[fgummett]

CBC News - Health - Heart disease risk factor found in 20% of teens

One in five students in Grade 9 have at least one major risk factor for heart disease and stroke, a new Canadian study suggests.

The findings show an accelerating decline in the heart health of Canadian teens, said study author Dr. Brian McCrindle, a pediatric cardiologist at the Hospital for Sick Children in Toronto.

"Children shouldn't have these profiles," McCrindle said in a statement.

The risk factors measured included:

* High cholesterol.
* High blood pressure.
* Obesity.

He presented the research at the Canadian Cardiovascular Congress 2009 in Edmonton on Tuesday.

Between 2002 and 2008, the number of Grade 9 students with one or more cardiovascular risk factors rose to 21 per cent from 17 per cent, the team found after looking at 20,719 students in Ontario's Niagara region.

The number of obese teens went from 11 per cent to 13 per cent over the study period. More teens also had high blood cholesterol levels, which increased from nine per cent to 16 per cent in six years.

The magnitude of the increase is astonishing, said Dr. Beth Abramson, a spokesperson for the Heart and Stroke Foundation.

The number of students with high blood pressure dropped from 19 per cent to 17 per cent.

Overall, the results suggest teens have room for improvement in their diet and exercise levels.

Public health messages fall in deaf ears

"What it does suggest is that just informing the public and educating them about the problem doesn't necessarily translate into changes in policy or in behaviour," McCrindle said.

Public health advocates haven't been able to hit the message home, agreed Dr. Tom Warshawski, chair of the Childhood Obesity Foundation.

"Quite clearly what we've been doing hasn't been effective," said Warshawski, who was not involved in the research.

Warshawski pointed to two key factors in childhood obesity: sugar-sweetened drinks and screen time.

Banning junk food in schools has also been proposed to change behaviour.

The data were collected by Heart Niagara Inc., a non-profit corporation that worked with school boards and public health officials in a Grade 9 physical education curriculum enrichment program designed to prevent chronic disease.

They assessed students' blood pressure, height and weight, and blood cholesterol, for nearly all Grade 9 students in the system.

I guess I have to question why this dramatic increase continues to gain momentum... are kids really less active and drinking more pop in 2008 than they were in 2002? How much longer are we going to blame this on just behaviour and lifestyle?

[sarahspins]

Originally Posted by fgummett

I guess I have to question why this dramatic increase continues to gain momentum... are kids really less active and drinking more pop in 2008 than they were in 2002? How much longer are we going to blame this on just behaviour and lifestyle?

From what I see in my own 13 (almost 14) year old brother.. YES

I know I am one to talk, since I am currently overweight myself (though I can at least in part blame my thyroid problem on that, plus weight gained and not entirely lost through 3 pregnancies - I am making an active effort to deal with my excess weight, not just ignoring it) but the kid really has no clue about food, and what is okay to eat, and what is really just not. I know teenagers (especially boys) eat a ton, but there's a fine line between "eats a lot" and "eats far too much" - and I think there are a lot of teenagers out there who really just eat too much of the wrong stuff.. and by wrong I mean WAY wrong.

That said, I was not overweight at his age... and I drank plenty of soda back then and didn't really think about what I ate (at all), but I can say without any hesitation at all that I was MUCH more active than he is.. and that is really where I think most of the problem is... back when I was a teen, the internet was around, but there just wasn't as much stuff to suck up all of your free time as there is now... if you got bored you went out and did stuff. Kids just don't do that anymore.

[fgummett]

That is not my experience of sharing time with my teenage son and his friends over the past 7 years (he is 19 next January).

I think the current approach is very shortsighted... if in doubt "sloth and gluttony"... let's try thinking outside the box people, 'cos the current stance clearly isn't working

Seriously... you were more active... no offense meant but I'll bet if you asked your mom she was even more active... and her mom before that.... heck if we go back enough generations humans must have been buzzing around like humming birds... seriously!

