Declining Health of Our Children: Type 2 Diabetes and Obesity

RoseMarie Pierce, B.Sc. Pharm., “The Holistic Pharmacist”

Declining Health of Our Children: Type 2 Diabetes and Obesity

A child’s health is directly related to their level of nutrition, even before they are born. A pregnant woman’s nutrient intake affects the health of the unborn infant, and the effects can follow the child into adulthood. Childhood obesity is one of the most noticeable results of a nutrient-poor maternal diet, especially one comprised of highly refined carbohydrates. Women with gestational diabetes (diabetes developed during pregnancy) are at the highest risk of giving birth to a child who will develop type 2 diabetes later in life. Type 2 diabetes, once called adult-onset diabetes, is affecting more and more children, some as young as 6 years old. Most children with type 2 diabetes are considered overweight. It is important that pregnant women carefully control their sugar intake, given their baby receives all the excess sugar. Women with high blood sugar levels tend to deliver babies weighing 9 lbs and larger at birth.

“In our Human Nutrition Program at Rockefeller University, we see that, in many cases, diseases associated with nutrition have a pediatric origin with a geriatric outcome and children who are overweight are more likely than normal weight children to become obese adults,” Co-director Dr. Barbara Levine said. “This increases their lifetime risk of developing life threatening conditions such as coronary heart disease, hypertension, type 2 diabetes mellitus, gallbladder disease, osteoarthritis, and some cancers.” Studies show that children who become overweight before their fifth birthday are more than twice as likely to become obese adults.

According to the American Academy of Pediatrics, 10% of four- and five-year-olds are too heavy for their age. Approximately one quarter to one third of children and teens are now overweight. These figures are double to triple the statistics found in the late ’70s. Overweight individuals are more likely to lose their sensitivity to the effects of insulin, the blood sugar regulating hormone. When the body becomes insensitive to insulin, blood sugar (glucose) rises. This condition is known as impaired glucose tolerance – a precursor to type 2 diabetes. Results from a recent study published in the New England Journal of Medicine on childhood obesity and the prevalence of type 2 diabetes among children indicated a 21 – 25% impaired glucose tolerance among obese children between 4 and 18 years of age.

Many people have searched for quick, easy solutions to this problem, and the drug companies are capitalizing on this serious health issue. Will diet drugs and oral anti-diabetic drugs soon be widely dispensed as cures for obesity and diabetes in our children, joining the ranks of the mega-prescribed Ritalin and Prozac? Currently, there are more than one dozen approved diet drugs in North America. Two of the more popular ones in Canada are orlistat (known as Xenical) and sibutramine (known as Meridia), both having a number of reported adverse side effects including GI problems, hypertension, anorexia, and insomnia. Experimental work on children is already ongoing with these and other diet drugs originally intended for obese adults and for other conditions, including diabetes and depression. The vast majority of over-the-counter diet remedies, let alone synthetic pharmaceuticals, should not be administered to children.

One natural alternative is to focus on increasing physical activity and reducing consumption of ’empty calories’. In the year 2001, Lancet (357: 505-508) reported on a study that included over 500 school children, aged 11 and 12 with various ethnic backgrounds. According to the study, for every can or glass of sugar-sweetened beverage (12 oz. of Soda contains 40 grams or 10 teaspoons of sugar) consumed on a daily basis, the risk of obesity appears to increase by a factor of 1.6. The majority of K-12 schools allow the promotion and sale of soft drinks and chocolate bars in school cafeterias and vending machines. Many school children are exposed to large budget, multi-national corporate junk food marketing and sales in their schools. California and several other states are starting to pass laws that protect children from this kind of advertising in their schools.

The eating behaviors of children are also influenced by the relationship between parent and child. Parental insensitivity and/or unresponsiveness to the feeding cues from the child are thought to contribute to feeding problems. Parental control over the amount of food consumed, or the control of unwanted behavior through food rewards or by depriving food, is the central problem in feeding practices. Both of these factors can undermine the infant and young child’s ability to attend to their internal cues of hunger and satiety. Children with controlling mothers often end up with less ability to self-regulate caloric intake.

On the other hand, parents can help insure their children receive the key nutrients to support them through the finicky years, by offering them a well-balanced, varied diet low in refined sugar to supply the basics, and perhaps a multivitamin for insurance. Vitamin storage levels are actually found to be lower in obese children and adults. A multivitamin supplement in powder form (without the high sugar content of most chewables), added into a good quality whey powder protein shake first thing in the morning, can be given to most children.

It is important for both the school system and parents to work together to impart a holistic view of health and wellness and a solid grounding in nutrition to their children. Exercise and laughter have both been shown in studies to effectively reduce blood sugar levels. Exercise programs in schools, decreased TV time, and an environment provided by parents that nurtures healthy physical activity and laughter would go far in supporting a child’s health.

References:
1. Whitaker, RC., Pepe, MS., et al. Early adiposity rebound and the risk of adult obesity. Pediatrics 1998 Mar;101(3 Pt 1):E5.
2. Moms Can Help Prevent Diabetes: Proper birth size and breastfeeding linked to lower rates of diabetes http://www.diabetes.ca/Section_Main/NewsReleases.asp?ID=6
3. Ranjana Sinha, M.D., et al. Prevalence of Impaired Glucose Tolerance among Children and Adolescents with Marked Obesity. N Engl J Med 2002; 346:802-810 854-855

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RoseMarie Pierce, B.Sc.Pharm, earned her degree in Pharmacy from Dalhousie University in 1972. After extensive studies in herbal and nutritional medicine, RoseMarie integrated these disciplinary practices with her pharmacy education to become Canada’s first Holistic Pharmacist.