Health Reform Begins at Home: Fruit and Veg Consumption and Childhood Obesity

Posted Saturday, February 6th, 2010

I am a mother now, and I can’t turn it off.  Especially when I read something as shocking as the recent statistics from the CDC about adequate fruit and vegetable intake.

A new-ish report from the CDC says that less than one-third of U. S. adults meet the government’s goals for eating enough fruits and vegetables, and only 13% of high school students eat enough vegetables.    This is particularly shocking when one considers that the government’s goals do not come close to what some experts suggest.  But even worse news is that 25% of kids 9 months-4 years old get 0 (that’s right, ZERO) fruit, and 30% get absolutely no, zero, zip, vegetables.

WHAT?  Are you kidding me?

No.  No, they are not kidding me. And this makes me very, very sad.  Even sadder when I discovered that they consider the fried potato a vegetable, so that of the two-thirds that do get vegetables, 46% of them are ONLY consuming the fried potato.  Potato, though better than nothing, is not exactly a nutritional heavyweight, and FRIED potato…….hey, it’s yummy, but hey, counting it as vegetable consumption is laughable at best.

Seventeen percent of US kids are clinically obese, and one in three US children considered overweight.  Childhood obesity is now an epidemic.  The CDC reports that “number of adolescents who are overweight has tripled since 1980 and the prevalence among younger children has more than doubled.” Being overweight during childhood and adolescence increases the risk of developing serious long-term medical problems such as high cholesterol, hypertension, hyperlipidemia,and and type 2 diabetes, which has also become epidemic in children. Overweight and obese children also suffer respiratory ailments (including sleep apnea,) orthopedic problems, gastro-intestinal disease, early puberty, and psychological problems, including depression, as a youths.

So, in addition to becoming an extensive problem, this has become quite an expensive problem.  In fact, children treated for obesity are approximately three times more expensive to the health care system than the average insured child.  God only knows how much more expensive the uninsured children are.  According to the CDC, the hospital costs associated with childhood obesity alone were estimated at $127 million during 1997–1999 (in 2001 constant U.S. dollars), and in 2000, “the total cost of obesity in the United States was estimated to be $117 billion—$61 billion for direct medical costs and $56 billion for indirect costs.” And as the incidence of childhood obesity continues to rise, and the cost of healthcare in general continue to rise, these numbers are going to become even more staggering.  And unsustainable.

Even worse, obesity (childhood or otherwise) is also a deadly problem.  It is estimated that about 112,000 deaths are associated with obesity each year in the US. That’s a heck of a lot of lives, and a heck of a lot of cash, to be saved by addressing and treating obesity, including childhood obesity, alone.

Sadly, the obesity rates and the cost of treatment are even higher among low-income minority children.  A Medstat report found that annual healthcare costs are about $6,700 for children treated for obesity covered by Medicaid and about $3,700 for obese children with private insurance.  These cost are even higher when you look at treating adults.  Low-income families, while they can afford food, often have to resort to inexpensive yet filling foods.  These foods are  filling because they consist of simple carbohydrates, salt, sugar and other ingredients linked to obesity.

Can eating more fruits and vegetables help to prevent obesity? Absolutely.  For example, a report in Obesity: A Research Journal examined changing the diet of at-risk children and their parents. The report compared two groups: one with an increased fruit and vegetable intake and the other with a decreased high-fat/high-sugar food intake.  ”Percentage of overweight change was greater for parents who targeted increases in fruit and vegetable intake than reductions in high-fat/high-sugar intake. The main contribution to weight control is a reduction in caloric intake, and dietary restriction is needed to lose weight. These results suggest that a differential focus on what can be eaten versus what cannot be eaten may make it easier to adhere to the caloric reductions needed for weight control. The interventions were designed to improve child eating habits and to prevent increases in the percentage of overweight in these high-risk children. The interventions were successful in meeting this goal, and if continued over time, the interventions might be useful in preventing the development of obesity.”

I figure, most of us in the US have nearly full control over what our child eats for at least the first couple of years.   My toddler isn’t currently given the option of a fried potato, or soda, or a delicious Quarter Pounder with Cheese, and so she doesn’t know what she is missing.  And even if she did, she can’t talk yet, so we can’t argue about it.  I win!  For now, at least.  Therefore, I’m cramming all the high quality fruit and veg I can into that little gal while I can.

Studies show that an infant/toddler’s exposure to different flavors can form his/her eating habits throughout childhood. Much infant and toddler formula and food is loaded with sugar, salt, simple carbohydrates, and other ingredients linked to obesity.  Relying on such foods not only puts your child at immediate risk for being overweight or obese, but also teaches him/her to prefer these foods to whole foods which are unsweetened, unsalted, and flavored with natural herbs, spices and the like.  Therefore, it is putting the child at risk of acquiring eating habits that will keep him/her on the fast-track to obesity and all its complications.

Now, I suffer no delusions that my child will never find out about french fries, chimichangas, orange soda and baked brie.  I fully realize that she is likely to have a phase where she will only eat ______.  But, in her early toddler years, if she has never met a hot dog, she is unlikely to suddenly demand it be her sole diet.  Additionally, she is going to have a few years of happily gulping down an extensive variety of fruit and vegetables that have no added sugar, salt etc.  And this, hopefully, will bring her back to the program after her food strike.

And for the rest of you, wanna save on health care costs?  For the rest of your life?  And, enjoy a higher quality of life? Eat yer vegetables.  Eating them can’t be worse than the consequences of NOT eating them.

