A jarring study published in the New England Journal of Medicine followed 5,000 American Indian children from childhood through middle age and found that those subjects in the study who had been obese as children were more than twice as likely to die before the age of 55.

Although this study was conducted among Pima Indians who have historically had high rates of obesity, in truth, the obesity rates of these test subjects were on par with the current rates of childhood obesity today. For this reason, the study’s findings probably do indeed translate to the wider population. There are some specific factors among the Pima Indians that might make the study less generalizable, but, in my view, these are pretty minor factors, as the study focused on the increased risk that high body mass index brought to these people.

Research has been somewhat mixed on the topic of breast feeding as a protection against the development of childhood obesity. A University of Copenhagen study examined over 5,000 men and women who were born between 1959 and 1961. At one year the babies who were breastfed for longer periods of time have lower body mass indices. At additional endpoints though, later into childhood adolescence and adulthood, there was no further correlation between the duration of breast feeding and the body mass index. But, the introduction of solid foods at an earlier age was associated with a small increased risk of being overweight at age 42.

It is a bit difficult to know how much credence to give this single study, however interesting. There are undoubtedly benefits of breastfeeding that include nutritional and immunologic benefits as well as psychological benefits to develop in babies. Whether delaying the introduction of solid foods past four or six months does protect against obesity it is a bit difficult to determine, though there may be some small affect at work here. Generally speaking, breast feeding in the early months is healthy for the developing baby and beyond the first three or four months it is difficult to discern the strong effects with the transition to formula and food.

The Michelle Obama lead initiative to fight obesity in America is “Let’s Move”.

Let’s Move, describes that it will:
1.Give parents the support they need
2.Provide healthier food in schools
3.Help our kids be more physically active
4.Make healthy, affordable food available in every part of our country.

Let’s take a look at each of these sections. I am going to jump to healthier food in schools because this is such an important and also such a difficult one to achieve.

The Let’s Move website that discusses healthier schools begins with some very compelling background information such as many children consume at least half of their daily calories at school. The site then serves as a call to action for schools and communities to provide healthier school lunches and breakfast. The part of this is what is called the Healthier US School Challenge (HUSSC), which is established to “recognize schools that are creating healthier school environments through promotion of good nutrition and physical activity.” To be certified as an HUSSC school the school must meet certain criteria. The most important of which appear to be that lunches are offered demonstrate healthy menu planning and principles of the dietary guidelines for Americans and that meet USDA nutrition standards.
The overall initiative is described is one that partners with the US Department of Agriculture as well as major school food suppliers who have agreed to some changes in the meals provided and to meet standards from the Institute of Medicine within five years. There is also a commitment mentioned to double the amount of produce that is served within ten years. A proposal to add a billion dollars per year to help improve school lunches and update the Child Nutrition Act is also mentioned. It takes some digging, but ultimately this leads to a link of the Institute of Medicine recommendations about the nutrition facts recommended for school lunches and breakfast. Following the links and going down into the specifics of the nutrient contents that are recommended, one finds a very disappointing emphasis on dietary fat and very little actual mention of the main culprit of the childhood obesity epidemic, the increased consumption of simple carbohydrates. The recommendations for calorie targets are reasonable and beneath the calorie targets for specific nutrient guidelines, once again, indicate what percentage of the calorie consumption should come in the form of fats. A range of vitamins also are discussed.
While these guidelines in general will be helpful at providing some specific targets that would avoid the very overly calorie dense meals available at school lunches and breakfast, they offer an awfully bureaucratic and old fashioned kind of approach. Let’s all be clear, a massive health problem is occurring because kids are consuming massive amounts of carbohydrates. So to solve that it seems to me that schools need to, yes, create healthy breakfasts and lunches with reasonable calorie limitations, but should point out in glaring, big, bold letters that the carbohydrate content needs to be reduced. Secondly, an analysis of how children are then consuming the “extra” carbohydrate calories will lead to some additional solutions, such as replacing the soft drink vending machines and eliminating the availability of high carbohydrate snacks and treats and replacing them with healthier choices.
Look, I realize this is the Federal Government and it is the same government that has been subsidizing the production of high fructose corn syrup due to incomprehensible political machinations. But, our nation’s kids are getting fat and developing type 2 diabetes and the primary cause appears to be an increased consumption of simple carbohydrates. Let’s just shine a giant spotlight on the main problem and not get too distracted with all this Byzantine bureaucracy and the emphasis on an old fashioned food pyramid and a nonsensical obsession with dietary fat.
I applaud Michelle Obama for highlighting this issue and for adding the weight of her office to it. I know that much good can come of her and the President’s investment in this problem and then finding a solution for it. Focusing on healthier meals in schools is a critical step and their leadership is greatly appreciated. I am disappointed that the website on this highly important topic gives a very complex and diluted message that ultimately is backed up by a big, outdated bureaucratic notion and fails to unambiguously wag a finger at the massive carbohydrate consumption problem. We will look at more of these initiatives in future blog posts.

