Obesity and emotional problems appear to develop together from age 7
April 27, 2019
Science Daily/European Association for the Study of Obesity
Obesity and emotional problems, such as feelings of low mood and anxiety, tend to develop hand-in-hand from as young as age 7 years, according to new research being presented at this year's European Congress on Obesity (ECO) in Glasgow, UK (28 April-1 May).
The analysis of a large nationally representative sample of over 17,000 children in the UK finds that regardless of their socioeconomic status, girls and boys with obesity at age 7 were at greater risk of emotional problems at age 11, which in turn, predicted high body mass index (BMI) at 14 years of age.
While the study did not investigate the reasons why obesity and emotional problems develop together during childhood, the researchers say that a range of factors are likely to be involved.
"Children with higher BMI may experience weight-related discrimination and poor self-esteem, which could contribute to increased depressive symptoms over time (as has been shown in adults), while depression may lead to obesity through increased emotional eating of high-calorie comfort foods, poor sleep patterns, and lethargy," explains Dr Charlotte Hardman from the University of Liverpool, UK, who co-led the study. "Our findings highlight the importance of early interventions that target both weight and mental health and minimise negative outcomes later in childhood."
Adolescence is a key developmental period for both obesity and emotional problems. But how they relate to each other over time is unclear, and little research has focused on the onset and co-occurrence of these disorders through childhood and adolescence.
Lower socioeconomic status is strongly associated with both obesity and poor mental health, but it is unknown whether the association between these two health outcomes is merely a function of shared socioeconomic disadvantage.
In this study, researchers used statistical modelling to assess associations between obesity and emotional problems in 17,215 children born in the UK between 2000 and 2002, who are taking part in the Millennium Cohort Study -- a nationally representative, UK birth cohort study of over 19,000 individuals born at the start of the millennium.
Information on children's height and weight (BMI) were collected at ages 3, 5, 7, 11 and 14 years, and parents filled in a questionnaire on their children's emotional problems such as feelings of low mood and anxiety. The researchers adjusted for a range of factors known to affect both obesity and mental health including gender, ethnicity, socioeconomic status, and behavioural problems, as well as parents' mental health.
Rates of obesity and emotional problems increased gradually throughout childhood and adolescence. Almost 8% (814/10,767 children with available data) of young people were obese by the age of 14, and around twice that number were reported to have had feelings of low mood and anxiety (1369/10,123).
By adolescence, around a fifth (137/693) of those with obesity also had high levels of emotional distress.
The analysis found that obesity and emotional problems tended to occur together in mid-childhood and adolescence between the 7 and 14 years of age, but not in early childhood (3 to 5 years of age).
On average, girls had higher BMIs and emotional symptoms than boys from 7 to 14 years of age, but co-occurrence and development of obesity and emotional problems were similar in both girls and boys.
After taking socioeconomic status into account, the association between BMI and emotional problems was reduced slightly, suggesting that socioeconomic disadvantage may partly explain the link between children's obesity and poor mental health.
"The shared socioeconomic risk in the development of obesity and poor mental ill-health could be explained by numerous factors. For instance, socioeconomically deprived areas tend to have poorer access to healthy food and green spaces, which may contribute to increased obesity and emotional problems, and compound the effects of family-level socioeconomic disadvantage," says Dr Praveetha Patalay from University College London, UK who co-led the research.
"As both rates of obesity and emotional problems in childhood are increasing, understanding their co-occurrence is an important public health concern, as both are linked with poor health in adulthood. The next steps are to understand the implications of their co-occurrence and how to best intervene to promote good health."
The authors acknowledge that their findings show observational associations, so conclusions about cause and effect cannot be drawn. They point to several limitations, including unmeasured confounding, parent report, and the attrition rate that may have influenced the results.
https://www.sciencedaily.com/releases/2019/04/190427201943.htm
Bigger portions lead to preschoolers eating more over time
April 12, 2019
Science Daily/Penn State
Preschoolers may not be as good at resisting large portions of everyday foods as was previously thought, according to Penn State researchers.
In a study, the researchers examined whether children between the ages of three and five were susceptible to the portion size effect -- the tendency of people to eat more when larger portions are served.
They found that when served larger portions of typical meals or snacks, the children consumed more food, both by weight and calories.
Alissa Smethers, a doctoral student in nutritional sciences, said the findings -- recently published in the American Journal of Clinical Nutrition -- suggest that caregivers should pay close attention to not just the amount of food they serve but also the variety of food.
"It's hard to define portions that are appropriate for all preschoolers, since their calorie requirements vary due to differences in height, weight and activity level," Smethers said. "But it's a good idea to look at the proportions of different foods you're serving, with fruits and vegetables filling up half the plate and with smaller portions of more calorie-dense foods, as recommended in the USDA MyPlate nutrition guide."
Barbara Rolls, Helen A. Guthrie Chair and director of the Laboratory for the Study of Human Ingestive Behavior at Penn State, added that the results also suggest that the portion-size effect can be used strategically by caregivers to help children eat more fruits and vegetables.
"The positive side is that you can use the portion size effect strategically, for example by serving larger portions of fruits and vegetables to increase their consumption," Rolls said. "You can also serve them at the start of the meal or on their own as snacks. When there are no other foods competing with them, kids may be more likely to eat them."
Smethers said that while it was known that adults are likely to eat more when served larger portions of food over time, it was thought by some researchers that young children can sense how many calories from food they need and adjust their eating habits accordingly, a process called "self-regulation."
Previous studies have tested this theory by looking at children's eating habits at one meal or over a single day. But Smethers said it may take longer -- up to three to four days -- for self-regulation to kick in, and so she and the other researchers wanted to study the portion size effect in children across a full five days.
The researchers recruited 46 children between the ages of three and five from childcare centers at the University Park campus for the five-day study. All meals and snacks were provided for the children, who during one five-day period received baseline-sized portions -- based on Child and Adult Care Food Program requirements -- and during another period had portions that were increased in size by 50 percent.
"In the larger portion meals, we wanted to serve portion sizes that the children might encounter in their everyday lives," Smethers said. "For example, instead of getting four pieces of chicken nuggets, they would get six, for a 50 percent increase."
During both five-day periods, the children were allowed to eat as much or as little of their meals or snacks as they wanted. After the children were done eating, the leftover foods were weighed to measure how much each child consumed.
Additionally, each child wore an accelerometer throughout each five-day period to measure their activity levels, and the researchers measured their height and weight.
After analyzing the data, the researchers found that serving larger portions led to the children eating 16 percent more food than when served the smaller portions, leading to an extra 18 percent of calories.
"If preschoolers did have the ability to self-regulate their calorie intake, they should have sensed that they were getting extra over the five days and started eating less," Rolls said. "But we didn't see any evidence of that."
The researchers also found that children with higher BMI percentiles for their age were more likely to be influenced by larger portions. Additionally, the portion size effect seemed stronger in children with overweight or obesity than for children without.
"We found that while the portion size effect is powerful overall, some children seemed to be more susceptible to the effect than others," Smethers said. "Children who were rated by their parents as more responsive to food when it's in front of them were also affected more by portion size, while children who were rated as paying attention to whether or not they were actually hungry were less affected by portion size."
https://www.sciencedaily.com/releases/2019/04/190412110333.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