Stories about: obesity

Preschool obesity is down, but Feds need to do more

Young child on scale ShutterstockThe scales may not be tipping up quite so precipitously for some low-income preschoolers. So says a recent report from the Centers for Disease Control and Prevention (CDC). Bucking the previous trend, 19 states saw small decreases in obesity rates among preschoolers between 2008 and 2011, while rates held steady in another 20 states. Is this cause for celebration, cautious optimism or concern?

Perhaps all of the above, says David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital. “The report is a small, but encouraging, sign after nearly half a century of bad news.”

The latest data, along with several other reports, are raising hopes that the era of continually rising obesity rates may be drawing to a close. But most epidemics aren’t halted by a small crook in the prevalence curve. In fact, containing the obesity curve will require more muscle from federal decision makers, Ludwig contends.

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Is obesity on the rise among children with sickle cell disease?

Obese child on a scale
Obesity is more common in sickle cell disease than thought. Why?

Ask many doctors about their image of a child with sickle cell disease (SCD), and they’ll describe a short, skinny child, perhaps almost malnourished. For decades, that image was accurate.

That perception needs to change, though. A group of sickle cell specialists from hospitals in New England—members of the 11 institutions in the New England Pediatric Sickle Cell Consortium (NEPSCC)—recently made a surprising observation: Nearly a quarter of children with SCD are overweight or obese. The question is, why?

The answer may start with their red blood cells (RBCs).

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A mutation and a mystery: Weight gain without a change in energy use

Why did the mouse at left gain so much weight?

Two mice scurry around in an enclosure crossed through with light beams. The beams track their movement to measure their energy expenditure, along with the amount of oxygen they breathe in and carbon dioxide they exhale. The mice, who are siblings, are equally active and are held to the same diet, but there’s one critical difference: One mouse is noticeably heavier than the other.

“These [heavier] mice aren’t burning the fat,” says Joseph Majzoub, MD, chief of endocrinology at Boston Children’s Hospital. “They’re somehow holding onto it.”

In fact, the mice have to be underfed by 10 to 15 percent just to stay as slim as their siblings. Their experiences seem to parallel those of people who complain of gaining weight even when they don’t eat more than others. When allowed to eat as much as they want, the mice quickly begin to eat three to four times as much as the others and balloon to more than twice their size.

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For overweight adolescents, health begins at home

(Flickr/Anonymous Account)
(Flickr/Anonymous Account)

This post is third in a series on obesity. Read last week’s posts on food addiction and what it means to define obesity as a disease.

The goal of any community health intervention is for individuals to achieve daily lifestyle goals in a way that realistically takes into account their cultural backgrounds, neighborhoods, families and home lives. For overweight or obese adolescents, these intimate surroundings play a pivotal role in allowing healthful behaviors to take root.

Research teams at Boston Children’s Hospital and suburban affiliate Wareham Pediatrics are conducting a study that lets adolescents collaborate with their doctors online to improve their weight. Videoconferencing technology, provided by Boston Children’s Telehealth Program, brings services directly to subjects in their homes.

“We’re bringing high-quality interventions directly to kids in the community where they live and simultaneously learning about the community itself,” says Cara Ebbeling, PhD, associate director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, and one of the leading researchers. “For example, we are looking at what grocery stores are located in the community and what opportunities exist for physical activity.”

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This is your brain on a high-glycemic diet

Are sugary foods fueling addiction?(Incase/Flickr)
Are sugary foods fueling addiction?(Incase/Flickr)

Is there such a thing as food addiction? A study using brain imaging suggests that high-glycemic foods may trigger the same brain mechanism tied to substance addiction.

A team led by David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, found that consuming highly processed, rapidly digested carbohydrates can cause excess hunger and stimulate brain regions involved in reward and cravings. These findings suggest that limiting such “high-glycemic index” foods could help obese individuals avoid overeating.

Published this week in The American Journal of Clinical Nutrition, the study investigated how food intake is regulated by dopamine-containing pleasure centers of the brain.

“Beyond reward and craving, this part of the brain is also linked to substance abuse and dependence, which raises the question as to whether certain foods might be addictive,” says Ludwig.

