TIPPING THE SCALE ON KIDS’ DIABESITY

The link between childhood obesity and diabetes

Sadly, we have a new(ish) word in our medical vocabulary: diabesity. It refers to the combined harmful effects of obesity and type 2 diabetes. And even sadder: kids are not exempt.

The annual incidence rate of childhood obesity in Canadian kids is at about 12 percent. And kids with obesity have an estimated fourfold risk of developing type 2 diabetes.

The good news is that both obesity and type 2 diabetes are very responsive to simple diet and lifestyle modifications. Take heart in the fact that you can help your child vastly improve their quality of life and shift the trajectory of their health.

A Weighty Problem

Obesity refers to excess fat, but since body fat testing isn’t very accessible, the body mass index (BMI) has become the standard by which overweight and obesity are calculated. Childhood obesity is defined by a BMI at or above the 95th percentile for age and sex. The most common cause of obesity in children is a higher caloric intake than caloric expenditure, combined with being genetically more likely to gain weight.

THE OBESITY-DIABETES CONNECTION

The rising obesity rate for children and teens is contributing to their increasing rate of type 2 diabetes. Even being moderately overweight before puberty significantly increases the risk of type 2 diabetes and cardiovascular disease in midlife.

Childhood and adolescent-onset type 2 diabetes is associated with poorer glycemic control (blood sugar level) and more severe diabetes-related outcomes (e.g., high blood pressure) than adult-onset type 2 diabetes. If it’s poorly controlled, type 2 diabetes can impact nearly all organs in the body, affect healthy growth and development, and lead to disability down the road. But remember that with simple diet and lifestyle modifications, your child can grow healthily and live a healthy life.

Test, don’t guess

If your child has type 2 diabetes or if you’re tracking their risk, it is important to regularly monitor blood sugar with an at-home glucometer or with routine blood work.

In addition to testing fasting glucose, glucose tolerance, and Hba1c, ask your GP or ND to test for fasting insulin. Insulin resistance can show in the blood years before glucose becomes high. Results can give you a head start on implementing diet and lifestyle modifications for your child.

Symptoms of type 2 diabetes in kids

• slow healing of cuts and wounds

• incr eased urination

• blurry vision

• increased thirst

• fatigue

• incr eased hunger

• dark ened areas of skin, usually the underarms and neck

Modelling Movement

Since the core of most childhood obesity rests on an imbalance between caloric input and output, physical activity is crucial for the prevention and management of both obesity and type 2 diabetes. Parental physical activity and parental encouragement of exercise are both related to their children’s activity level.

Move together

Some evidence suggests that joint physical activity, involving parents and kids exercising together, is particularly beneficial.

Make it fun for all

Choose physical activities that are fun for both of you, ones that feel more like games than chores. Consider taking a nature guidebook on a hike with your child to identify trees, bugs, and birds, or incorporate the family dog in a backyard soccer game.

Vitamin D deficiency and diabesity

There is an association between vitamin D deficiency and obesity in kids. Low vitamin D also negatively affects pancreatic cell function and insulin sensitivity, which suggests that deficiency may be involved in poor glucose control in obese children. It’s likely beneficial for Canadian kids to supplement with vitamin D throughout winter, at least, and get their blood levels tested to adjust their dosage.

Sweet Eats

Modelling healthy eating is also important for your kids, though this one can be a bit more of a challenge when you’re dealing with picky eaters!

BACK-TO-SCHOOL TOOLKIT FOR BETTER HEALTH

Help your kids feel their best as they head back to school this cold and flu season. Discuss these immune-supporting strategies with your health care practitioner.

Vitamin D

Deficiency of this important vitamin is associated with increased rates of respiratory infections.

Probiotic

Taking a probiotic may reduce the incidence of the common cold.

Vitamin C

While vitamin C is available in many fruits and vegetables, taking a supplement may decrease the duration of the common cold in children.

Zinc

This nutrient plays a role in the prevention of pneumonia and may decrease the duration of a cold by one-third.

Get them in the kitchen

Try wrangling your kids and teens into the kitchen to help you cook dinner. This helps them learn about nutrition and may also encourage them to be more adventurous about trying new healthy foods.

Choose wisely when you shop

When you’re shopping for groceries, minimize the amount of potentially obesity-causing foods in your cart, including sugary drinks, processed foods, candy, animal products, and refined grains. The Mediterranean diet, which is low in processed foods and high in vegetables and fish, is beneficial for reducing glucose levels and BMI in children with excess fat in the abdomen.

Use serving strategies that work

To help your child avoid consuming too many calories, try serving dinner on smaller plates and give them a vegetable rich snack before dinner. Swap liquid calories in the form of pop and juice for water. If your child is water-averse, try popping a few berries in their water for some added flavour.

Use these diet tips to keep things in balance

Food pairings: Avoid blood sugar spikes by pairing a carbohydrate-rich food with a source of protein, healthy fat, or fibre.

Low glycemic index foods: Foods that won’t cause a dramatic spike in blood sugar levels include berries, apples, vegetables, and whole rather than white grains.

Chromium and magnesium foods: Encourage foods such as broccoli and turkey (rich in chromium) and spinach and tuna (rich in magnesium), which improve blood sugar regulation and insulin sensitivity.

Minimize sugar intake: Avoid pop, baked goods, candy, and processed foods.

Gut microbiome and diabesity

Evidence suggests that children with diet-related obesity have a poor makeup of bacteria in the gut. The probiotic strains Bifidobacterium and Lactobacillus are associated with healthy gut bacteria; their levels have been found to improve with weight loss among obese children. These strains of probiotics can be beneficial as a supplement to assist weight loss in kids with obesity.

Supplementing with prebiotic fibre also improves appetite control, positively affects the gut microbiome, and reduces body fat in overweight or obese children.

Why is something that should be so simple so challenging, and how can you fix it?