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While a great deal of research on childhood obesity has spotlighted the long-term health problems that emerge in adulthood, a new UCLA study focuses on the condition's immediate consequences and shows that obese youngsters are at far greater risk than had been supposed.

Compared to kids who are not overweight, obese children are at nearly twice the risk of having three or more reported medical, mental or developmental conditions, the UCLA researchers found. Overweight children had a 1.3 times higher risk.

"This study paints a comprehensive picture of childhood obesity, and we were surprised to see just how many conditions were associated with childhood obesity," said lead author Dr. Neal Halfon, a professor of pediatrics, public health and public policy at UCLA, where he directs the Center for Healthier Children, Families and Communities. "The findings should serve as a wake-up call to physicians, parents and teachers, who should be better informed of the risk for other health conditions associated with childhood obesity so that they can target interventions that can result in better health outcomes."

With the dramatic rise in childhood obesity over the past two decades, there has been a parallel rise in the prevalence of other childhood-onset health conditions, such as attention deficit-hyperactivity disorder, asthma and learning disabilities. But previous studies on the topic have been limited due to a narrow focus on a specific region of the county, a small sample size or a single condition.

The new UCLA research, a large population-based study of children in the United States, provides the first comprehensive national profile of associations between weight status and a broad set of associated health conditions, or co-morbidities, that kids suffer from during childhood.

Overall, the researchers found, obese children were more likely than those who were classified as not overweight to have reported poorer health; more disability; a greater tendency toward emotional and behavioral problems; higher rates of grade repetition, missed school days and other school problems; ADHD; conduct disorder; depression; learning disabilities; developmental delays; bone, joint and muscle problems; asthma; allergies; headaches; and ear infections.

For the study, the researchers used the 2007 National Survey of Children's Health, analyzing data on nearly 43,300 children between the ages 10 and 17. They assessed associations between weight status and 21 indicators of general health, psychosocial functioning and specific health disorders, adjusting for sociodemographic factors.

Of the children in the study, 15 percent were considered overweight (a body mass index between the 85th and 95th percentiles), and 16 percent were obese (a BMI in the 95th percentile or higher).

The study, which is currently available online, will be published in the January-February print issue of the journal Academic Pediatrics.

The UCLA researchers speculate that the ongoing shift in chronic childhood conditions is likely related to decades of underappreciated changes in the social and physical environments in which children live, learn and play. They propose that obesity-prevention efforts should target these social and environmental influences and that kids should be screened and managed for the co-morbid conditions.

The researchers add that while the strength of the current study lies in its large population base, future studies need to examine better longitudinal data to tease out causal relationships that cannot be inferred from a cross-sectional study.

"Obesity might be causing the co-morbidity, or perhaps the co-morbidity is causing obesity - or both might be caused by some other unmeasured third factor," Halfon said. "For example, exposure to toxic stress might change the neuroregulatory processes that affect impulse control seen in ADHD, as well as leptin sensitivity, which can contribute to weight gain. An understanding of the association of obesity with other co-morbidities may provide important information about causal pathways to obesity and more effective ways to prevent it."

A very good point!

This study is somewhat limited as it only looks at children between the ages of 10 and 17. Yet probably everyone of us know quite a few youngsters who are much younger than that and are grossly overweight which does rather point to the unmeasured third factor mentioned by Mr. Halfon. His example of exposure to toxic stress moving through to ADHD seems more of an open invitation to receive funding rather than a legitimate reason for the problem with childhood obesity. In fact in many ways, they seem to me, to have missed entirely the point at comparison of children’s heights, weights and body shape from the 1950s, say, with those that we see around us now. Tied into the diet that both groups were eating would reveal a lot more than the study I believe.

Problems that we see within our child population now just weren't around back then but neither were the children who grew up back then faced with a diet that was rich in sugar grain and other high carbohydrate ingredients. Neither did they have open access to copious quantities of sugar-filled carbonated drinks that the youngsters of today drink without any moderation whatsoever. While the children who grew up in the 50s and 60s may not have had copious quantities of it they still had meat and an assortment of vegetables as part of their regular fare, something that is sadly missing from the diet of many youngsters today.

Common sense together with a little understanding of history, a small amount of research points to the simple fact that this problem is really down to three main factors. Firstly, the western population has become slowly, over the last few decades, less and less educated about what constitutes a good diet which together with the fact that general food preparation skills aren't being passed on as they used to be has meant that people are more and more becoming reliant upon convenient foods as a way of providing nutrition to their family. That is of course augmented through the pressure of smart marketing campaigns that leveraged social pressure pseudo science and takes full advantage of the ignorance of its target market. Those first two factors lead ultimately to the last factor which is that people now make exceptionally poor food choices not just for themselves but for their children as well; consequences of which we are seeing all around us.

The UCLA researchers preposition that obesity prevention should target social and environmental influences is more or less half right but together with those social and environmental influences, they need to understand that this include the need to better educate both children and parents for at least the two next generations in order to reverse and recover from the problem that we're seeing with overweight youngsters right now.

Cheers,

Mark