New York City Mayor Michael Bloomberg recently banned extra large sugary sodas from restaurants and convenience stores in the city. Regardless of your opinion of this measure – most New York City residents narrowly approve it – it has helped trigger a national discussion on how to prevent and manage obesity and childhood diabetes.
Throughout this debate, many health advocates call for a “holistic” approach. After all, if New York City residents really want soda, they’ll just buy it on their own time. But what does a “holistic” approach constitute?
For an answer, we suggest this illuminating column. It argues that education is the key, and proper preventative care should start at a young age. For example, politicians and administrators must ensure that every school provides healthy nutritional options and physical education classes. Fast food, junk food, and sodas should be stricken from the menu. It also suggests that food and soda manufacturers stop advertising to children.
This approach is sure to be controversial. But with childhood diabetes reaching epidemic proportions, we as a society have little choice.
If you talk to health-conscious parents, they’ll tell you that keeping their children away from sugary drinks sometimes seems like an unwinnable battle.
Sure, they can control what their children drink in their home, but beyond that, they’re basically powerless. Some schools are slowly phasing out high-sugar sodas and juices from their vending machines and cafeterias, but not quickly enough.
Perhaps the greatest obstacle facing parents is the constant advertising barrage courtesy of large food and drink manufacturers.
It’s no secret that Coca-Cola, Pepsi, and other sugary drink-makers and fast food manufacturers want to lure kids in at a young age. They want lifetime consumers. Hence the cartoon mascots, Happy Meals, and catchy jingles. When faced with this marketing machine, parents may feel overwhelmed.
But there is good news on the horizon: Disney recently announced it would stop advertising junk food on its children programs.
For some, it’s just a publicity stunt, as sugary drinks aren’t part of the ban. For others, like First Lady Michelle Obama, it’s a critical first step to reducing childhood obesity and childhood diabetes.
Time will tell if other corporations make similar moves to voluntarily ban such commercials.
New research suggests that childhood diabetes is even worse than previously expected. That’s because, according to the data, Type 2 diabetes progresses faster and is more difficult to treat in children than in adults.
The study came from the New England Journal of Medicine, where researchers applied multiple treatment plans across the sample size of children between 10 and 17. In one, children received Metformin, the drug used to treat childhood diabetes, yet it failed to control blood sugars in half the cases.
More alarmingly, even when lifestyle changes and one-on-one counseling were added to complement an existing drug regimen, the results were only mildly better. Successful treatment rates improved when a second drug was added, but the rate was only at 60 percent. Furthermore, the drug that was added, Avandia, is known to cause heart attacks and strokes in adults.
Bottom line: childhood diabetes is tremendously difficult to manage. That isn’t to say it’s insurmountable, but this difficulty should further underscore the need to prevent diabetes from occurring in the first place.
A new study from the University of California – Davis seems to have further strengthened the link between obesity and diabetes – but from a different angle.
Researchers found that there exists a strong link between maternal obesity and diabetes (along with autism and other related disabilities.) This is because poorly-managed glucose can expose the fetus to the mother’s abnormally high glucose levels. The fetus, in turn, creates high insulin levels in response, which is then carried over once the mother gives birth.
Furthermore, findings suggest that mothers with diabetes have a 2 1/3 greater chance of giving birth to a child with developmental problems.
The takeaways from these findings are two-fold. One, obese mothers must make every effort possible to lose weight, lest they give birth to a diabetic or autistic child. And two, pregnant women living with diabetes must do everything within their power to keep their blood sugars under control to minimize the risk of giving birth to a diabetic or autistic child.
Childhood obesity has more than tripled in the United States across the past three decades. And if we as a society aim to bring this epidemic to a halt, everyone – including parents, teachers, doctors, and policy-makers – must realize that the risk of developing childhood diabetes is linked to not only what they eat, but where they live.
In other words, the characteristics of a child’s neighborhood – its walkability, proximity to parks, and access to healthy food – can be huge contributing factors to the development of obesity and diabetes.
Recent research confirms this, finding that children in a “favorable neighborhood environment” have close to 60 percent lower odds in being obese. And childhood obesity, as we all know, can contribute to diabetes.
Another study, for example, found that children who lived in rural areas got the appropriate amount of exercise; meanwhile, those in suburban or urban environments spent most of their time on buses or in cars shuttling from place to place.
Parenting can be hard work and can be especially difficult for those whose children lead sedentary lifestyles. All too familiar a scenario today; a child or teenager coming home from school and subsequently spending hours on end in front of a computer, television, or playing video games. The parent suggests going outside or some other active recreation but has difficulty getting them off the couch.
So what can be done?
Fortunately, there are some helpful strategies out there to help parents get their children to become more active without resorting to threats and groundings. For example, it’s important to try and balance a child’s recreation time. That means not banning them from using computers or playing video games entirely, but instituting a type of trade-off, where an hour of exercise is rewarded with 30 minutes of video game time.
Also, remember that quality trumps quantity: fifteen minutes here, 50 jumping jacks there, are just as good as two hours of non-stop strenuous activity. Most importantly, make it a group effort. Children will be more likely to enjoy exercising if done in tandem with a parent.
Childhood diabetes is a nationwide epidemic and the best way to curb its spread is through preventative care and practices. This is particularly important as many pregnant diabetic women may be at risk of transmitting diabetes to their child.
With that in mind, there’s some good news to report this week from the Colorado School of Public Health. It found that pregnant diabetics can reduce the chances that their child will become obese and, in turn, potentially diabetic, by breast-feeding them for, at a minimum, six months.
The study tracked 94 children from diabetic mothers with approximately 400 from non-diabetic mothers for 13 years. The children who were breast-fed by diabetic mothers for at least six months, had a slower growth of body mass index, which contributes to obesity.
