -- regardless of the weight gain later -- had the greatest impact on infant size. Infants born to women with weight gain that exceeds the 2009 Institute of Medicine guidelines for weight gain during pregnancy, prior to 24 weeks, were 2.5 times more likely to be born large.

Maternal obesity and weight gain in pregnancy have been strongly linked to the development of overweight and obesity in children, although few studies have examined in-depth gestational weight gain with infant birth weight and childhood obesity. "Obstetrician gynecologists need to begin to educate patients who are pregnant or planning to become pregnant on the implications of weight gain in pregnancy on infant outcomes and the development of childhood obesity," said Leanne M. Redman, PhD, FTOS, who led the study and serves as Associate Professor & Director of the Reproductive Endocrinology & Women's Health Lab at LSU' Pennington Biomedical Research Center.

Overall, women who are pregnant or planning to become pregnant should understand the impact that weight gain has on both short and long-term health risks for their child. Since this period of early pregnancy could have the strongest influence on the development of increased adiposity in the child, it is the opportune time to initiate lifestyle interventions in pregnant women. "International clinicians, clinical researchers and pediatricians should care about this research as findings suggest attention to healthy weight gain early in gestation may be warranted," said TOS spokesperson Suzanne Phelan, PhD, Professor of Kinesiology, Cal Poly, San Luis Obispo.

In an accompanying editorial published in Obesity, Cheryce L. Harrison, PhD discusses gestational weight gain and its association with infant birth weight, agreeing with the recent Obesity study. "These results validate previous literature in smaller cohorts while notably advancing this field of research in one of the largest, most well-defined mother-infant cohorts," said Dr. Harrison.

https://www.sciencedaily.com/releases/2017/08/170828100800.htm

Is childhood obesity a psychological disorder?

Study uses fMRI to observe relationship between neurological activity and risk for obesity

August 22, 2017

Science Daily/Children's Hospital Los Angeles

A team of researchers, including senior investigator, Bradley Peterson, MD, director of the Institute for the Developing Mind at Children's Hospital Los Angeles, used fMRI to investigate neural responses to food cues in overweight compared with lean adolescents. The team observed that food stimuli activated regions of the brain associated with reward and emotion in all groups. However, adolescents at an increasing risk for obesity had progressively less neural activity in circuits of the brain that support self-regulation and attention.

"This study establishes that risk for obesity isn't driven exclusively by the absence or presence of urges to eat high-calorie foods, but also, and perhaps most importantly, by the ability to control those urges," said Peterson, who is also a professor at the Keck School of Medicine at the University of Southern California.

The public health implications of childhood obesity are staggering. More than half of all adolescents in the U.S. are either overweight or obese. Children of overweight parents (2/3 of adults in the U.S.) already are or are likely to become overweight. Since excess weight has been linked to a myriad of health issues shown to limit human potential and add to the skyrocketing cost of healthcare, researchers are actively seeking novel approaches to understand better the causes of obesity and alter its trajectory. This study, recently reported in the journal NeuroImage, may offer such an approach.

"We wanted to use brain imaging to investigate a key question in obesity science: why do some people become obese, while others don't?" said Susan Carnell, PhD, assistant professor of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine and first author on the study.

Of the 36 adolescents (ages 14 to 19 years) enrolled in the study, 10 were overweight/obese, 16 were lean but considered at high risk for obesity because they had overweight/obese mothers and 10 were lean/low risk since they had lean mothers. The adolescents underwent brain scanning using fMRI, while they viewed words that described high-fat foods, low-fat foods and non-food items. Then they rated their appetite in response to each word stimulus. Following the activity, all participants were offered a buffet that included low- and high-calorie foods -- to relate participants test responses to real-world behavior.

The investigators observed that after viewing food-related words, brain circuits that support reward and emotion were stimulated in all participants. In adolescents who were obese or who were lean but at high familial risk for obesity, they observed less activation in attention and self-regulation circuits.