WORKSHOP: Using the Wisdom of the East to Keep Your Family Healthy Through the Flu Season

Posted Monday, September 28th, 2009

mm-fluflyer

To D or not to D: New Guidelines for Vitamin D Supplementation

Posted Wednesday, September 23rd, 2009

 The American Academy of Pediatrics (AAP) has recently issued updated guidelines for vitamin D intake for infants, children, and teens to prevent vitamin D deficiency and Rickets.  The AAP now recommends that all children, including newborns, receive 400 IU of Vitamin D daily.  

Despite the fact that vitamin D dietary sources are rare (it is nearly impossible to get adequate vitamin D from diet alone), vitamin D is actually produced in the skin in response to ultraviolet sunlight.  Should be easy to get then, right?  Wrong.  Not even here in So Cal where it hasn’t rained since my 8 month-old was born (or so it seems.)  Why is it so hard to get?  

For one thing, the amount of sunlight exposure needed to synthesize adequate vitamin D is nearly impossible to determine, as there are countless variables.  Secondly, most of us, even in So Cal, don’t even come close to getting enough exposure. Since the risk of skin cancer increases with sun exposure, many folks either avoid the sun altogether, or cover up with extra clothes or a sunscreen, which, even in a relatively weak SPF 8 lotion, can decrease your body’s ability to synthesize vitamin D by 95%. Infants are especially are at risk, as it is not recommended that they go out in the sun for long periods.  According to the AAP, “Indirect epidemiologic evidence now suggests the age at which direct sunlight exposure is initiated is even more important than the total sunlight exposure over a lifetime in determining the risk of skin cancer.” Dark skinned folks are also at greater risk for vitamin D deficiency as they have increased difficulties synthesizing vitamin D from sunlight.  Also, the farther away from the equator you are, the longer you need in the sun to get adequate vitamin D.   And, FYI, you can not absorb the type of sunlight that is required for vitamin D synthesis through glass.  So, despite the fact that you can get fried on your  annoying commute, you cannot enjoy the benefits of vitamin D supplementation.  Drag.  

Vitamin D is essential for the proper absorption of calcium and phosphorus and promotes the development of teeth and bones.  Deficiency of Vitamin D leads to bone decalcification and weakening, as well as the terrible disease rickets, which can lead to skeletal deformities.   Vitamin D deficiency has recently been linked to diabetes and certain forms of cancer.  According to Medscape, “New data suggest that vitamin D has a potential role in maintaining innate immunity and in reducing the risk for certain chronic diseases including diabetes and cancer. This new evidence may eventually change the definition of vitamin D sufficiency or deficiency. Currently, vitamin D insufficiency in adults is defined as a level of 25-hydroxyvitamin D of 50 to 80 nmol/L and vitamin D deficiency as a level less than 50 nmol/L.”

Although Rickets has been relatively rare in Westernized countries, it is still seen, especially in breast-fed children and children with dark pigmentation.  For this reason, it is now recommended that breast-fed infants begin vitamin D supplementation within the first few days of life, as human milk has less than .06 percent of the vitamin D your baby needs.  Infants who are fed at least 500 ml of formula a day, are likely getting the vitamin D they need, as long as the formula was made in the US.  The AAP, however, does continue to recommend exclusive breast-feeding for at least the first 6 months of life when possible.  So, it is not recommended that you switch your baby to formula just to get the vitamin D benefit.  Instead, talk to your doctor about supplementation.

Unless you are a beach bum or supplement daily, there is a good chance you are vitamin D deficient.  A free test: Push hard on your sternum.  Or give someone else the thrill.  Don’t be a sissy, really press down there.  Does it hurt?  Then you may have vitamin D deficiency.

As always, the aforementioned information is just that, information, and is not intended to diagnose you, cure you, or turn you into a doctor.  All of your decisions regarding your health should be made with your personal heath care provider, as he/she is the only one that knows all of the particulars of your state of health.

With that in mind, go forth in health.

Melissa M Monroe, PhD, L.Ac

Eastside Family Acupuncture

WHO recommendations for H1N1 antiviral therapy

Posted Sunday, September 20th, 2009

The World Health Organization (WHO) has recently issued guidelines to primary care providers (PCPs) regarding antiviral treatment of novel influenza A (H1N1), as well as other influenza strains.  This is the first flu pandemic to strike in over 41 years, and cases have been confirmed in over 100 countries.  

A vaccine for H1N1 is not yet ready, but is expected to be ready by the fall.  The CDC, “has recommended that certain groups of the population receive the 2009 H1N1 vaccine when it first becomes available. These target groups include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems. We do not expect that there will be a shortage of 2009 H1N1 vaccine, but availability and demand can be unpredictable. There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others: pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency medical services personnel with direct patient contact, children 6 months through 4 years of age, and children 5 through 18 years of age who have chronic medical conditions.”

Where vaccines work to prevent infection in the first place, antivirals are drugs given to treat people who have already been infected.  Once the antiviral medications for H1N1 are available, the World Health Organization (WHO) recommends that “at-risk” patients (such as pregnant women, neonates and patients less than 5 years old) with confirmed, or strongly suspected, H1N1 2009  be treated ASAP.  Other “at-risk” groups include patients over the age of 65, nursing home residents, and patients who are either immunosuppressed or who have chronic illnesses.  Other patients with confirmed cases of H1N1 should also be treated with antiviral therapy.

In order to stop the spread of the disease to your family, friends and community, it is recommended that everyone follow a few, simple, common sense actions:

  • Cover your mouth and nose when you sneeze or cough. Then, throw the tissue you used to do that in the trash can.  
  • Wash your hands, often, with soap and water, but especially after you sneeze or cough.  You need to wash your hands for at least 20 seconds (the ‘ol Happy Birthday song is about that long).  
  • Avoid touching your eyes, nose, and mouth at all costs.  
  • STAY HOME IF YOU GET SICK.  C’mon folks.  
             
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