What Leveling of childhood obesity?

July 13th, 2016 No comments »

Much has been made recently of a purported drop in childhood obesity, particularly among children age 2 to 5. (See my Oct. 2015 blog, Did the White House Spin CDC Study to show progress in childhood obesity?”) Now, a new study finds “no evidence of a decline in obesity prevalence in any age group, despite substantial clinical and policy efforts targeting the issue.” The paper by Ashley C. Skinner, Eliana M. Perrin and Joseph A. Skelton in Obesity used NHANES data from 1999-2014 and found, “A clear, statistically significant increase in all classes of obesity continued from 1999 to 2014.” They also reported that severe obesity (class II and III) showed a significant increase in adolescents and non-Hispanic black children.  They state, “By including severe obesity, our results also highlight particular areas of concern. In 2013-2014, nearly 10% of adolescents met criteria for Class II obesity, and nearly 5% also met criteria for class III obesity…The 4.5 million children and adolescents with severe obesity will require novel and intensive efforts for long-term obesity improvement. With scarce resources, and increasing costs of comorbid conditions, there is an urgent need for targeted interventions to stem the rise in severe obesity among children, in addition to policies and clinical efforts designed to prevent obesity. Policy efforts are yet to yield substantive changes in obesity prevalence but few have specifically targeted severe obesity.” Amen

Debunking ‘progress’ on childhood obesity

May 2nd, 2016 No comments »

Much has been made recently of a purported drop in childhood obesity, particularly among children age 2 to 5. (See my Oct. 2015 blog, Did the White House Spin CDC Study to show progress in childhood obesity?) Now, a new study finds “no evidence of a decline in obesity prevalence in any age group, despite substantial clinical and policy efforts targeting the issue.” The paper by Ashley C. Skinner, Eliana M. Perrin and Joseph A. Skelton in Obesity used NHANES data from 1999-2014 and found, “A clear, statistically significant increase in all classes of obesity continued from 1999 to 2014.” They also reported that severe obesity (classII and III) showed a significant increase in adolescents and non-Hispanic black children.  They state, “By including severe obesity, our results also highlight particular areas of concern. In 2013-2014, nearly 10% of adolescents met criteria for Class II obesity, and nearly 5% also met criteria for class III obesity…The 4.5 million children and adolescents with severe obesity will require novel and intensive efforts for long-term obesity improvement. With scarce resources, and increasing costs of comorbid conditions, there is an urgent need for targeted interventions to stem the rise in severe obesity among children, in addition to policies and clinical efforts designed to prevent obesity. Policy efforts are yet to yield substantive changes in obesity prevalence but few have specifically targeted severe obesity.” Amen

The Impact of Childhood Sex Abuse on Eating Disorders and Obesity

December 16th, 2015 No comments »

The Atlantic magazine has a powerful essay by Olga Khanz on the role of childhood sexual trauma leading to disordered eating and obesity. The piece highlights the work of Dr. Vincent J. Felitti. For more on Dr. Felitti’s work and related research see our post from November, 2011.

Is CDC Massaging the Obesity Stats?

November 22nd, 2015 No comments »

The world was positively giddy this week following the release of a new CDC Obesity prevalence report. There was so much self-congratulation going on in the childhood obesity world I was afraid of an outbreak of carpal tunnel syndrome.

The headlines shouted that the childhood obesity numbers had stabilized and many groups claimed credit for the success. The CDC reported that, “the prevalence of obesity among U.S. youth was 17% in 2011-2014. Overall, the prevalence of obesity among preschool-aged children (2-5 years) (8.9%) was lower than among school-aged children (6-11 years) (17.5%) and adolescents (12-19) (20.5%).” The report goes on to state, “Between 2003-2004 and 2013-14, however, no change in prevalence was seen among youth.”

