Thursday, June 26th, 2014
The obesity rate among American kids may actually be higher than the 18 percent of children the Centers for Disease Control currently classifies as obese, according to an analysis published in the journal Pediatric Obesity. As many as 25 percent of obese or overweight kids may not be counted because the tally is based on the body mass index (BMI), a calculation that researchers say is flawed because children’s height and weight change rapidly as they grow–and not always in proportion with each other.
More from The Wall Street Journal:
“BMI is not capturing everybody who needs to be labeled as obese,” said Francisco Lopez-Jimenez, director of preventive cardiology at the Mayo Clinic in Rochester, Minn., who headed the study with Asma Javed, a pediatric endocrinology fellow.
Measuring body-mass index is a relatively easy and inexpensive way to screen for obesity among large groups of people, such as children in a school setting. A problem is that BMI, a calculation based on a person’s height and weight, isn’t well suited to children because their height and weight don’t proportionally increase as they grow, said Ruth Loos, a professor of preventive medicine at the Icahn School of Medicine at Mount Sinai in New York, who wasn’t involved with the Mayo study.
“It doesn’t mean that we cannot use BMI in childhood but it requires extra caution,” she said.
Other recent research has linked everything from sleep deprivation to weight-based name calling with an elevated risk of childhood obesity. Research released earlier this year had claimed a significant drop in the childhood obesity rate in the U.S., but subsequent research actually showed a sharp increase in the number of severely obese kids.
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Friday, May 2nd, 2014
Almost a third of mothers say they like their bodies–stretch marks, scars, and all–after having had babies more than they liked their bodies before pregnancy, according to a new survey of 3,000 moms. More from Today.com:
Although 70 percent of women said they feel worse about how their body looks after having kids, 30 percent of moms like their body better and feel more “powerful and confident” in their looks, according to a 2013 TODAY.com survey of more than 3,000 women.
“I went through the body image thing a lot of girls go through in college, when I was fixated on my body and my weight,” says Leslie Goldman of Chicago, mom of a 2-year-old daughter who is expecting her second child in six weeks. “None of that was a part of my life after my late twenties, but postpartum is still so freeing and empowering for me to watch my body in a whole new light, healing from surgery and still producing food to feed my baby.”
While Goldman felt a bit self-conscious about her C-section scar in the beginning — when it was “very red and kind of puckery” — now, in the gym locker room, she’s happy she has a physical sign of motherhood and views other women with C-section scars as kindred spirits. “I’m sure many women working out are moms,” Goldman says. “But when I see the C-section scar, I know we went through the same thing and it’s a signifier we’re all in this together.”
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Wednesday, April 16th, 2014
New research has linked a mother’s weight with the risk that her baby could either be stillborn or die shortly after birth. Reuters has more:
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The risk was greatest among the most obese women, the authors write in The Journal of the American Medical Association.
“The main message of the study is that maternal overweight and obesity increases the risk of fetal death, stillbirth and infant death,” said Dagfinn Aune, the study’s lead author, from Imperial College London.
“Since excess weight is a potentially modifiable risk factor, further studies should assess whether lifestyle and weight changes modifies the risk of fetal and infant death,” he told Reuters Health in an email.
Stillbirths, when a child dies in the womb toward the end of pregnancy, account for a large part of the estimated 3.6 million neonatal deaths that occur each year, the researchers point out.
Previous studies have linked women’s weight during pregnancy to the risk of their children dying in the womb or shortly after delivery due to complications. Some could not show their findings were not due to chance, however.
For the new study, the researchers pulled together data from 38 studies. Together, these included over 45,000 accounts of child deaths that occurred shortly before or after delivery, although a few studies counted deaths up to one year after birth.
According to the U.S. National Institutes of Health, a person of normal weight would have a body mass index (BMI) – which is a measure of weight in relation to height – between 18.5 and 24.9.
An adult who is 120 pounds and five feet, five inches tall, for example, would have a BMI of 20.
A BMI between 25 and 29.9 is considered overweight, and a score of 30 or above is considered obese.
Tuesday, March 18th, 2014
A study published last month in the Journal of the American Medical Association, which claimed a 43 percent drop in the number of preschool-aged American kids who have a weight problem, is being questioned as a possible statistical anomaly, and not an indication that the childhood obesity epidemic is on its way out. Reuters reports on the challenge, which is coming from obesity experts from Massachusetts General Hospital and other places:
In fact, based on the researchers’ own data, the obesity rate may have even risen rather than declined.
“You need to have a healthy degree of skepticism about the validity of this finding,” said Dr. Lee Kaplan, director of the weight center at Massachusetts General Hospital in Boston.
No evidence of the kinds of major shifts in the behavior among preschoolers aged 2 to 5 exists which would explain a 43 percent drop in their obesity rates, he said.
The latest study is based a well-respected data set taken from the National Health and Nutrition Examination Survey, or NHANES, which has been conducted annually since the 1960s and involves in-person interviews and physical exams.
