Overweight 2-year-olds showing signs of major health problems - 08/14/...

http://www.miamiherald.com/2011/08/14/v-print/2359304/overweight-2-...

Posted on Sun, Aug. 14, 2011

Overweight 2-year-olds showing signs of major health problems

By Deborah S. Hartz-Seeley Special to The Miami Herald If you think a fat baby is cute and healthy, you need a new baby picture. An overweight child is being set up to be an unhealthy adult, says Dr. Sarah Messiah, a research associate professor and pediatric epidemiologist at the University of Miamis Miller School of Medicine. She has just published a paper demonstrating for the first time that overweight children as young as age 2 are showing signs of metabolic syndrome, a condition that can lead to heart disease, stroke and diabetes.

DANIEL BOCK / FOR THE MIAMI HERALD

Metabolic syndrome occurs when a child or adult exhibits at least three of five cardiovascular conditions: hypertension or high blood pressure, high blood-sugar levels, excess fat around the middle of the body, low levels of good cholesterol and elevated levels of blood fats such as triglycerides. One of the first problems to occur on the road to this condition is that an overweight child becomes insulin-resistant, a precursor to diabetes. Dr. Tracie Miller, professor of pediatrics and epidemiology at the University of Miami Miller School of Medicine, has seen the condition in children as young as 5 years old. The first indicators of insulin resistance are velvety brown patches of thick skin growing in folds and creases of the childs neck and arms. These are called acanthosis nigricans. Mom and grandma may tell the child to wash his neck because they think it looks dirty, says Dr. R. Will Charlton, a pediatric endocrinologist at Joe DiMaggio Childrens Hospital in Hollywood. But its a sign of a much more serious problem than needing a bath. When you overeat and are overweight, the body cant handle the quantities of food its being asked to process. And it doesnt react to insulin the way it should, says Audrey Ofir, associate professor of clinical pediatrics at Jackson Memorial Hospital in Miami. The pancreas, trying to produce insulin to regulate the movement of blood sugar into the cells, becomes stressed as it struggles to compensate for its heavier workload. The overworked

Dr. Tracie Miller watches as David Raez, 9, left, and his brother Daniel, 7, work out at UM's Childrens Rehabilitation Unit for Nutrition and Cardiac Health.

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Overweight 2-year-olds showing signs of major health problems - 08/14/...

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pancreas can burn out as blood sugars continue to rise. Insulin resistance is not only an early warning sign of type2 diabetes, but it can lead to kidney problems and elevated blood-fat levels resulting in coronary heart disease. Diabetes is a major issue with overweight children, says Ofir. I see it in my practice at a much earlier age than I did 20 years ago. Overweight children are also apt to develop gallstones that result from eating too much fat. The gallbladder takes care of the garbage in the body. The overflow gets turned into stones, Ofir says. Obese youngsters can also develop nonalcoholic steatohepatitis, which resembles the liver disease found in adult alcoholics. In children, however, this condition is caused by fat that infiltrates the liver, resulting in inflammation and scar tissue. This can lead to permanent liver damage and cirrhosis. Being overweight can even trigger asthma, as excess weight causes inflammation throughout the body. When its detected, the body activates its immune system, and this can trigger breathing problems, Miller explains. Kids who are obese have worse asthma, Charlton adds. Overweight children also suffer sleep apnea the same problem that causes adults to snore and have trouble breathing. Children with apnea often cant get a good nights sleep, which leads to a lack of concentration in schoolwork and emotional issues. Sleep apnea is caused by excess fatty tissue in the upper airways that blocks the flow of oxygen, resulting in carbon dioxide building up in the body and brain. The heart then has to work harder. Joint pain also is a byproduct of being overweight. Overweight children can experience pain in the hips, ankles and knees, much like an adult. Carrying extra weight can wear out the joints, Charlton says. They may even experience a separation of the hip joint from the femur bone. The shearing force caused by their weight pushes on the ball end of the joint, separating it from the growth plate in the bone, Charlton explains. The blood supply is damaged and the bone crumbles. Surgery is required. You know theres a problem when the child comes in with a limp and complains of knee or ankle pain, Charlton says. Overweight children also tend to grow taller at an earlier age and go through puberty sooner than their thinner counterparts. One reason is that the body takes an adrenal hormone in fat cells and converts it to estrogen. When there are a lot of fat cells, theres a lot of estrogen. This not only can cause the child to go through puberty earlier, but also causes bones to mature faster, explaining the added height for their age.

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Overweight 2-year-olds showing signs of major health problems - 08/14/...

http://www.miamiherald.com/2011/08/14/v-print/2359304/overweight-2-...

So no matter how cute you think your child looks, consider the problems that come with carrying excess weight. And if your child experiences any of these problems or symptoms, visit your pediatrician or primary-care doctor. The doctor will know what to do, Miller says. He will have records of the childs weight over time and can give the problems some perspective. Deborah S. Hartz-Seeley can be reached at debhartz@att.net.

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