New findings about the causes of childhood obesity

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Childhood obesity is not just a public health concern in western countries; it is rising across the world, particularly in poor and low-income countries.

In a new study, researchers found that the factors causing childhood obesity are quite different for wealthier and poorer countries, and in the big picture, management of the disease is complex.

The research was conducted by a team of Yale scientists.

Children who meet the definition of obese have body mass indexes (BMIs) of 85% or 95% above average.

According to previous research, BMI data from 200 countries showed pediatric obesity has risen from 4% in 1975 to 18% in 2016—or from 5 million to 50 million girls, and 6 million to 74 million boys.

While childhood obesity rates have plateaued in the U.S., they continue to climb in countries across East Asia, the Middle East, North Africa, and South Asia.

Childhood obesity comes with a number of serious consequences: increased risk for developing diseases such as Type 2 diabetes, fatty liver disease, and cardiovascular disease, as well as an approximately 80% chance of remaining obese into adulthood.

In the study, the team focused on understanding the mechanism that causes Type 2 diabetes, a chronic condition in which the body develops insulin resistance and can’t process glucose properly, causing sugar to build up in the bloodstream.

The risk for metabolic disease linked to childhood obesity is not a function of body mass index, according to the paper, but of how and where the body stores fat.

The team used MRI scans of patients to discover that obese children who are prone to metabolic diseases such as fatty liver disease and heart disease have a layer of subcutaneous fat that is thinner than average.

Unable to store the excess abdominal fat in that layer, the body pushes it into other tissues in the body, including as fat droplets in the liver.

The liver then becomes inflamed and contributes to the development of insulin resistance. From 2002-2012, Type 2 diabetes rose by 4.8% among youth under 20. And Type 2 diabetes is more aggressive in children than adults.

Further complicating matters is that childhood obesity often develops into Type 2 diabetes during the teenage years, when controlling a child’s diet can be challenging.

The only way to mitigate obesity is better nutrition, Caprio concludes, but dietary options for many kids tend toward carbs and highly enriched processed food.

In the U.S., the problem is inertness, but there is more awareness about the dangers of consumption of sugar and soda.

In China, India, and South America, they are pushing these products and soda consumption is very high. And the water is not drinkable.

Still, rates are plateauing in the U.S., due in large part to broader awareness. That public education effort needs to be expanded to further curb rates in the U.S. and abroad.

One author of the study is Dr. Nicola Santoro, assistant professor of pediatrics (endocrinology).

The study is published in Nature Metabolism.

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