Brain circuits that support attention and self-regulation showed the greatest activation in lean/low-risk adolescents, less activity in lean/high-risk participants and least activation in the overweight/obese group. Also, real world relevance mirrored fMRI findings -- food intake at the buffet was greatest in the overweight/obese participants, followed by the lean/high-risk adolescents and lowest in the lean/low-risk group.

"These findings suggest that interventions designed to stimulate the self-regulatory system in adolescents may provide a new approach for treating and preventing obesity," said Peterson.

https://www.sciencedaily.com/releases/2017/08/170822092156.htm

Women's age at first menstrual cycle linked to heart disease risk

December 15, 2014

Science Daily/American Heart Association

The risk of heart disease, stroke and high blood pressure was significantly higher when menstruation began at age 10 or younger, or age 17 or older. First menstrual cycle at the age of 13 posed the lowest risk of heart disease, stroke and high blood pressure.

Researchers analyzed data collected from 1.3 million women aged 50 to 64 years old, who were mostly white. After over a decade of observation, those women who had their first menstrual cycle at the age of 13 had the least risk of developing heart disease, stroke, and high blood pressure.

Compared to women who had their first menstrual cycle at age 13, women with their first menstrual cycle at age 10 or younger, or age 17 or older, had up to:

• ·      27 percent more hospitalizations or deaths due to heart disease;
• ·      16 percent more hospitalizations or deaths from stroke; and
• ·      20 percent more hospitalizations with high blood pressure, or deaths due to its complications.

"The size of our study, the wide range of ages considered, and the vascular diseases being examined made it unique and informative," said Dexter Canoy, M.D, Ph.D., study lead author and cardiovascular epidemiologist at the Cancer Epidemiology Unit, Nuffield Department of Population Health at the University of Oxford in the U.K.

"Childhood obesity, widespread in many industrialized countries, is linked particularly to early age at which the first menstrual cycle occurs. Public health strategies to tackle childhood obesity may possibly prevent the lowering of the average age of first menstrual cycle, which may in turn reduce their risk of developing heart disease over the long term."

The effect of age of the first occurrence of menstruation on heart disease was consistently found among lean, over-weight, and obese women, among never, past or current smokers, and among women in lower, middle, or higher socioeconomic groups.

For the majority of these women, however, their additional risk of developing a vascular disease was small. Of the million women, only four percent of them had their first menstrual cycle occurring at age 10 or younger, and only one percent at age 17 or older.

http://www.sciencedaily.com/releases/2014/12/141215185203.htm

Early to bed and early to rise: it's keeping kids leaner

September 30, 2011

Science Daily/American Academy of Sleep Medicine

Researchers recording the bedtimes and wake times of 2,200 Australian youths found that the night owls were 1.5 times more likely to become obese than the early birds, twice as likely to be physically inactive and 2.9 times more likely to sit in front of the TV and computer or play video games for more hours than guidelines recommend.

A study in the Oct. 1 issue of the journal Sleep recorded the bedtimes and wake times of 2,200 Australian participants, ages 9 to 16, and compared their weights and uses of free time over four days. Children who went to bed late and got up late were 1.5 times more likely to become obese than those who went to bed early and got up early. Furthermore, late-nighters were almost twice as likely to be physically inactive and 2.9 times more likely to sit in front of the TV and computer or play video games for more hours than guidelines recommend.

"The children who went to bed late and woke up late, and the children who went to bed early and woke up early got virtually the same amount of sleep in total," said co-author Carol Maher, PhD, a postdoctoral fellow with the University of South Australia. "Scientists have realized in recent years that children who get less sleep tend to do worse on a variety of health outcomes, including the risk of being overweight and obese. Our study suggests that the timing of sleep is even more important."

Maher said mornings are more conducive to physical activity for young people than nights, which offer prime-time TV programming and social networking opportunities. This relationship between time of day and available activities might explain why more sedentary and screen-based behaviors were observed with later bedtimes, she said. At a time when research is showing that teenagers have a natural tendency to stay up late and wake late, the results of this study could stand as a warning.

"It is widely accepted that the sleep patterns of adolescents are fundamentally different from children and adults, and that it is normal for adolescents to stay up very late and sleep in late in the morning," Maher said. "Our findings show that this sleeping pattern is associated with unfavorable activity patterns and health outcomes, and that the adolescents who don't follow this sleep pattern do better."