Naturally, there may be other factors at play here, such as diet, level of exercise, and access to quality medical care. But the science is irrefutable around two facts: one, children born to diabetic mothers have a higher risk of being obese, and higher obesity increases the risk of diabetes.
Therefore, any data that can help reduce the risk of childhood obesity and with it, childhood diabetes, should be embraced.
Given the alarming rise of childhood diabetes, health policy experts have expressed a wide array of strong opinions around the best way to curb this epidemic. All experts and pediatricians are in agreement, for example, that teaching kids the importance of exercise and a good diet is critical. Yet a recent effort to curb childhood obesity has kicked off a controversy around the most effective strategies available for reducing childhood obesity and, in turn, childhood diabetes.
Atlanta has the nation’s second-highest childhood obesity rate, so a local group called Strong4Life launched a billboard campaign showing unhappy obese children with messages like, “Chubby isn’t cute if it leads to Type 2 diabetes” and “Being fat takes the fun out of being a kid.”
Needless to say, it sparked a firestorm, as opponents argued such messages were damaging to the self-esteem of obese children and could even encourage bullying. Strong4Life, meanwhile, countered by saying the ends justify the means: obese children are more likely to become diabetics, and in turn, have their lives be in danger.
It’s a tremendously complicated issue, and one in which its importance to balance the fact that while children do need to be reminded of the importance of a good diet, their self-esteem is particularly fragile and must be dealt with accordingly.
Childhood diabetes is one of the biggest health challenges facing America today. And when we typically talk about the ailment, we frequently see the link to childhood obesity, which is particularly prevalent in suburban and rural areas where children and their parents drive everywhere.
But childhood obesity and diabetes is also rampant in urban areas, particularly poor neighborhoods. Children in these neighborhoods rarely have access to fresh fruit and vegetables, at least compared to those in more affluent areas. In addition, many of these neighborhoods are dangerous, precluding opportunities to exercise.
But there is good news, and it comes from one of the largest urban areas, New York City. In what will hopefully be a model for other urban areas, the city has seen small, but nonetheless encouraging, improvements in the rates of childhood obesity.
Based on new data from the Centers for Disease Control, the obesity rate of children between five and 14 dropped by over five percent from 2006 and 2011.
And while experts are not unanimous that this drop can be attributed to any one specific initiative, they agree that the city has taken the lead in its anti-obesity efforts, which contain an anti-soda marketing campaign, a ban on trans-fats, and calorie labeling in chain restaurants.
Many teens believe they are invincible. This is why many of the warnings parents instill in them while they are children become a kind of white noise in their heads the moment they become teenagers and strive for their independence.
We warn them of the dangers of drugs, alcohol and cigarette smoke. We have discussions about healthy eating, exercise and the need to get plenty of sleep. We hope these lessons and values remain with them throughout their life. And, while, for the majority of kids they do, they all have to go through the teen years which for some, test a parent’s patience but for others can induce real fears.
A child with childhood diabetes spends their entire life watching their parents protect them, diligently testing their blood sugar, providing a healthy diet and giving them their diabetes medication. They understand only too well what it takes to manage their diabetes. So, it seems unacceptable that when they reach the teen years that this is something they begin to neglect.
It is not uncommon for teens to rebel against their treatment for diabetes. They may eat the wrong foods, become lax in monitoring their glucose levels and not report to you the results. This can be extremely scary. They understand that they are not like other teens, who can binge on junk food with no repercussions. Their neglectful behavior can be life-threatening; however, some teens are desperate to fit in, they don’t care of the cost.
It is highly recommended that you make sure your child, at a very young age, is in a support group with other children with Type 1 diabetes. There are camps they can attend where they can meet other children and know that they are not alone. If you notice severe withdrawal and a change in moods or habits, it is extremely urgent that you seek professional help.
Recent research has revealed another critical component in effectively treating childhood diabetes: the role that sleep plays in a child’s blood sugar levels and overall health.
Researchers found that children with type 1 diabetes have greater difficulty getting a good night’s sleep compared to those without diabetes. This lack of quality sleep, in turn, makes it difficult for children to control their blood sugars. And this lack of control adversely affects a child’s performance in school, creating what is, in essence, a vicious cycle.
The fact that children – diabetic or otherwise – are failing to get a good night’s sleep isn’t news, of course. Highly active children, who shuttle from sports practice to school to karate lessons often have trouble getting to sleep at a reasonable hour. Similarly, those who spend a two or more hours in front of a television or computer find themselves over-stimulated at night and unable to sleep.
All of which further underscores the importance of a good night’s sleep for diabetic children. Parents should regulate their activities after dinner and allow for “down time” without over-stimulating the brain, monitor the child’s level of fatigue during the school day, and stay in close contact with their doctor.
Childhood diabetes may, in fact, be the most pressing public health concern facing the country today. Rates of childhood diabetes – inextricably linked to childhood obesity – continue to rise, particularly amongst minority and urban populations.
And it’s not rocket science why this is so. For starters, parents are faced with the seemingly insurmountable power of junk food and the companies who market it. It happens all the time: a child is in the cereal aisle, begging his mother or father to purchase that tremendously sugary cereal. And more often than not, the parent acquiesces.
Of course, the marketing of sugar is everywhere; in television commercials, movies, and even in schools, where soft drinks can be purchased from vending machines. Compounding this challenge is the fact that many children, particularly those in urban areas, don’t need the needed exercise to help keep the weight off.
So what can be done? Well, first, parents must take a more active role in regulating their children’s diets, including more fruits and vegetables and less junk food. Schools must serve healthier meals and make an effort to promote exercise, which is why we applaud Michelle Obama’s “Let’s Move” campaign. And most of all, adults should lead by example. As tempting as that bag of cookies looks, put it down. Try an apple instead.