Empowering Healthy Kids Blog

Growing evidence shows that not only does a healthy body lead to a healthy mind, but a smart one too:

The California Department of Education (CDE) looked for a correlation between fitness scores and test scores. They found that kids who were deemed fit (by a standard test of aerobic capacity, BMI, abdominal strength, trunk strength, upper body strength and overall flexibility) scored twice as well on academic tests as those that were unfit.  In the second year of the study, socio-economic status was taken into account, to possibly eliminate that variable as an explanation. As expected, those in the upper-income brackets scored better overall on the academic tests, but within the lower-income set of students, the same results were observed — kids who were more fit performed better academically.

Also from the article, a quote fromJohn Ratey, a Harvard clinical associate professor of psychiatry:

In his latest book, “Spark: The Revolutionary New Science of Exercise and the Brain” (2008, Little, Brown), John Ratey, a Harvard clinical associate professor of psychiatry, argues for more physical fitness for students as a cure for not only their obesity but also their academic performance.

“I cannot underestimate how important regular exercise is in improving the function and performance of the brain.” Ratey writes. “Exercise stimulates our gray matter to produce Miracle-Gro for the brain.” That “Miracle-Gro” is a brain chemical called brain-derived neurotropic factor, or BDNF. When we exercise, our working muscles send chemicals into our bloodstream, including a protein known as IGF-1.

Once in the brain, IGF-1 orders the production of more BDNF. The additional BDNF helps new neurons and their connections grow. In addition, levels of other neurotransmitters are increased after a strenuous exercise session.

“Dopamine, serotonin, norepinephrine — all of these are elevated after exercise,” says Ratey. “So having a workout will help focus, calming down, and impulsivity — it’s like taking a little bit of Prozac and a little bit of Ritalin.”

My philosophy towards public health and social problems is to find work on the solution from the ground up. Start with the individual, then family, then local community, then state, then national. This is why I like this initiative - the solution is skewered towards the local community:

Picking up the phone may not be the best form of exercise, but the CanDo Coalition is hoping people will do it to help defeat obesity.

The local nonprofit organization is using an automated telephone survey to gather information on the health needs of Loveland residents, so the group can plan ways to help local residents eat better, get active and prevent obesity.

The CanDo Coalition began in 2003, Englert said, as a response to the obesity rate in Larimer County, which had doubled during the previous 10 years.

The founding organizations were the Poudre Valley Hospital Foundation, Colorado State University and the city of Fort Collins.

Over the past five years, the CanDo Coalition has worked with Fort Collins schools, employers, health care professionals, new mothers, low-income residents and older adults to improve residents’ health habits.

In the schools, CanDo created a “School Wellness Kit” for teachers and parents, to help them find ways to get children to eat healthier, exercise more and limit TV, computer and video-game time.

The coalition also has helped Fort Collins businesses start exercise, weight-management and stress-management programs.

The funding for the Loveland expansion came from LiveWell Colorado, a partnership of health care organizations, charitable foundations, nonprofit organizations and public health agencies.

Teenagers from low income homes are fitter than their higher income counterparts:

…young South African children from poorer backgrounds are less active than their wealthier counterparts, according to the “BratTrax” survey conducted by Youth Dynamix.

The survey of 1110 children in 2007 and 2008 shows that 65% of lower-income children aged between seven and 12 “do nothing to keep healthy and fit”. Lack of sports and parental support are among the reasons for this, the report says.

But when they hit their teens, upper-income adolescents, with time pressures caused by homework and extra-mural activities, become less active than their poorer counterparts.

I’m a bit late to the party on this but here’s some commentary about the child obesity rates levelling off:

From US News:

There’s some not-bad news about childhood obesity today: A study published in the Journal of the American Medical Association finds that the prevalence of kids with a high body mass index, or BMI, showed no significant increase between 1999 and 2006.

If that trend is borne out in data for subsequent years, it’s at least a sign that the upward creep of child BMI may have leveled off. But it’s by no means great news, since it still means more than 16 percent of kids between 2 and 19 had BMIs at or above the 95th percentile, while about 32 percent were at or above the 85th percentile. I know—that looked weird to me, too: How can 16 percent of kids be above the 95th percentile? (It’s like Lake Wobegon, where all the children are above average!) But those percentile charts are based on decades-old data on kids’ weight; kids have gotten heavier in proportion to height, so now 16 percent of them are at or above the level that used to be the cutoff for the top 5 percent.