[foxl]

Frank, I have got 3 SKINNY KIDS. I look at their classmates and am horrified. My kids eat like "Americans," too. Okay, one further, they are ovo-lacto-vegetarians, meaning their carb:protein ratio is pretty high.

Genetics? Nah.

All 3 were born in other countries, I have no clue what their birthmothers look like but I am betting they had NO prenatal care and sure as heck did not have much nutrition education. I am interested in the concept of prenatal genetic switching, needless to say.

[fgummett]

Sounds like you are doing a great job there Linda... good for you and for their future health! My boy is also lean and now is [just] taller than me... although I will say that I was also lean up until my mid/late-twenties

Originally Posted by foxl

...their carb:protein ratio is pretty high.

As in more carbs than protein? But I'm betting those are carbs from real whole foods and not refined/concentrated in processed/packaged foods?

Originally Posted by foxl

...I am interested in the concept of prenatal genetic switching, needless to say.

As in Epigenetics? I watched a documentary on that recently... fascinating concept... I'd like to learn more.

[foxl]

Frank, the whole point is, my kids eat like 'MERICANS ... they like the gross gloppy mac and cheese from a box, they like taco bell burritos, they like pizza. And one case, that is almost ALL she will eat. They eat sugary-gross cereals.

I would LOVE to take credit for their weight and health, but they are picky ... and I PANDER. Just to get some kind of calories into them.

Part of their poor diet stems from having developed their tastes in their original countries, in poor care situations. My youngest was so malnourished (protein-calorie) that at age 2.5 when I picked her up, she had no hair -- and what hair she has 3 years later is still thin and light brown (this is a known problem in international adoptees from some places). I do not blame the orphanages, but they are POOR. She ate rice once a day, noodles twice. The only thing I could get her to eat besides noodles at first was eggs. And my son had rickets (vit D deficiency), and I suspect other malnutrition. And vitamin supplements are unthinkable in such places.

Maybe it is macronutrient exposure in utero ... or maybe micronutrients.

[sarahspins]

Originally Posted by foxl

Frank, I have got 3 SKINNY KIDS.

Mine are built like rails too I don't "limit" what they eat as much as just provide them with "better" choices than I think most american kids have... we don't usually keep juice or soda in the house, and I think that makes a HUGE difference.. they do eat their fair share of processed foods, junk, and candy, but within limits. We are also very active and I encourage them to play outside just as much as inside - we actually HATE being stuck inside because of bad weather (and I am not afraid of rain, but wet + cold is usually not a good combo).

I see a lot of kids/families where the kids are basically babysat by the TV or the computer.. that's a bigger problem IMO than what kids are eating.

[foxl]

I should add, it is not like I am not working on their diets ... with some success. They now will eat some green objects without gagging, for instance. We do not do juice or regular soda.

They have PE only twice a week, but we have them in swimming lessons twice a week, too.

And we do limit TV viewing. But seriously. I do doubt it is their immediate or current environment activity or diet.

[ODAR]

OK - here's my story - have two girls - one as you know is 16 - dx as t2 -was premature birth - half of a twin -hence small birth weight. From the age of 0-6 she was underweight for her age and height - then wham the weight started creeping up. My second child was born when the eldest was 6 (did my eldest find comfort in food when Mom was busy with new Baby?).

My youngest is now turning 11 in November - extremely skinny (weighs 20's something kilos). She is very active and has a healthy appetite. Both kids eat the same food, drink the same soda, basically eat the same rubbish - oh and have the same father.... so why the difference in weight?

The eldest is a bookworm, high achiever where studies are concern. Loves her music and her Ipod/Internet - she always up on the net on facebook, twitter etc to all hours. Basically a Computer Geek - she even did all of my husbands webpage for his business!.

The second is a social butterfly... loves her bike, swimming and basically running outside... can't sit still... not interested in books, studying etc. She too has an ipod and laptop, but only goes on it for social networking. She only eats when hungry.. the eldest sees the food and is instantly hungry! Hence I think the difference in their weight!