Other findings from the University of South Australia study:

Early-bed/early-risers went to bed 70 to 90 minutes earlier, woke up 60 to 80 minutes earlier and accumulated 27 minutes more moderate to vigorous physical activity each day than late-risers.

Late-bed/late-risers watched TV, played video games or were online 48 minutes longer each day than early-bed/early risers, primarily between 7 p.m. and midnight.

Only 12 percent of late-bed/late-risers had an average of two hours or less screen time per day, which is recommended for children and teens by the Australian Department of Health and Aging. In comparison, 28 percent of early-bed/early risers met the recommendation for screen time.

On a broad scale, late-bed/late-risers replaced about 30 minutes of moderate to vigorous physical activity with 30 minutes of sedentary behavior each day, relative to the early-bed/early-rise group.

Body-mass index (BMI) scores were higher in late-risers than early-risers, and late-risers were more likely to be overweight or obese. Late-bed/late-risers tended to have few siblings, live in major cities, come from lower household incomes and have a part-time job.

http://www.sciencedaily.com/releases/2011/09/110930052216.htm

School obesity-prevention curriculum can reduce medical costs

August 1, 2011

Science Daily/Children's Hospital Boston

Teaching middle-school children about nutrition and exercise and encouraging them to watch less TV can save the health care system a substantial amount of money, suggests a new economic analysis.

"Because eating disorders can be so expensive to treat, preventing even one case in the five Planet Health schools translated into reducing medical costs by $34,000," says Austin. "But if we scale up our calculations to include, say, 100 middle schools in Massachusetts, the medical costs reduced by preventing bulimia increase to over half a million dollars. And if we scale up nationwide, to say 1,000 schools, the potential reduction in the medical cost burden is sizable."

Austin notes that obesity prevention programs that stigmatize obesity or create a sense of blame can actually contribute to eating disorders. "We need to be smart about choosing obesity prevention strategies that, at the same time, can prevent eating disorders," she says. "Our study shows that when we do both, we substantially increase the benefits, both in terms of health and reducing medical costs."

http://www.sciencedaily.com/releases/2011/08/110801161416.htm

Women who gain too much or too little weight during pregnancy at risk for having an overweight child

April 14, 2014

Science Daily/Kaiser Permanente

Gaining both too much or too little weight during pregnancy appears to increase the risk of having an overweight or obese child, according to a study. In one of the largest studies to examine current Institute of Medicine recommendations regarding pregnancy weight gain in relation to childhood obesity, researchers reviewed the electronic health records of 4,145 racially diverse females who had completed a health survey between 2007 and 2009 and subsequently had a baby.

In one of the largest studies to examine current Institute of Medicine recommendations regarding pregnancy weight gain in relation to childhood obesity, researchers reviewed the electronic health records of 4,145 racially diverse female members of Kaiser Permanente in Northern California who had completed a health survey between 2007 and 2009 and subsequently had a baby.

Researchers reviewed the medical records of those children between ages 2 and 5 years old and found that:

·      Among all women who gained more than the recommended weight during pregnancy, 20.4 percent of their children were overweight or obese, compared with 19.5 percent in women who gained less than recommended weight and 14.5 percent in women who gained weight within the guidelines.

·      Women with a normal Body Mass Index measurement before pregnancy who gained less than the recommended amount were 63 percent more likely to have a child who became overweight or obese.

·      Women with a normal BMI before pregnancy with weight gain above recommendations were 80 percent more likely to have an overweight or obese child.

"The stronger association we found among normal weight women who gained too much or too little weight during pregnancy suggests that perhaps weight gain in pregnancy may have an impact on the child that is independent of genetic factors," said senior investigator Monique M. Hedderson, PhD, Kaiser Permanente Division of Research in Oakland, Calif.