From Extension Daily on the reasons for the levelling off:

Still, [Dr Robert] Keith says that while some behavioral changes surely have occurred, the possible peak in childhood obesity may actually have nothing to do with lifestyle changes. Future studies even may prove that the peaking effect had little to do with educational outreach and everything to do with a combination of several environmental and human genetic factors.

In fact, Keith says it is possible two pervasive environmental factors — a chronic lack of exercise coupled with a wide access to calories — have contributed to spiking obesity rates among children most genetically susceptible to these factors.

In effect, what is widely viewed as a peak is actually a genetic saturation point.

“It is possible that we’ve reached our saturation point in terms of the levels of physical inactivity and the amount of calories current available to us versus the number of children who are becoming obese,” Keith says.

Simply put, he says, all of the people most susceptible to obesity based on current levels of physical activity and levels of available calories have become obese.
And this theory, if it turns out to be true, presents a sobering reality to Keith and other health and nutrition specialist.

From Time, interviewing Cynthia Ogden (lead researcher of the study):

Ogden wouldn’t speculate as to why national childhood overweight trends appear to have stalled. It could be that kids have hit the fat ceiling — they’ve gotten as heavy as they’re ever going to get. Or, perhaps the most obvious answer is the nationwide effort to combat obesity by getting kids — and parents — to eat better and exercise more. From Arkansas, where state officials have begun sending annual childhood health reports to parents, to Massachusetts, where the town of Somerville launched a community-wide intervention to improve the diet and fitness of children, state and local governments have recognized and begun addressing childhood obesity.

One thing that needs to be noted is that Body Mass Index is used , which does have some flaws (which I have written about earlier).

This is pretty cool from HandsFree3D:

I like the fact that it is camera based (like the EyeToy) and no extra wearable sensors are required. I also like the way which they’ve implemented “flying mode”. Plus, they’ve got a Matrix reference.

As we discussed earlier, evidence is growing that genetics is an important factor in childhood obesity. New longitudinal research from Canada shows now shows a link between income and obesity:

The study suggested that the impact of a neighbourhood’s poverty level rather than affluence may matter most in a child’s weight. It is possible that neighbourhoods may become more important as children age and have more freedom to access the neighbourhood. It is also possible that disparities emerge over time, as children are exposed to such environments over a longer period.

This got me thinking. Why would families on low-income be more likely to overweight and obese? Perhaps it’s simple economics: A family will try to maximise the amount of energy intake for the least cost possible - in other words more calories per dollar. If you spend a greater proportion of money on food, then you are sensitive to this equation. Apparently, I’m not alone with this opinion:

Healthy eating really does cost more.

That’s what University of Washington researchers found when they compared the prices of 370 foods sold at supermarkets in the Seattle area. Calorie for calorie, junk foods not only cost less than fruits and vegetables, but junk food prices also are less likely to rise as a result of inflation. The findings, reported in the current issue of the Journal of the American Dietetic Association, may help explain why the highest rates of obesity are seen among people in lower-income groups.

The scientists took an unusual approach, essentially comparing the price of a calorie in a junk food to one consumed in a healthier meal. Although fruits and vegetables are rich in nutrients, they also contain relatively few calories. Foods with high energy density, meaning they pack the most calories per gram, included candy, pastries, baked goods and snacks.

The survey found that higher-calorie, energy-dense foods are the better bargain for cash-strapped shoppers. Energy-dense munchies cost on average $1.76 per 1,000 calories, compared with $18.16 per 1,000 calories for low-energy but nutritious foods.

The survey also showed that low-calorie foods were more likely to increase in price, surging 19.5 percent over the two-year study period. High-calorie foods remained a relative bargain, dropping in price by 1.8 percent.

Although people don’t knowingly shop for calories per se, the data show that it’s easier for low-income people to sustain themselves on junk food rather than fruits and vegetables, says the study’s lead author Adam Drewnowski, director of the center for public health nutrition at the University of Washington. Based on his findings, a 2,000-calorie diet would cost just $3.52 a day if it consisted of junk food, compared with $36.32 a day for a diet of low-energy dense foods. However, most people eat a mix of foods. The average American spends about $7 a day on food, although low-income people spend about $4, says Dr. Drewnowski.

Researchers in the UK have found a strong link between childhood obesity and genetics:

more than three quarters of the difference between children’s waistlines, with lifestyle factors such as diet and exercise playing a much smaller role.