Hey, great news, no?  Well, the 17% figured was derived from averaging three groups: 2-5YOA, 6-11 YOA and 12-19 YOA. I question of including 2-5 year olds. The prevalence for this group is about half for the other age groups. And, frankly, they are toddlers. Their prevalence figure probably represents parental panic at the prospects of raising an overweight child. This panic may lead to restrained eating strategies which often fail as the child grows up. As soon as the child starts to exercise more control over their own feeding and behavior, the prevalence rate doubles. Doubles! Taking the 2-5 years old out of the equation, the youth prevalence rate is 19%, not 17%. , 19% is not leveling off. (Truth be told I did not attempt to re-calculate the historical figures without the 2-5 age group.) Keep in mind that CDC views obesity as a binary switch. You are either obese or not. They do not take into account the growth of body weights within the obesity category, i.e. class III or severe obesity growth.

Finally, the CDC does note, “The prevalence of obesity among U.S. adults remains higher than the Healthy People 2020 goal of 30.5%. Although the overall prevalence of childhood obesity is higher than the Healthy People 2020 goal of 14.5%, the prevalence of obesity among children aged 2-5 is below the goal of 9.4%.”

Before popping the champagne, advocates and the media should consider that we are moving further and further away from the targets of Healthy People 2020, not to mention Healthy People 2010. Therefore, it is reasonable to ask if self-congratulation based on failure is an appropriate response.

Does Breastfeeding Increase Infant Weight?

October 31st, 2015 No comments »

According to a new article by Michael Goran and colleagues it depends on which components of breast milk, (sugary complex carbohydrates called human milk oligosaccharides (HMOs) are present. 25 mother-infant dyads were studied at one and six months of age. Goran is quoted in the Irish Times saying, “But typically we think of obesity risk kicking in after weaning, the timing of introduction to solid foods, early exposures to sugary beverages. Clearly there is something going on before weaning even in babies who are exclusively breast-fed.”

Two HMOs, LNFPII and DSLNT, were each associated with about an extra pound of fat mass at 6 months. Another, LNFPI,  seemed to be protective, linked to a pound less of fat at six months.

 

CDC Spins Breastfeeding-Obesity Link

October 27th, 2015 No comments »

CDC is continuing to perpetuate the old canard that breastfeeding is protective against childhood obesity. In the recently released publication, Vital Signs: Improvements in Maternity Care Policies and Practices that Support Breastfeeding-United States, 2007-2013,  the CDC states “In addition, evidence suggests that breastfeeding is associated with a reduction in the risk for obesity and diabetes in children (3).”

The reference is a 2007 evidence report on CDC’s sister agency, the Agency for Healthcare Research and  Quality website. However, unlike several other citations, there is no link to the paper. Why? Perhaps because AHRQ identifies the paper as “Archived” and states, “It (the paper) was current when produced and now may be out of date.” Here’s the link:  http://archive.ahrq.gov/clinic/tp/brfouttp.htm#Report.

Maybe out of date? No fooling! See here, here and here for updated research which CDC decided to overlook.

 

Overselling Breastfeeding

October 21st, 2015 No comments »

Courtney Jung has an interesting opinion piece in the New York Times, “Overselling Breastfeeding.” The writer points out that the goals for the duration of breastfeeding are more accessible to upper and middle-class white women than other mothers. Furthermore, she decries the drift from making breastfeeding a choice for mothers to make to policy decisions which penalize non-breastfeeding mothers. She writes, “Demographic differences in breastfeeding rates also justify government interventions that punish poor women who do not breastfeed. This isn’t just the little unobtrusive little “nudge” in the right direction, designed to compel people to make better decisions. It’s more like a shove, with a kick for good measure.”

Jung notes that arguments that breastfeeding prevents childhood obesity have been largely disproved. See our analysis on this point.

 

Did White House Spin CDC study to show progress in childhood obesity?

October 20th, 2015 No comments »

The Daily Caller reports receiving emails under the Freedom of Information Act purporting to show White House influence to spin CDC prevalence figures to support Michelle Obama’s Let’s Move initiative. This does not come as a big surprise. We have been reporting here on the over-optimistic predictions of the end of the obesity epidemic. See here, here, here, herehere and here.