"Gaining either too little or too much weight in pregnancy may permanently affect mechanisms that manage energy balance and metabolism in the offspring, such as appetite control and energy expenditure," said the study's lead author Sneha Sridhar, MPH, Kaiser Permanente Division of Research. "This could potentially have long-term effects on the child's subsequent growth and weight."

http://www.sciencedaily.com/releases/2014/04/140414092115.htm

Battling obesity in the classroom with exercise

October 5, 2015

Science Daily/University of Michigan

There's another burst of seat-bouncing, giggling and shouting in a simulated classroom. Through a new study, researchers hope to find ways to redesign classrooms and develop a curriculum to add in two-minute exercise breaks throughout the day -- "a prescription for physical activity" -- and incorporate the additional fitness as seamlessly as possible for teachers.

Marcus isn't having it. "How do you call that cheating?" demands Patton, an 11-year-old cyclone of energy.

Patton admits it's tough to sit still. Like millions of other U.S. middle and grade school kids he gets scant exercise during school because budget and time restraints have slashed recess and lunch periods.

Hasson, assistant professor at the U-M School of Kinesiology, seeks to remedy that problem by studying kids like Patton in a collaborative research project called Active Classroom. Partners include the School of Public Health Momentum Center, Taubman College of Architecture and Urban Planning, and School of Education.

Researchers hope to find ways to redesign classrooms and develop a curriculum to add in two-minute exercise breaks throughout the day -- "a prescription for physical activity" -- and incorporate the additional fitness as seamlessly as possible for teachers.

Clarke Fields, 9, and Patton, are between activity breaks now, meaning they'll play games, watch television or do something else sedentary between one of the 20 activity breaks. That's 40 minutes of exercise by the end of the school day -- but still only two-thirds of the recommended 60 minutes for kids.

Hasson's physical activity study differs from others in that it focuses on the built and curricular environments rather than solely focusing on behaviors, nutrition and exercise.

Her initial findings are promising: By incorporating low-, medium- or high-intensity activity, kids may burn 100-300 more calories a day. She found they quickly refocused on school work, and none reported disliking the exercise.

Their enthusiasm shows. Patton and Fields snap to attention when Hasson shouts: "Ready for an activity break?"

They jump up and record their resting heart rates. Nicki Minaj pumps out of the computer and they're off: Two minutes of high-intensity jumping jacks, skiers, butt kicks and high-knees. Hasson, who's also a former competitive volleyball player, jumps and kicks along with them, shouting encouragement.

"Time!" The students, breathless and smiling, shout out heart rates and perceived exertion scores and Hasson writes them on a whiteboard.

After the exercise, students take a quick math test to gauge how easily they reset back to learning mode. By the end of this first study phase, researchers will also know which intensities and exercises are best for weight management, fitness, cognition and other factors that impact a child's well-being in and out of the classroom.

The other essential parts of the research are "playable" hallways and classrooms. Hallways could be designed with pathways or longer routes and encourage room-to-room movement or activities like hopscotch. Classes might include furniture that teachers can store or rearrange and structures such as climbing walls.

Patton's mother Tabia arrives during another activity break. She teaches elementary school and supports Hasson's goal but remains guarded. Climbing walls in a classroom with 30 kids? That sounds hard to manage. Still, she says she'd love to be able to do this in her classroom.

"When (Marcus) has to sit for long periods of time, it's hard for him to focus," Tabia Patton said, and she knows this is true for many kids.

Hasson understands if teachers are concerned.

"The kids will be an easy sell," she said.

Indeed, their self-reported perceived exertion is almost always much lower than their actual exertion, which means they're working a lot harder than they feel like they are. They also report enjoying the exercise days more than the sedentary days when they're instructed to use a tablet.

The biggest challenge will be convincing overworked teachers and pressured administrators that it's doable, Hasson says.

Hasson's next steps are to partner with teachers like Tabia Patton in the Ann Arbor and Ypsilanti elementary schools to pilot this project in an actual classroom with the long-term goal of implementing the project nationwide. With waistlines expanding and lifespans shortening, she says it's a public health priority.

"This generation of kids is expected to live two to five years less than their parents, and this problem is directly related to diet and physical inactivity," Hasson said.

http://www.sciencedaily.com/releases/2015/10/151005121703.htm