The CDC defines obesity in adults as having a body mass index – a ratio of weight to height – above 30, but in children it is defined by where the individual falls on age- and sex-specific growth charts.
The 2011-2012 version of the survey included 9,120 people; 871 of them were 2 to 5 years old.
In some research 871 would be considered a large number. But when the obesity rate is fairly low, having a sample of a few hundred makes it easier for errors to creep in through random chance.
“In small samples like this, you are going to have chance fluctuations,” said epidemiologist Geoffrey Kabat of the Albert Einstein College of Medicine in New York City.
To be sure, the CDC scientists were aware of the statistical limitations of their data, and their paper clearly stated that the findings were imprecise.
The 43 percent headline figure refers to the drop from the 13.9 percent rate in 2003-04 to the 8.4 percent rate in 2011-2012. The change of 5.5 points represents a decline of 40 percent from the original 13.9 percent. (The 43 percent trumpeted by a CDC press release comes from rounding those numbers to 14 and 8, respectively.)
In addition to the small sample size and a lack of supporting evidence from other recent surveys of childhood weight, experts cite a dearth of signs of behavioral changes that would contribute to improving obesity numbers. More from Reuters:
For obesity rates to drop, researchers reckon, young children have to eat differently and become more active. But research shows little sign of such changes among 2-to-5-year olds, casting more doubt on the 43 percent claim.
Such a decline would require changes in exercise, food consumption and sleep patterns, said Mass General’s Kaplan “There is no evidence of that,” he said.
In 2010 [WIC (Women, Infants and Children) program researcher Shannon] Whaley and her colleagues examined the effectiveness of WIC classes and counseling to encourage healthy eating and activities for women and children in the program.
Their findings were discouraging: Television watching and consumption of sweet or salty snacks actually rose, while fruit and vegetable consumption fell – changes that could lead to weight gain. One positive was a rise in physical activity.
Apart from the WIC program, few anti-obesity efforts target preschoolers, Kaplan pointed out. That makes a precipitous decline in obesity in that group highly unlikely.
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Monday, March 17th, 2014
A major doctor’s group is urging obstetricians to have serious, often difficult conversations with their patients, telling them that being overweight or obese can have negative impact on both their fertility and their pregnancy health. More from Time.com:
The latest news about the negative effects of our nation’s obesity epidemic on everything from fertility to pregnancy and maternal mortality recently prompted the American College of Obstetricians and Gynecologists (ACOG) to urge doctors to talk with patients about the benefits of slimming down before trying to conceive. It’s part of an ongoing push to make chats about women’s “reproductive lifespan” as routine as an annual pap smear. Just as doctors have historically shied away from telling women that their eggs are getting too old, many haven’t been eager to point out that a woman’s size might come in between her and her dream of becoming a mother.
“For a woman who’s been trying for a year, the last thing she wants to hear is to take another year off to lose weight,” explains Dr. Jeanne Conry, ACOG president and assistant physician in chief at The Permanente Medical Group in Roseville, California. “But if a woman walks into my office who’s been trying to get pregnant and she has a body mass index of 30 or over [more than 180 pounds for a 5’5” woman] and she’s having an irregular period, the first thing we’re going to do is discuss a healthy diet and exercise program.”
Of course, doctors point out that the majority of the estimated 30% of obese women in the U.S. have no problems conceiving. But there’s a growing body of evidence that’s difficult to ignore. Obesity raises a woman’s risk of gestational diabetes, hypertension, premature delivery, miscarriage, and stillbirth. A mother’s chance of having to undergo a caesarian section is 34% if her BMI is over 30, and 47% if her BMI is over 35—compared to 21% for women with a BMI under 30, according to one study. There’s even evidence that babies born to obese women have a greater chance of suffering neural defects than those whose mothers are normal weight, and will be at greater risk of being obese themselves.
In one recent survey of more than 3,300 women, one-third responded they didn’t believe or were unsure whether a woman’s weight affected her chances of conceiving. The doctors’ organization hopes that encouraging ob-gyns to broach the topic will educate women about that connection, considering that about 6% of infertility is due to obesity (another 6% is due to being too thin), according to statistics by the American Society for Reproductive Medicine. (That goes for men, too, since a recent French study showed their excess poundage contributed to low sperm production.) The good news is that 70% of these women will get pregnant naturally after they lose or gain enough weight to get closer to a healthier BMI.
The other goal is to help patients set and achieve weight-loss goals, or even consider weight loss surgery if they’re severely obese. But adding those expectations on top of conceiving can feel daunting to many women, says Julie Friedman, PhD, a psychologist who directs a weight management program comprised of counseling, workshops, and support groups, at Insight Behavioral Health Centers, a chain of outpatient mental health treatment centers based in Chicago. “They’ve struggled with their weight their whole lives and now they’re going through something so stressful, saying ‘Now you’re telling me to lose weight when I’m this stressed out and trying for a baby?’”
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