Since Dx my eldest has to exercise an hour or more a day... way more on weekends! If she wants to eat "junk food" she has to pump weights and just move her body that little bit extra than normal.... I have laid down the rules and am sticking to them - I have basically told her that in order for her to enjoy the rest of life - she needs to move her body twice as much as she usually does! She is finally getting the message - especially after her visit from the endo. She now realises that her future is in her own hands and she has to make the right decisions.. ... there's a price she has to pay for Junk Food or should I say High Carb Intake.. but she's getting it.. she knows.....

[fgummett]

My theory -- in part based on something I heard/read from Gary Taubes -- is that we are now facing a multi-generational issue:

1st generation...
it makes sense to me that the BG management system can tolerate several years of abuse by being challenged with large amounts of sugar but after maybe as many as 20 years the system starts to fail. This fits in with my own experience of being lean up until my mid to late 20s and struggling with excess fat mass and ultimately Type 2 D since then. It also fits in with what I have read about communities that switch from their traditional diet to "Western" food... again there seems to be about a 20 year "incubation" period before Type 2 D becomes widespread, where there was none before

2nd generation...
I understand it is already well established that babies born to mothers who had GD or full-blown Type 2 D during the pregnancy, are at greater risk for overweight and Type 2 D themselves. Now consider that many pregnant women may already be well down the 20 year road I described above, although not yet officially diagnosed with Type 2 D... I suspect that foetal BG management system is already being overloaded in utero while still developing, so in effect they are born with a "head start" on the road to excess fat mass and ultimately Type 2 D.

Have you watched the presentation that John (xMenace) posted here... Sugar: The Bitter Truth

And while not wanting to downplay the role of physical activity... it is important for so many reasons... exactly how much extra exercise does it take to balance out that slice of white bread?

[DeusXM]

are kids really less active and drinking more pop in 2008 than they were in 2002? How much longer are we going to blame this on just behaviour and lifestyle?

To be honest, I'm not really sure what else you can actually blame it on, unless you believe there's some sort of deviant mutation in genetics taking place across the States.

The fact is that being overweight is now pretty much considered as culturally acceptable. Let's look at this in stages.

When I first started school at the end of the 1980s, there were hardly any fat children. Most of us spent our breaktimes playing football or tag. Lunch tended to be sandwiches and crisps and sweets. The very few fat kids we had would be teased, relentlessly. Kids are cruel.

Let's then skip forward a few years to when I was at secondary school in the late 90s. Many of the kids starting in the years below us were all, generally, fatter than my year had been when we started. Again, no real obvious changes in diet, or indeed, apparent activity. And the fat kids got picked on. But the perception of what was 'fat' had changed.

Now let's take things to their logical conclusion now, 20 years after I first started school. Overall, our cultural acceptance of obese people has shifted. Kids that would be considered a source of ridicule 20 years ago are considered by their peers as normal. Which means parents presumably feel a lesser need to step in and keep an eye on their kids' diet. 20 years ago, a 6 year old weighing six stone would have come home in tears after being picked on all day and maybe Mum and Dad would have thought 'hmm, fewer sweets in future, Johnny'. Now that same kid is coming home, happy - so that little checkpoint is missing.

It's not just with kids - our whole culture is starting to shift to try and see obesity as acceptable. We have people demanding larger seats on airlines. We have parents suing Nintendo because Wii Fit told them their kid was overweight.

Rightly or wrongly, obesity used to be seen as something an individual had to deal with, rather something that should be accepted. Yes - the overweight are still ridiculed. But do you really think that 20 years ago, an obese person would even considered demanding a bigger seat on a plane?

Added to this, yes, there has been a massive drop in childrens' activity levels. When I was a kid, very few kids had games consoles because they were expensive. And the games weren't exactly longlasting. There was also only about 4 hours of childrens' TV programming a day (in the UK, at least). Fast forward now, and every kid has console, a TV in their room and access to dozens of 24-hour kids TV channels. The last 30 years have seen an increase in wealth generally, which increases access to 'luxuries' like consoles and DVDs and computers (oh, and food).

