Philip J. Goscienski, M.D.
June 2006
Chubby cheeks, cherubic children. What could make a mother (or grandmother) more proud? It was probably no different in the Stone Age, when a little extra fat provided insurance against those days or weeks when food was not plentiful. Today's toddlers never have to face food scarcity but mothers still encourage them to finish the bottle, to drain the glass or to join the Clean Plate Club. In the past that encouragement didn't matter much, for as children became more active their baby fat disappeared. Beginning a little more than a single generation ago however, sedentary entertainment — television, video games and computer activity — replaced childhood play. Although nutritionists complain about fast food, soft drinks and overeating in general, we can account for the current epidemic of childhood obesity almost entirely by the calories that children fail to burn in physical activity.
Childhood overweight and obesity are not benign. We can no longer expect that they will "grow out of it." Roughly half of overweight children below the age of 10 years will become overweight teenagers and most of those will be overweight or obese adults.
Childhood obesity has more than quadrupled since 1970 and it now affects 17 percent of children between the ages of 10 and 17 years. Pediatricians have had to revise the growth charts that are part of every patient's record and they fret that 300-pound adolescents are no longer the exception. What is more ominous, physicians who care for children now see two conditions regularly that their training never prepared them for, type 2 diabetes and metabolic syndrome.
We used to call it adult-onset diabetes but type 2 diabetes occurs in children as young as 6 years. Complications of diabetes such as blindness, amputations and kidney failure, crippling conditions that most physicians only saw in adults beyond the age of 50, now occur before the age of 30 in an unlucky few. It seems that these dread complications of type 2 diabetes show up earlier in persons whose disease begins in childhood, as if the disease process is somehow compressed. Type 2 diabetes is a 100 percent preventable disease but these victims will enter middle age unable to earn a living and will present an enormous burden to the nation's health care system. Few diseases are as expensive as diabetes.
Metabolic syndrome, also known as insulin resistance syndrome, is a collection of conditions that have been organized into a single group. It is very uncommon in individuals who maintain normal weight. Its elements include abdominal obesity and abnormally high blood pressure, cholesterol, blood sugar and insulin. Some physicians include disturbances of the blood clotting mechanism. That might explain why persons with metabolic syndrome have a high risk of heart attacks and strokes, which together claim about one million American lives every year. As childhood obesity rises, so does the childhood incidence of metabolic syndrome, occurring in more than one third of obese adolescents.
Obesity, type 2 diabetes and metabolic syndrome have strong genetic components but heredity is not predestination. By helping our children to make the right lifestyle choices we can look forward to a generation that is free of these diseases.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.