Lead author of the study, Dr. Jane Wardle:

Weight gain in a child is unlikely to be the fault of the parents and is more likely to be due to the child’s genetic susceptibility.

The study was conducted using a twin study and drew the following conclusions:

The researchers found that, overall, the twins’ heights and weights were greater than the 1990 averages, though BMI was similar. Waist circumferences were substantially higher than in populations in 1990, particularly in girls. They also found that identical twins were more likely than non-identical twins to have similar BMI and waist circumference measurements, suggesting a genetic component to these characteristics.

Using the modelling method, the researchers conclude that variation in BMI scores is 77 per cent heritable, while variation in waist circumference is 76 per cent heritable. They also found that the “shared-environment” had little effect on BMI and waist circumference (10 per cent each).

One problem that I find with these studies is that it shows correlation but not causation, but the researchers discuss such criticisms:

• Firstly, the common finding that the shared environment has little effect. In studies of obesity, this is surprising considering the fact that many models suggest that the environment is “the root cause of obesity”. They say that this finding suggests caution when assuming that if all parents followed “current child-feeding recommendations, the obesity problem would be solved”.
• Secondly, twin studies assume that identical and non-identical twins share the same environment (in the uterus and in the family). There is discussion in the scientific literature about whether this is an accurate assumption, however the researchers here say that the effect is small and “it would not materially change the conclusion”.
• Thirdly, such studies do not identify genes responsible for traits or behaviours. No major genes that cause obesity have been identified and obesity is likely to be due to the influences of many different genes, affecting appetite as well as how fat is stored. 

Until such time as the boffins find a “fat” gene can we understand the cause of obesity an, hopefully, from that finding the best ways to combat it. What this study also means is that parents who are overweight and obese must not abandon their and their children’s efforts to lead an active and healthy lifestyle. It just means they have to work a little harder at it.

Apparently playing the Wii uses an extra 60 calories per hour compared to playing an XBox; which is equivalent of walking an extra 12 minutes.

Type 2 diabetes is a function of a poor lifestyle health choice and unfortunately we are seeing the rise in the prevalence of type 2 diabetes in children. Now a new study shows that Adult Type 2 diabetes can be predicted in childhood:

Researchers at the Cincinnati Children’sHospital Medical Center found that parental history of diabetes, as well as the presence of metabolic syndrome in childhood were major predictors of type 2 diabetes in adulthood. The finding was particularly true for black American men and women, the researchers report.

People with metabolic syndrome have at least three of the following health issues: high blood pressure; high triglycerides; high body mass; high blood glucose; and low levels of “good” high density lipoprotein (HDL) cholesterol.

More good work from the Robert Wood Johnson Foundation with their Active Living Research initiative. In particular, their latest research on designing active living environments for children. Here is a summary of their conclusions (emphasis added):

• Obesity rates have increased dramatically among children of all ages in the United States, and physical inactivity contributes to the epidemic. Today, two thirds of adolescents do not meet the Surgeon General’s recommendation of 60 minutes of physical activity daily.
• Children and teens living in low-income communities and African-American, Latino, Native American, Asian and Pacific Islander children have a low percentage of physically active youth and are especially vulnerable to obesity.
• There is strong evidence linking access to facilities like parks, playgrounds and recreation programs with increased physical activity and reduced risk for obesity among kids. Studies also show that low-income and minority communities offer significantly fewer opportunities for residents to be active than do higher income communities.
• Young people living in neighborhoods that provide sidewalks, safe streets and destinations within walking distance from home are more physically active than those living in low-walkable suburbs.
• Safe Routes to School (SRTS) projects improve facilities like sidewalks and crosswalks, slow traffic and encourage policies that make it safer and easier for children to walk and bike to school. There is initial evidence that SRTS programs result in more students walking and biking to and from school.
• Schools can offer many opportunities for children to be physically active, including effective PE programs, updated playgrounds, well-maintained equipment and supervised activity breaks throughout the school day.
• Research-based PE programs have been shown to improve students’ physical fitness levels, yet many studies reveal a significant lack of PE programming in U.S. schools, especially among high school students and students living in low-income communities.
• Parental concern over traffic safety and neighborhood crime is a significant barrier to physical activity among children, especially in low-income communities.
• There is evidence linking excessive TV viewing to increased risk for obesity among children, and minority children are especially vulnerable. School-based interventions that promote physical activity and encourage students and parents to limit TV time show promise for reducing the risk of childhood obesity.