Then coincide this with the crippling culture that says if you let a kid outside out of your site for more than a minute, some paedophile will kidnap, rape and kill them....you've got a perfect storm of an increasing acceptable 'normal' weight, increased access to sedentary leisure activities, and a decrease in access to more active leisure pursuits.

There's already a clear cut reason why kids are getting fatter that doesn't even need to refer to diet, or genetics, or some mystery cause.

[fgummett]

Even if I accept your reasoning over the last 20-30 years DeusXM, I was quite specific in asking about the period of this study, 2002 - 2008... do you see this trend continuing... children are just getting more and more sedentary and eating more and more junk food... isn't there some physical limit to this theory?

[DeusXM]

I absolutely see this trend continuing, right up to the point we actually see kids having heart attacks. There's still a little way to go before all kids adopt entirely sedentary activities and the point I was making about the increasing acceptance of being overweight as normal demonstrates that we'll be seeing even fewer parents intervening or kids feeling they need to do something.

What we're seeing in the change is the inevitable result of that shifting acceptability. I've already said that when I was at school, the kids a few years younger than me already seemed 'larger' than me at that age - so it doesn't surprise me that a survey sees a significant difference over five years.

I expect unless something is done (such as a cultural shift where people actually learn to say 'no' to something once again) we will see this trend continuing with a grim inevitability.

I would also argue that efforts made to try and blame the problem on anything other than a lack of exercise and discipline will also exacerbate the problem. Focusing efforts on finding some 'conspiracy' reason such as genetics/immunisation/white bread, instead of diverting resources to force parents to take responsibility for their children and intervene would be a serious mistake.

[ODAR]

DeusXM; - I have to agree with you - being a parent myself of an overweight type 2 teen.

I have often had heated arguments with my daughter about her weight..... she would retort that I was (a) anorexia, (b) controlling and (c) obsessed about weight! I had only started to gain weight about 4 years ago - prior to that I was always underweight (slightly) as I was very active then, but circumstances led to my change of living and thus got diabetes. She would also say that she's not the fattest kid in school - and that there were way many kids fatter than her. I would then reply that I didn't care about the other kids... that she was my concern - etc etc. She was accepted by her peers and was not self conscious about her weight at all!
Anyway, my husband and I would try the reward system where if she exercised and played more sport outside of school she would get certain privileges. This however only lasted for a few weeks - and then she would back out of it saying she had to study for this exam or that... Yes my daughter is an "A" grade student - she represents her school in debates/ inter-school sports and was also Year Student Councillor... but there was no balance - and admittedly I failed her in pushing her to be more active.
I totally agree that Parents have to take responsibility before it's too late! I can actually remember telling her that she was heading for a lot of sickness if she continued eating and not exercising... I also remember telling her that she would end costing me a lot of money in medical bills because she was "unhealthy". Little did I know she was going to end up being a type 2 diabetic at age 16!

Since dx - we have had our fights and arguments - but I am adamant that she portion size her food servings and exercise everyday... otherwise I will pull the modem ( and this time she knows I'm not joking).

The downside to all this attention to food and weight have played a negative part on my youngest daughter - who from a very early age - refuses to eat anything that she considers "Fattening" ( can't win)

She is much better towards her attitude to food now but for a long time - she had a very unhealthy view of food and body image.

[fgummett]

OK it seems obvious... "sloth and gluttony" and its simple... "we just need our children to be more active and eat less junk food"... so why is it still getting worse do you really believe that parents are not interested in their childrens' health even at just a genetic level we have a vested interest in our offspring living at least long enough to pass on our genes to their offspring who need to live long enough... and so on...

Why, with such a simple cause and such a straightforward solution, is the situation still getting worse year after year after year... isn't there even the slimmest possibility that we are missing something from the picture here?