Childhood Obesity and Diabetes
Is There Really a Childhood Obesity Epidemic?
The unfortunate facts and fallout of the current common ways of living in North America are inevitably hitting us here in Nova Scotia. There is an epidemic of childhood overweight and obesity in Canada. Between 1978/79 and 2004 the percentage of overweight and obese children between the ages of 2 and 17 rose from 15-26% in Canada. The sharpest rise was in the youth group aged 12-17 in which rates of obesity and overweight rose from 15% to 29%. This sad fact is a huge contributor to more dismal fact that these children are now sicker than they have ever been with increased rates of type 2 diabetes, high blood pressure, sleep apnea, early menstruation. In addition, over weight children have more social problems, may be more at risk for eating disorders, and typically continue to be overweight as they age.
Overweight occurs when body mass index, reflecting the relationship between height and weight, is greater than the 85th percentile and obesity occurs when it is greater than the 95th. Another way of discerning if concern is warranted is simply noting if there is abdominal obesity present. If the size of you or your child’s waist is greater than their hips you’re in or moving into the problem zone. If you look around you when you’re out and about you might notice many adults falling into this category; it is easy to think it’s not a problem because it’s so common. However, this is commonplace scenario is one of the greatest contributors to rising health care costs because this rise in obesity is very much related to the rise in Type 2 Diabetes, a disease with many long term complications.
What’s causing this massive rise of overweight and obese children? Kids are not exercising enough and are eating way too much sugar and simple carbohydrates; though it’s does seem to be a bit more complicated than just that, those are still the two most important contributors. Obesity is actually an hormonal disease which both causes and is caused by similar factors that cause type two or Non Insulin Dependent Diabetes Mellitus. The foundations for developing these problems starts very early on, and parental health and habits play a large role in disease progression.
One of the key hormonal players in this disease process is insulin. Insulin is an anabolic (building up and storing) hormone and is secreted in the pancreas by beta islet cells in response to eating especially to rises in blood sugar. When it is released from the pancreas it signals cells to take sugar in, make energy out of it, and make fat (stored energy). In Type 1 Diabetes Mellitus there is autoimmune destruction of the Beta Islet cells of the pancreas resulting in complete loss of the cell’s ability to take up sugar and so they signal for more food and the excess sugar in the blood causes increased urination and thirst resulting in the classic signs of diabetes mellitus of excess urination, thirst, hunger and weight loss.
Type two diabetes results from the opposite scenario of too much insulin (from too much sugar and obesity) which causes the body to stop recognizing and responding to it (insulin resistance), resulting in the same symptom of increased hunger as type 1, despite chronically elevated blood sugar. Obesity contributes to the disease developing because fat itself causes insulin resistance. So we when eat a lot of sugar, don’t exercise enough, or have a strong predisposition to storing fat, insulin levels are elevated for a prolonged time and because the cells aren’t getting what they need the body continues to signal for more insulin straining the pancreas which eventually can’t keep up. As a result, type 2 diabetes can end up requiring treatment with insulin.
As with all things, there are many nuances to the risk factors for children developing non insulin dependant diabetes including genetic predisposition, length of being overweight, nutritional factors, and exercise. However, we know that obesity is the number one contributing factor to developing diabetes type 2 and children are equally at risk; in fact overweight and obese children are more at risk over their lifetime because they have more years of elevated insulin and the resulting insulin resistance. The number one cause of death in people with type 2 diabetes is heart disease, in large part due to the damage to small blood vessels as a result of the chronically elevated blood sugar. This damage is the cause of kidney disease, circulation problems, and eye diseases that result from diabetes. Epidemic therefore is an accurate description of this very serious problem.
Identifying Children at Risk for Obesity, Type 2 Diabetes, and Cardiovascular Disease, Diabetes Spectrum Vol 18 2005 Retrieved: http://spectrum.diabetesjournals.org/content/18/4/213.full.pdf+html on Dec 4 2015.