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Experts urge screening for obesity in kids

Experts urge screening for obesity in kids

Doctors should screen children and teens between 6 and 18 years for extra pounds, a federal task force recommends.

For children who are found to be obese based on their body mass index (BMI), a standard measure of the relationship between height and weight, the task force also calls for referrals to a comprehensive program that includes dietary advice, physical activity, and behavioral counseling to promote weight loss.

The new recommendations update earlier ones from 2005. Skyrocketing rates of obesity have reached between 12 and 18 percent in 2- to 19-year-olds, increasing up to 6-fold since the 1970s, members of the United States Preventive Services Task Force report in the February issue of the journal Pediatrics. Obesity is linked to the early development of diabetes and high blood pressure.

For their update, the task force reviewed 13 studies of behavioral intervention in 1258 obese children and adolescents.

Moderate- to high-intensity programs, involving more than 25 hours of contact with the child and/or the family over a six-month period, resulted in a decrease in BMI 12 months after the beginning of the intervention.

In addition to dietary and physical activity counseling, effective programs included behavioral-management techniques such as self-monitoring and eating management. However, the programs only worked in children who followed through on treatment.

Harms of screening — for example, adverse effects on growth, eating-disorder pathology, or mental health issues — were judged to be minimal.

It is unclear if the recommendations can be applied to children who are overweight but not obese. And there was no convincing support for interventions that lasted less than 25 hours per six months, or for screening children below age 6.

Yet some experts take issue with what they consider the narrow age bracket of the recommendation.

“The USPSTF falls short of the mark in not recognizing the developmental trajectory of obesity in childhood,” writes Dr. Sandra G. Hassink, from the Dupont Hospital for Children in Wilmington, Delaware, in a related commentary.

Hassink urges pediatricians to screen all children. “Working with families to screen for high-risk nutrition and activity behaviors that contribute to obesity in early childhood must be part of that task,” she writes.

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Overweight mothers linked to infant heart defects

in.reuters.com

Overweight mothers linked to infant heart defects

Women who are overweight or obese when they get pregnant are more likely to give birth to children with congenital heart defects, according to a U.S. government study released on Thursday.

The study, conducted by the U.S. Centers for Disease Control and Prevention, concluded that women who were overweight or obese at the time they became pregnant were 18 percent more likely to give birth to babies with heart defects, while severely obese women had a 30 percent increased risk.

The babies had problems including obstructive defects on the right side of the heart and defects in the tissue separating the heart’s two upper chambers, the researchers reported in the American Journal of Obstetrics and Gynecology.

“Congenital heart defects are the most common types of birth defect, and among all birth defects, they are a leading cause of illness, death and medical expenditures,” said Dr. Edwin Trevathan, a CDC expert on birth defects and developmental disabilities.

The CDC, the U.S. government’s disease watchdog, recommends that overweight women work with their doctors to achieve a healthy weight before pregnancy.

Researchers examined the health of 6,440 infants with congenital heart defects and 5,673 infants without problems, all of whose mothers were interviewed as part of the CDC’s National Birth Defects Prevention Study.

They assessed obesity according to each woman’s body mass index, or BMI, which relates weight to height. A woman 5 feet, 5 inches tall and weighing 190 pounds (86 kg) would have a BMI of 31.6, while a woman of the same height who weighs 160 pounds (72 kg) would have a BMI of 26.6.

The researchers defined overweight as a BMI of 25 to 29.9, moderate obesity as a BMI of 30 to 34.9 and severe obesity as a BMI of 35 or above.

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