A disturbing study of British children found that among 12,000 3-year-olds, the risk of childhood obesity was 34% higher if grandparents cared for the children full-time.
Parents as caregivers and other substitutes like daycare centers and babysitters did not produce an increased risk of obesity, but grandparents as caregivers did.
While the study did not investigate the precise reasons why grandparents appeared to lead to greater obesity among these children, it is speculated that a more indulgent attitude toward sweets and treats and food choices may be the answer. What we might fondly recall as the sweet doting grandmother or grandfather who indulged us in home baked cookies and treats might have a darker implication in today’s environment of escalated childhood obesity. Grandparents may also be less physically active and may promote less physical activity among small children.

The White House has officially endorsed the “Let’s Move” campaign that is taking an ambitious approach to partner with food companies, media, athletes, school lunch providers and federal agencies in an effort to prevent childhood obesity. This is exactly the sort of effort this has been missing for the last thirty years, and most egregiously in the last ten years.

While I am not going to like every single aspect of the Institutes of Medicine’s recommendations, it is undeniable that this is a profoundly positive and massive effort to address a massive nationwide health problem. Nothing short of this type of initiative will succeed. In fact, this is probably only one of many critical steps that will be necessary to actually make a dent in the epidemic and decrease the rate at which our nation’s children become obese, develop diabetes and die at earlier ages, living less full lives.

I had the great pleasure of talking on the air with Bill Dean on his program The Morning Brew that airs in Minnesota. Bill is a fantastic host and we got to discuss the importance of weight loss and maintaining a healthy weight as well as my recently released book, Life Changing Weight Loss. Bill also noted he himself was diagnosed with vitamin D deficiency, a surprisingly common finding for a great many of us. Usually the symptoms of vitamin D deficiency are fatigue and loss of energy so they can be very subtle. Most people don’t even realize they have it.
We also touched on a number of topics including childhood obesity.
Bill is a great host and I hope I have an opportunity to appear as a guest on his show again.

A few weeks back Michelle Obama launched her national campaign against Childhood Obesity. I am very pleased to see that the first lady has chosen this incredibly important issue to help the future of America. I will be posting my thoughts from time to time regarding the progress and effectiveness of the “Let’s Move” Campaign headed up by Mrs. Obama. I have already sent her a letter thanking her for her efforts on this important cause. Let’s hope that together we can make progress to win the fight against childhood obesity.

Here is a copy of the letter:

February 17, 2010

The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

Dear Mrs. Obama,
I am writing to thank you for your “Let’s Move” initiative and your efforts to raise awareness of childhood obesity and combat this serious health problem.
As a physician battling on the front lines of the obesity epidemic, I am grateful for your leadership and courage on this issue. I hope that our own Reno-based Obesity Prevention Foundation may be kept apprised of your further efforts and endeavors in this regard so that our community, schools and kids may be of benefit.
The complex problem of obesity requires a solution at many levels, at the personal and family level, at the school and community level, and at the state and national policy level. Your own work greatly helps our own local community effort with the Obesity Prevention Foundation as we work to educate parents and children, raise awareness of the disease and provide tools to combat and prevent it.
Best wishes to you and your family.
Sincerely,

Kent C. Sasse, M.D. , MPH, FACS
Founder of the Obesity Prevention Foundation
Medical Director, iMetabolic.com
www.obesitypreventionfoundation.org

I am so excited to announce that our very own Obesity Prevention Foundation will sponsor and support the Kid’s Run, a proud feature of the Reno Rock-n-River Marathon. I have been talking up this event for months, actually ever since last year’s event at which I and over thirty of our colleagues from iMetabolic and Western Bariatric Institute and the Obesity Prevention Foundation ran, walked or otherwise completed the 10K portion of the race. We even had some amazing racers who had just completed their own weight loss surgery in the weeks prior and proudly completed the race. This coming May we hope to seal the team of as many as 100 racers and raise awareness for childhood obesity prevention efforts in our community. Join us for this year’s event! You can download and print out a race registration form here.

The Nevada capital is adorned in blue to draw attention to diabetes, the timing couldn’t be better. More Americans than ever suffer with diabetes. Increasingly, this disease is afflicting old and young and the vast majority of cases stem from obesity. A small percentage, less than around 5% today, of all diabetes is type 1 diabetes, a condition that typically comes on in young people and is related to a loss of function of pancreatic data, islet cells and diminished insulin production. The remainder of cases stem from the complex metabolic disorder known as type 2 diabetes. Most such cases arise with weight gain and age, but today with more and more teenagers and children becoming obese, we see a dramatic rise in type 2 diabetes among young people.
Hopefully, greater awareness will lead to more resources, thoughts and effort being applied where it will yield the greatest results: in prevention. Visit obesitypreventionfoundation.org for ways you can help.

It seems like in this modern era we have all become very skeptical of the motivations of corporate philanthropy. Most of us experience no surprise whatsoever when we learn that corporations that are giving money to charities do so with a calculus that counts exactly how much PR the philanthropy buys them and balances it against advertising dollars. We all form our own judgments about the purity of philanthropy and charity when we see similar behavior from individuals.
But, I must say I am quite pleased that there is often an intersection between commercial success, good PR, and doing the right thing, especially for kids. So I am quite gratified to see the National Football League among many other organizations has turned its attention to the problem of childhood obesity and has organized a campaign and a message to fight childhood obesity. If their campaign can raise the level of consciousness in the public and among the leadership of the country to a higher level it may, one day, lead to some powerful and tangible solutions to this pervasive and devastating problem.