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Solving Childhood Obesity – Part I

Recently released this month was an interesting piece on childhood obesity.  It is part of the Let’s Move campaign that is headed by First Lady Michelle Obama.  The report entitled Solving the Problem of Childhood Obesity within a Generation is full of good information (full report available at www.letsmove.gov).  I am usually skeptical of such reports because they seem to just recycle to same old information that has gotten us into the problem in the first place.  This report seems to be different.  Over the next couple of weeks, I am going to try and break down most of the recommendations that were put forth in this new report. Some of the recommendations I find very refreshing.  They are often things chiropractors, naturopaths and nutritionists have been recommending for years.  I’m glad to see traditional medicine catching up.

I have spoken many times on this blog about childhood obesity and what a large problem it is in the US.  The numbers are staggering.

  • One in every three children (31.7%) ages 2-19 is overweight or obese.
  • Obesity is estimated to cause 112,000 deaths per year in the United States, and one third of all children born in the year 2000 are expected to develop diabetes during their lifetime.
  • The current generation may even be on track to have a shorter lifespan than their parents.

Also, this takes a massive toll on our health care system.  As health care costs continue to rise many economists say that they could eventually bankrupt the country.  Each year, obese adults incur an estimated $1,429 more in medical expenses than their normal-weight peers.  Overall from 1998 to 2008 medical costs related directly to obesity in adults increased by almost four fold from $40 billion to over $147 billion.  Childhood obesity now contributes to $3 billion in medical costs.

Unfortunately the trends of obesity are continuing to rise and have risen substantially in the last 30-40 years.  In particular, the levels of obesity have increased significantly since 1980.  Obesity has more than doubled among adults (rising from 15% to 34%), and more than tripled among children and adolescents (rising from 5% to 17%) since 1980.

While most people know that being overweight increases the likelihood of heart disease, there are other problems associated with it as well.  Obesity increases the risk of cancer, diabetes, arthritis, depression and osteoporosis to name a few.  Quality of life is also affected.  Children who are obese report a lower health-related quality of life (a measure of their physical, emotional, educational, and social well-being). One study actually found that children who are obese have similar quality of life as children with cancer!

So the question is how do we solve the problem?  The first part of the solution might surprise you.

Breastfeeding

Children who are breastfed are at reduced risk of obesity.77 Studies have found that the likelihood of obesity is 22% lower among children who were breastfed. This effect was noted all the way into adolescence suggesting that breastfeeding your child has very long lasting effects.  Other studies have shown that for every month a child is breastfed up to 9 months, a 4% reduction in the risk of being obese is observed.

In my practice I recommend that my patients breastfeed up to 12 months if possible.  Routinely I hear from expectant or new mothers that their doctors ‘recommend’ breast feeding but that they won’t lose out on anything if they choose formula.  This may stem from the years when women were being told that breast milk was no match in terms of nutrients to what could be concocted in a lab.  It is clear now that breastfeeding is an important part of the early life of a child.

Even though the research clearly points out that breastfeeding is critical most children (67%) do not breastfeed after three months.  The protection offered by breast milk is from several factors.   First, synthetic formulas contain twice as much protein as breast milk.  This stimulates insulin to be secreted in amounts that are too high.  This leads to excess fat storage.

Second, the biological response to breast milk differs from that of formula. When feeding a baby, the mother’s milk prompts the baby’s liver to release a protein that helps regulate metabolism.  This is not produced with formula.  Also,  giving formula is associated with unfavorable concentrations of leptin, a hormone that inhibits appetite and controls body fatness.

So why don’t more women breast feed? It is a complicated answer that has physical, social and cultural factors.  However, in this country we don’t make it easy for new mothers.  In the hospital a newborn is often taken from their mother and necessarily given formula.  This makes it difficult for the baby and the mother to learn how to properly breastfeed.  Part of the solution is to designate hospitals as “baby friendly” as determined by an independent group appointed by the government.  A hospital is given this baby friendly designation if they meet certain criteria for breastfeeding.  Currently, only 3% of births occur in baby friendly hospitals.

My advice to patients is always to breastfeed.  Do everything you can to make sure it happens.  If any doctor tells you that formula is ‘just as good’ as breast milk, find another doctor.  If you cannot breastfeed directly, try and pump your breast milk.  The advantages of breast milk over formula are huge.  After all a million years or so of evolution can’t be wrong.  In my next blog we will talk about chemical exposure and screen time and how it relates to childhood obesity.  I hope you’ll continue to read.

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