2017-05-04 / Front Page

UNE studies childhood obesity

By Garrick Hoffman
Staff Writer

BIDDEFORD – While obesity remains an issue nationwide, its prevalence remains an issue not just in Maine, but in York County as well, and studies are underway to examine it.

According to 2015 data provided by StateOfObesity.org, a website that publishes an annual report detailing statistics related to obesity, 17 percent of American children are obese.

Maine is ranked 13th in overall prevalence with 28.2 percent of 10- to 17-year-olds who are overweight or obese, according to the Child Policy Research Center.

In York County, 11.6 percent of high school students are obese, according to 2013 data published in the 2016 Shared Community Health Needs Assessment on Maine. gov.

Dr. Paul Visich, professor and chairman of the Exercise and Sport Performance Department at University of New England, said childhood obesity is one of the greatest public health concerns of our time.

“When you have children already in the obese category, it becomes extremely difficult to make changes unless there’s complete involvement from families, schools and environments,” he said. “It becomes worrisome because it’s being predicted that our children will have decreased life expectancy for the first time in many, many, many years because of issues surrounding obesity and its influence on cardiovascular disease and on many other health perimeters. That’s real concerning.”

According to the Center for Disease Control and Prevention, obesity is defined as a body mass index, or BMI – a measure used to determine obesity – at or above the 95th percentile for children and teens of the same age and sex. Body mass index is calculated by dividing a person’s weight in kilograms by the square of height in meters. For children and teens, body mass index is age- and sexspecific and is often referred to as BMI-for-age. A child’s weight status is determined using an age- and sex-specific percentile for body mass index rather than the body mass index categories used for adults. This is because children’s body composition varies as they age and varies between boys and girls. Therefore, body mass index levels among children and teens need to be expressed relative to other children of the same age and sex. BMI does not measure body fat directly.

For example, according to the Center for Disease Control and Prevention, a 10-year-old boy of average height – or 56 inches – who weighs 102 pounds would have a body mass index of 22.9 kilograms per square meter. This would place the boy in the 95th percentile for body mass index, and because child’s body mass index is greater than the body mass index of 95 percent of 10-year-old boys in the reference population, he would be considered obese.

The Center for Disease Control and Prevention listed behaviors, genetics and community as principal causes of childhood obesity, similar to those among adults. Behaviors that influence excess weight gain include eating highcalorie, low-nutrient foods and beverages; inadequate physical activity; sedentary activities such as watching television or other screen devices; medication use and sleep routines. Environments that don’t support healthy habits likewise contribute to obesity. These environments can include care centers, schools or communities that don’t offer healthy food and drinks or promote physical activity. Peer and social supports, marketing and promotion, and policies within the community can also influence childhood obesity.

The Center for Disease Control and Prevention lists a plurality of consequences related to childhood obesity. Among the more immediate health risks are high blood pressure and high cholesterol – risk factors for cardiovascular disease – increased risk of type 2 diabetes from impaired glucose tolerance and insulin resistance, breathing problems such as asthma and sleep apnea, joint problems and musculoskeletal discomfort, fatty liver disease, gallstones and gastro-esophageal reflex, or heartburn.

Childhood obesity is also linked to psychological maladies such as anxiety and depression, low self-esteem and lower self-reported quality of life, and social problems such as bullying and stigma, according to the Center for Disease Control and Prevention.

Children who are obese are more likely to become adults with obesity, which is associated with increase risk of serious health conditions such as heart disease, type 2 diabetes and cancer, in addition to the aforementioned immediate health risks, according to the Center for Disease Control and Prevention. If children are obese, their obesity and disease risk factors in adulthood are likely to be more severe.

The 2013-2017 Maine State Improvement Plan by the Maine Center for Disease Control and Prevention, a branch of the Maine Department of Health and Human Services, listed reduction of youth obesity as a priority, seeking to minimize consumption of sugar-sweetened beverages – particularly by limiting access in schools – and increase physical activity. It listed reducing youth obesity by 10 percent by June 30, 2017 as one of its goals, with a 10 percent decrease in proportion of Maine youth consuming one or more sugar-sweetened beverages a day and encouraging fruit and vegetable consumption in addition. Obesity was identified as one among three priorities in York County, along with public health emergency preparedness and behavioral health.

Although it’s unclear how close the Maine Center for Disease and Control is to their goal, 2015 data indicates that obesity rates for Maine youth have not changed significantly since 2011, except for a slight increase among middle school students, according to Dawn Littlefield- Gordon, coordinator for Chronic Disease Prevention and Control-Physical Activity and Nutrition at Maine Center for Disease and Control. Daily sugar-sweetened beverage consumption has remained flat in middle school students, but there was a slight decrease among high school students between 2013 and 2015, Littlefield-Gordon said.

