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Obesity in children and its health complications is an alarming national epidemic currently affecting both genders and all races.
Hispanic females may run a higher risk of complications from obesity, according to Houston researchers looking at causes and predictors of disease states stemming from childhood obesity.
A two-year study conducted by health-care providers at The University of Texas Health Science Center Medical School at Houston and UT School of Nursing at Houston looked at 2,432 students in the Aldine Independent School District.
Yet, among the 12 to19-year olds, comprised of 52 percent African-American and 40 percent Hispanic, the highest prevalence of obesity was found in 25.3 percent of the Hispanic males and 26.2 percent of the African-American females.
"Excess weight raises an individual's risk of developing many diseases and conditions, including Type 2 diabetes, cardiovascular disease, stroke and hypertension," says Dr. Mona A. Eissa, an assistant professor in the UT Medical School's Department of Pediatrics and director of the health science center's Pediatric and Adolescent Obesity Program.
She has had a growing interest in this issue because of the adolescents she sees at the Incarnation Health Clinic, a school-linked facility where Aldine students receive free health care services.
Eissa joined with nursing school faculty to design a study that would screen the more than 2,000 students to examine the possible association of central obesity (excess weight in the abdomen) and elevated blood pressure with a particular skin marking called acanthosis nigricans. This hyperpigmentation on the back of the necks of some African-Americans and Hispanics may be a sign of insulin resistance. Insulin resistance is linked to diabetes and obesity.
The study, funded by the Texas Higher Education Coordinating Board, sought to evaluate the link between acanthosis nigricans and insulin resistance.
Acanthosis was observed in 50 percent of the obese students. "Not everybody with insulin resistance has acanthosis, but most of the obese students with acanthosis have insulin resistance," Eissa observes. Of the Hispanic males identified as obese, 36 percent had elevated blood pressure.
Ordinarily, cells in the pancreas produce and secrete insulin. Resistance takes place when communication breaks down between insulin and the tissues, which do not sense that the insulin is there. The blood sugar level or blood glucose level goes up, prompting the cells to make more insulin. The result is high blood glucose and high blood insulin. Research is underway to determine what causes that communication disruption.
During the Aldine screenings, students were weighed and measured (body mass index) and checked for acanthosis. Measurements were taken of height, waist and hip circumferences.
"The fat around the abdomen seems to be a reliable predictor of insulin resistance, but there are so many variables," says Eissa. "Not everyone with insulin resistance is diabetic. A person can be obese and not have diabetes, and a thin person can have diabetes."
After being measured, the students rested for five minutes before their blood pressure was taken three times and then averaged. The youths filled out a short medical family history form.
During the screening process, if an Aldine student had very high blood pressure or if the nurses felt something was wrong, Eissa was called. Those who met the obese criteria and were willing to have blood drawn were studied further and offered free testing for fasting blood glucose and insulin levels. This part of the study required family approval.
Among obese students who returned for further testing, insulin resistance was 85 percent. The acanthosis predictive value for insulin resistance was 83 percent, so the marker seems to be working.
"Our data tell us that complications from obesity are common in all minority ethnic groups and especially Hispanic females," Eissa says.
"There was significant association between central obesity and acanthosis among all groups," Eissa says.
Results indicate that:
Their data also support the need for early childhood obesity prevention and management before complications develop. Interventions are being designed for students at the three schools where the study took place.
Student and parent input will be important because the family must be involved for any program to be successful. Education is the key because many parents and students do not understand the health risks that result from obesity, and do not understand why children are obese.
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Dr. Mona Eissa is an assistant professor in the UT Medical School's Department of Pediatrics and director of the health science center's Pediatric and Adolescent Obesity Program.
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Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