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Will obesity’s new status as a disease impact the future of care?

Obesity in the U.S., 2010: Percentage of people with a BMI over 30. (Wikimedia Commons)
Obesity in the U.S., 2010: Percentage of people with a BMI over 30. (Wikimedia Commons)
Obesity is moving up in the world: After much debate, the American Medical Association (AMA) has elevated it from a condition to a disease. Though the decision has sparked provocative discussion in the medical field, delegates from the American Academy of Pediatrics (AAP), the American Academy of Family Physicians, the American Association of Clinical Endocrinologists and the American Society of Bariatric Physicians are in support.

But can obesity’s new nomenclature actually impact treatment, especially for children?

“It’s a hard issue,” says Shari Nethersole, MD, medical director of Community Health at Boston Children’s Hospital. “In our health system, diseases are more incorporated into systems of care and get better coverage.”

On the other hand, she hopes the new definition doesn’t imply that because it’s a disease, obesity has to be a lifelong thing.

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Mapping obesity with Facebook

What you like on Facebook might say something about how obese your neighborhood is. (Dry Martini/Wikimedia Commons)
If one of my Facebook friends were to look through my list of “likes,” they’d find that I’m interested in music, cars, science and photography, among other things (and not necessarily in that order).

But if a researcher were to look across Boston at what people who are like me like—and post and share—on Facebook, a snapshot of data could tell them something else: roughly how obese metro Boston is.

That’s essentially what John Brownstein, PhD, and Rumi Chunara, PhD, concluded in a study recently published in the journal PLoS ONE. In it, they combined Facebook interest data—an aggregate of what people “like,” post on their timeline or share on others’ timelines—with health survey data to geographically correlate activity or television interests with obesity rates. 

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3 smartphone health apps you might not have expected

Melinda Tang, MEng, is a software developer for the Innovation Acceleration Program at Children’s Hospital Boston. This post is the first of a series highlighting fun and helpful mobile health applications and other interesting apps that developers in health care can learn from.

With more than 1 million mobile apps available today, there’s no doubt that mobile devices are changing the way we operate. With the push of a button or tap of a screen, we can turn our smartphones from entertainment consoles to travel guides to personal health monitors. One report estimates that a half billion people will be using mobile health apps by 2015.

Here are a few interesting examples I shared with the Mobile Apps working group at Children’s Hospital Boston, to inform our growing cadre of app developers and other health-IT-minded folks. These apps provide innovative solutions to problems you may never have thought your cell phone could solve — and in ways you might not have expected.

Mosquito Buster is an extremely simple app that lets you use your phone to replace standard mosquito repellants such as sprays and candles. Turn on the app, and your phone will emit a high-frequency pitch

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In diabetes, inflammation may be part of the solution, not the problem

Boosting proteins normally triggered by inflammation may be a new treatment approach for Type 2 diabetes.

Low-grade inflammation caused by obesity is widely believed to contribute to insulin resistance and type 2 diabetes. But, as it turns out, inflammation activates two proteins that appear critical for maintaining good blood sugar levels. Reporting in Nature Medicine, endocrinology researcher Umut Ozcan demonstrates that activating either of these proteins artificially can normalize blood sugar in severely obese and diabetic mice.

That’s a completely new way of looking at diabetes, and suggests a very different way of treating it.

“This finding is completely contrary to the general dogma in the diabetes field,” says Ozcan. “For 20 years, inflammation has been seen as detrimental, whereas it is actually beneficial.”

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Boosting the “good” fat: Kids may lead the way

Brown fat

Just as there’s good cholesterol and bad cholesterol, good carbs and bad carbs, there’s also good fat. Whereas white fat stores energy, padding our hips, thighs, arms and bellies, brown fat — studded with energy generators known as mitochondria – burns energy.  Newborns have a ring of brown fat around their necks, helping them stay warm. By adulthood, it’s detectable in only 3 percent of men and 7.5 percent of women, with higher rates among younger and thinner people.

In a study released yesterday by the Journal of Pediatrics, positron emission tomography (PET) scanning reveals the presence of brown fat in nearly half of children, though its level of energy-burning activity varies.

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