Visich is spearheading a study titled Cardiovascular Health Intervention Program, or CHIP, that looks at cardiovascular disease factors in children and how it is influenced by physical activity, obesity, sleep and other biomarkers, or measurable indicators of a biological state or condition. Visich said he recently learned that from 1980 to present, obesity has augmented from 7 percent to 17.5 percent among children 6 to 11 years of age.

“Risk of diabetes is going up as people gain weight,” he said. “People are developing impaired glucose tolerance. Diabetes is caused by the rise in obesity. We’ve seen a rise in diabetes like we’ve never seen before. Children are developing metabolic syndrome at earlier age, caused by numerous risk factors. There are a lot of issues obesity is creating, and risk of cardiovascular disease is one.”

Visich said cardiovascular disease remains the number one cause of death in America.

“It’s been number one for many, many years, and one of the driving forces of this is the issue of obesity,” Visich said. “Because of the rise of obesity in children and adults, it has the ability to affect numerous cardiovascular disease risk factors.”

The study focuses on children 9 to 10 years old, Visich said. The children are brought from Biddeford Intermediate and Buxton Elementary schools to University of New England, where Visich and other researchers assess risk factors. Researchers, including 20 to 30 students at the university, conduct a number of tests on the children such as measuring blood pressure and handgrip strength, determining their body mass index and having them perform running exercises.

Children are sent home with accelerometers, or devices that measure the acceleration of an object, for five days to measure their activity and sleeping patterns, the latter of which Visich said has become a bigger issue in recent years.

“Sleeping time (among adults and children) has declined, and there may be a direct association with the rise in obesity,” he said. “As sleep has declined, obesity has gone up.”

All of the data that is collected is sent back to parents in an effort to educate them about their children and get a better understanding of cardiovascular health, Visich said. If children aren’t in ideal health condition, the parents may be influenced to make changes to their children’s diets and exercise habits.

“With the rise in obesity, we want to make sure we do a good job at educating parents,” Visich said. “If kids are overweight as child, to get them to burn off extra 40 calories a day, it’s a lot easier than telling an adult to burn a couple thousand calories a week to get to a good weight. There are many more opportunities to get children to make changes than in the future as adults.”

Friday, April 28 marked the last day where data was collected, and 40 children from three different groups were brought to University of New England to have data collected on them. Visich will continue working through the summer to load the data into a database and generate a report to present to schools and superintendents. He’ll share the information with school boards with the permission of superintendents, though which schools are yet to be determined, he said.

“We’ll have really interesting information to see how our children compare nationally,” he said.

Visich said to give back to Biddeford Intermediate and Buxton Elementary schools, he and his team of researchers will provide an education program on dietary habits – or healthy eating habits – and physical activity. They also provide an after school physical activity program.

Visich is now seeking grant funding from the National Institute of Health – the national medical research agency under the U.S. Department of Health and Human Services, according to its website – to extend the study for another five years.

“We haven’t done a good job on prevention, and it’s really hurting us now with the issue of accelerated rates of obesity not only in our society, but in children also,” he said. “Children should be getting 60 minutes of exercise a day, seven days a week. For adults, it’s 30 minutes, five days a week. We’re learning kids are very, very inactive.”

The YMCA at Camp Sokokis in Biddeford offers a summer program to help combat obesity. It aims to provide an experience for all children, regardless of their family’s ability to pay, according to YMCA of Southern Maine Director of Advancement Sarah Leighton. This goal is achieved by providing scholarships for youth to make camp affordable, she said, and children can join for one week, a month or all summer long. Scholarships are determined by household income and a conversation with the family about what they can afford to pay.

The disparity of access to summer camps between highand low-income youth is considerable: 4 percent of lowincome youth attend camp, compared to 18 percent of high-income youth, Leighton said.

Camp Sokokis is situated on 26 acres at the YMCA Northern York County branch in Biddeford and can serve 200 children each week. Children get access to a climbing wall, high and low ropes courses, nature trails and an archery range.

It may seem paradoxical that youth need summer programs to combat obesity because summer may be perceived as a season when they get out most and exercise. However, this is a misconception because of inordinate screen time, Leighton said.

“Ideally, kids would get outside more in the summer. However, the days of playing outside until the street lights come on are past for many kids,” she said. “In fact, during the summer kids average seven hours of screen time a day – that’s an inordinate amount of sedentary time. Screen time is one of the biggest indicators of childhood obesity. In fact, kids who spend an hour or more in front of the TV each day are 72 percent more likely to be obese.”

Helen BreƱa, chief operating officer of YMCA of Southern Maine, said that “summer camp is about new experiences and exploring the outdoors, (where) children and teens learn the importance of good nutrition to help improve their wellbeing.”

Visich said the likelihood that an obese adolescent will be obese in the future is 85 percent.

“Changes are much, much, much more difficult to make as adult. It’s something that starts early,” he said. “The sooner we can make change, the better off we are.”

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