“The long term implications for that are devastating,” Dr. Mark Williams, a family physician at Premier Health Primary Care - Beavercreek, said about childhood obesity. “This is a disaster waiting to happen.”
Williams said childhood obesity is a “terribly important concern” and the projected increases in diabetes for young individuals is a direct result of childhood obesity.
Study shows dramatic increase
Even if the rate of new diabetes diagnoses among young people remains the same over the decades, type 2 diabetes diagnoses could increase nearly 70% and type 1 diabetes diagnoses could increase 3% by 2060, according to the Centers for Disease Control. Last year, the CDC stated an analysis of data from 2001 to 2017 showed the number of people under age 20 living with type 1 diabetes increased by 45%, and the number living with type 2 diabetes grew by 95%.
“This new research should serve as a wake-up call for all of us. It’s vital that we focus our efforts to ensure all Americans, especially our young people, are the healthiest they can be,” said CDC Acting Principal Deputy Director Dr. Debra Houry. “The COVID-19 pandemic underscored how critically important it is to address chronic diseases, like diabetes.”
In addition to the overall predictions, analyses of these data by race and ethnicity predicted a higher burden of type 2 diabetes for Black, Hispanic/Latino, Asian, Pacific Islander, and American Indian/Alaska Native youth.
Childhood obesity in Ohio
The increasing prevalence of childhood obesity is one of the explanations given for this projected increase in diabetes among youth, along with a predisposition to diabetes. Maternal diabetes increases the risk of diabetes in children, the CDC said.
The rate of childhood obesity in Ohio is between 16-18%, according to differing data sets from the 2019-2020 National Survey of Children’s Health and 2019 data from the Youth Risk Behavior Surveillance System.
“We definitely had an increase, especially during the 2020-2021 time frame of referrals,” said Dr. Melissa King, a pediatrician and program director in the Healthy Me clinic at Dayton Children’s Hospital. “It seems to have tampered back down.”
King said getting kids back in school has helped with increasing physical activity among children and getting kids eating on a schedule.
Risk factors to kids
Doctors say there are a number of factors that contribute to childhood obesity. Genetics and lifestyle factors are some of the first components that come to mind, but the social determinants of health like poverty, the way some cities are laid out, access to safe parks, and access to grocery stores are additional societal issues doctors say contribute to childhood obesity.
“Access to good healthy foods is a societal issue,” Williams said. Those living in food deserts, which are typically defined as areas where access to fresh and affordable produce is difficult to find, may have to rely on fast food or convenience stores for food. While it is still good that those areas have some source for food, Williams said, the food available may be high in calories and low in nutrients.
King said approximately 30% of the patients they see in their Healthy Me clinic identify as food insecure.
“Sometimes (food insecurity) doesn’t mean lack of food,” King said. “Sometimes it means lack of non-processed, non-shelf-stable, calorically dense but nutrient poor food.”
Williams said communities should promote more groceries like the Gem City Market, which is a full-service grocery store and deli located in the Salem Avenue corridor, to help bring groceries to food deserts.
Family predisposition and genetics play a big role, King said, in predisposing children to childhood obesity.
“Children who have a parent with obesity or children who have both parents with obesity have an increased risk by the time they reach their teenage years,” King said.
Additionally, environment is a big factor, as King said access to safe neighborhoods, safe parks, and affordable sports is important for children to have for exercise. The way some cities are laid is a factor, as well, if individuals rely more on transportation than being able to walk in their cities.
“The issues we face here in Dayton are different than issues they face in California or Florida or even New York,” King said. “We’re not a very walkable community, for the most part. There are segments of our community that are walkable, but for the most part, we rely on transportation outside of our own two feet, which decreases our overall physical activity.”
Children may have other underlying health conditions or medications affect their appetite, making them unsure of when to trust hunger cues, King said.
Ways to promote a healthy lifestyle
Families and loved ones can help promote healthy lifestyles for children through good role modeling, having family meals, and even taking small steps toward balanced meals and less sugary drinks.
Adults in the family can make physical activity and exercise a norm for the family, King said, even with something like five to 10 minute walks a few times a week, hiking, or participating in sports.
“Something to promote physical activity as a family,” King said.
King said the research is mixed on the impact of family meal times, but the benefits they have seen include giving parents a time to connect with their children, to model behaviors and good eating habits, and to have non-distracted time to eat. King also noted learning about recommended portion sizes. Doctors recommended children avoid soda pop and drinks with lots of sugar, as well.
King said reducing stigma or social judgement around weight can also be impactful, saying weight is complicated.
“Excess weight or obesity is really multi-factorial, and I feel like we do a lot of shaming or making it seem like it’s a moral failure,” King said. “We do a lot of identifying of positive and negative behaviors.” She used the example of how eating a pastry may be perceived as “bad,” but she said it is about having a balance.
“Am I doing some physical activity ... am I doing some fruits and vegetables in my diet?” King said, adding that taking small steps can help build habits like physical activity or eating vegetables. “It’s so complicated … It doesn’t have to be an all or nothing.”
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