Heart Experts Target Childhood Obesity

NEW YORK (Reuters) - The dire health effects associated with the ballooning waistlines of children and adolescents in the United States have prompted the American Heart Association to launch a new initiative targeting childhood obesity.

"Although we have been involved in this issue and the overall issue of children's heart health for some time, this is the first time that we are taking it to the level of creating a movement that is 'for kids and by kids,' according to Dr. Robert H. Eckel, of the University of Colorado at Denver and Health Sciences Center.

He and his colleagues describe the AHA's new efforts to combat childhood obesity in an editorial published this week in the American Heart Association's journal Circulation.

"Details are forthcoming" about the details of the new initiative, Eckel said in a telephone briefing Monday. He and his co-authors write that the AHA is revising its dietary guidelines for children and will soon issue recommendations to promote physical activity in schools.

The heart association will also enhance the Internet-based Choose to Move activity program and the faith-based Search Your Heart program that provides health information to churches throughout the nation. To its current collection of cookbooks, the association will add a new book this summer that will advise individuals how to lose weight and how to later maintain that lost weight and healthier lifestyle.

While most schoolchildren are eagerly anticipating the start of the summer vacation, the heart association is already planning to launch a back-to-school campaign in September that will target children and help them be in control of their own health. Currently, the AHA is developing a name for the campaign, as well as a logo and icon.

Such efforts are apparently needed in light of the obesity epidemic among American children and adolescents. The AHA discusses this prevalence of overweight, as well as its consequences, prevention and treatment in a new scientific statement released Monday.

"Our statement is not a new study, but an up-to-date review of the science related to childhood obesity," Dr. Stephen R. Daniels, of the Cincinnati Children's Hospital Medical Center told Reuters Health.

From 1980 to 2000 there was a three-fold increase in childhood overweight in the United States -- as many as 16 percent of 6- to 19-year-olds are overweight according to a recent National Institutes of Health report -- and the underlying reasons for this increase appear to be multifactorial.

It can be explained partly by an energy imbalance -- that is, more calories being consumed than being burned -- but research has also shown that birth weight may influence body mass index later in life, and that infants who experience rapid weight gain are likely to experience overweight during later childhood years.

Childhood and adolescent obesity is more than just a cosmetic issue, however. Various studies have shown obese children to be at risk for metabolic syndrome, or insulin-resistance syndrome, which, studies show, may increase the risk of cardiovascular disease and diabetes.

Other conditions, including inflammation and psychosocial conditions, such as depression, have also been linked to obesity in various studies. Also, excess weight present during adolescence may increase a person's risk of death from any cause, experts say.

Prevention of overweight may start as early as infancy, as some researchers have found that infants who are breastfed are less likely to become obese during childhood and adolescence than those who are bottle-fed.

In later years, children need to be taught healthy behaviors, including eating more fruits and vegetables and participating in more daily physical activity. Other efforts may require participation by various media, particularly in light of research linking television viewing with obesity, the AHA statement suggests.

"The statement emphasizes that prevention of obesity necessitates involvement by physicians, nurses, schools, the food and entertainment industries and other institutions that influence the diet and physical activity of our children," Daniels told Reuters Health.

When the goal is treatment, rather than prevention, potential strategies may range from age-specific diet- and activity-based changes to medication and even, in extreme cases, to surgery. Slow weight loss is recommended for children, but older adolescents may require a more aggressive approach similar to that taken by adults, according to the AHA experts.

Drug therapy may be useful, but many drugs have not been extensively tested on young people, and others may have unwelcome side effects. On the other hand, while rates of death in the short-term for of surgery seem to be low, this quick-fix approach is also associated with various complications, according to the statement.

SOURCE: Circulation, April 18, 2005.