STORY BYFirst of a Two-Part Series
Obesity in children is a national epidemic that includes all racial and ethnic groups and genders. As U.S. children go back to school, 15.3 percent of 6- to 11-year olds and 15.5 percent of 12- to 19-year-olds are overweight or obese.
This daunting public health concern is being confronted by numerous groups, including the American Medical Association, the American Heart Association, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics. Finding answers is complicated because it is not just a matter of teaching good eating habits to students; it includes educating families about the health hazards of obesity.
“ Obesity is more of a problem for the ethnic populations I work with, specifically African-Americans and Hispanics in the Aldine Independent School District [near Houston] which are at 20 percent and above,” pediatrician Mona A. Eissa says. “Some of these obese children and adolescents do not see themselves as obese, even though they are. Their families are not aware there is a problem or understand the relationship between obesity and diseases such as Type 2 diabetes, cardiovascular disease, and hypertension.”
Eissa is an assistant professor in the Department of Pediatrics at The University of Texas Health Science Center Medical School at Houston. She is also director of the Pediatric and Adolescent Obesity Program at the Health Science Center.
“Teaching nutrition and changing eating patterns is not easy,” says Dr. Deanna M. Hoelscher. “Food preferences are learned through repeated exposure to a new food. A person, child or adult, must try a new food at least 8 -10 times before they might adopt it as part of their usual diet.” Hoelscher is an associate professor and director of the Human Nutrition Center at UT-Houston’s School of Public Health.
UT-Houston’s Medical School and School of Public Health are among the institutions that have been working for more than a decade to find ways to turn the tide of obesity. The number of children who are overweight or obese has doubled over the last two decades.
Eissa, in collaboration with faculty of the UT-Houston School of Nursing, just completed a two-year study on “obesity and its complications: Type 2 diabetes and hypertension” in 2,300 middle and high school students.
Among the Hispanic students in the study, 26 percent of the boys and 21 percent of the girls were overweight; in the African-American group, 20 percent of the boys and 26 percent of the girls were overweight.
"In addition to the genetic factors, increased inactivity and increased caloric intake are the two main reasons children are overweight,” Eissa emphasizes. Involved in this unhealthy condition are:
Many of these children are developing Type 2 diabetes, high blood pressure, abnormal blood lipids, fatty liver, gallbladder diseases and musculoskeletal problems in addition to psychosocial complications. “Children and adolescents who are overweight often are depressed and have low self-esteem, especially the girls, who may develop eating disorders,” Eissa says.
As part of the study, overweight students are referred for further evaluation and dietary counseling. Referral was either to their primary care physician, if they had one, or to the Incarnation Health Clinic, which is a school-linked clinic where Aldine Independent School District students receive free health care services. At the clinic, students are interviewed and asked if they realize there is a problem and, if so, do they want to do something about it.
“We also require the cooperation of at least one parent, preferably the mother who is usually the one who buys the food and prepares the meals. The parent has to realize there is a problem and wants to help her child. Then this family receives nutrition counseling,” Eissa explains.
“ I work with the families because an obese child usually comes from a home with overweight parents and siblings. On the second visit, I ask them if the nutrition counseling was helpful, what worked with them and what didn’t, and that helps us streamline or change our recommendations to fit the needs of this community.”
As soon as all the data from the study is collected, the results will be presented to the participating schools, administrators and faculty at an in-service day, and later this year, an intervention program will be designed and presented to each school.
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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.
See Dr. Eissa also at:
Dr. Deanna Hoelscher is an associate professor of Behavioral Sciences and director of the Human Nutrition Center at the UT School of Public Health.
See Dr. Hoelscher also at:
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.
