Atkins Diabetes Revolution (45 page)

YOUNGSTERS NEED TO MOVE

TV isn’t the only culprit. Today half of all high school students aren’t taking phys ed class, mostly because their schools no longer require it or no longer even offer it. Currently, only Illinois requires
any
phys ed! Suburban neighborhoods without sidewalks, appropriate parental worries about the risks of unsupervised activity, and many other factors all conspire to keep kids indoors and sedentary; yet physical activity is crucial for their health. Regular physical activity helps build and maintain healthy muscles, bones, and joints. It helps control weight, reduce fat, and build lean body mass. It also helps children burn off excess energy and has been shown to help reduce feelings of depression and anxiety. Activities that decrease stress hormone production, as exercise does, are important in our stress-laden society—even for children. As a bonus, when kids are physically strong and don’t feel restless, depressed, or anxious, they do better in school and have fewer behavioral problems.

BLOOD SUGAR AND BEHAVIOR

You hear a lot about ADD in kids, but have you ever heard anyone talk about blood sugar problems in children? Kids with unstable blood sugar can suffer from mood swings, irritability, depression, and difficulty concentrating—which in turn can lead to serious problems with schoolwork and mental health. Dr. Atkins felt that these symptoms are often confused with learning disabilities and attention deficit hyperactivity disorder (ADHD). (In addition to nutritional deficits caused by poor diet, other environmental factors can contribute to these conditions.) The “treatment”is to medicate them with stimulants and/or antidepressants. (Some antidepressant drugs cause weight gain, which worsens the situation on all fronts.) Would you believe that Prozac is now being given even to preschoolers!

In Dr. Atkins’ experience, a high-carb diet and a lack of exercise can
lead to blood sugar imbalances that affect brain chemistry. These “behavioral problems” often dissipate once the underlying blood sugar problem is finally diagnosed and treated,and in some cases drugs are no longer needed.

In children with mental health issues,the ABSCP can be the foundation of their treatment program—of course, under the guidance of a physician.Stable blood sugar often helps a “hyperactive”kid stay calmer and more focused on schoolwork; it also helps stabilize mood.And once blood sugar is under control, kids lose their cravings for carbs and start to lose weight,which is the most effective treatment of all for depression caused by low self-esteem, poor body image, parental nagging, and the relentless teasing of other kids.Some psychiatrists have found the use of supplemental oils helpful for depression,as did Dr.Atkins.If additional medications are needed, then the sound nutritional base of the ABSCP will enhance the child’s health.

IS YOUR CHILD OVERWEIGHT?

With children, it’s a bit more complicated to decipher how overweight someone is.We can use the basic idea of the BMI to figure out if a child is overweight or not, but we have to adjust the numbers to account for the child’s age and gender, and for the fact that there is a wide range of normal growth rates. The BMI charts for children aged 2 to 20 give a BMI number based on weight and height,but then use a curve to show how the child’s BMI-for-age compares with that of all other children of the same age and gender.So,if a girl has a BMI-for-age that puts her in the 60th percentile, that means that compared with other girls of the same age, 60 percent have a lower BMI. A BMI-for-age that is below the 5th percentile would indicate that a child is underweight. A BMI-for-age in the 85th to 94th percentile for a child’s age and gender would mean that the child is at risk of being overweight. A BMI-forage in the 95th percentile or above means that the child
is
overweight. (Note that the term
obesity
is not used in this context.)

To put that into numbers, the normal weight for a 13-year-old boy who stands five feet three inches tall would be anywhere from 88 to 123 pounds. The normal range is so wide—35 pounds—because among boys that age there’s a broad range of normal physical development. Some boys will already be near their adult height and weight, while others are just reaching puberty. That same boy would be in the 85th to 94th percentile and at risk for being overweight if he weighed between 124 and 141 pounds, and he would be at the 95th percentile and overweight at 142 pounds. In some cases, the BMI-for-age charts can be a little misleading. A teen who is very strong and muscular, for instance,could seem to be at risk for overweight even though he or she is actually very fit and healthy. Similarly, a child with very poor health might seem to be in the midrange for his or her age, but should actually weigh more. For almost all kids, though, the BMI-for-age charts give a good idea of where their weight should be within a fairly broad range.

The great advantage of the BMI-for-age chart is that it can be used continually from age 2 until adulthood, so you can see where a child stands in terms of weight as he or she develops from toddler to young adult. (For more on BMI charts, go to www.cdc.gov/nchs/data/ nhanes/databriefs/growthch.pdf.)

As a parent, you may not be able to be objective about your child’s weight. There’s a natural tendency to think those excess pounds are just baby fat or chubbiness, and to think that the child will somehow grow out of it. Other parents worry needlessly that their children may be overweight because of their own struggles with weight. The BMI-for-age charts are completely objective, however, and give you a more accurate idea of whether your child is overweight, and if so, by how much.

IT’S NOT JUST IN THE GENES

Overweight kids grow up to be overweight adults. About a third of all adults who are obese or overweight were that way by the time they reached age 20.According to a recent study, being at or above the 95th percentile of BMI-for-age at age 12 is practically a guarantee of being overweight as an adult. A 12-year-old girl with a BMI of 25 or more would be in the 95th percentile of BMI-for-age and would have an 80 percent or better chance of being overweight as an adult.If she’s still in the 95th percentile of BMI-for-age at age 20, she has a better than 99 percent chance of a lifetime of obesity.
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Weight problems tend to be a family affair. That’s not surprising, as the parents supply not just the genes but the meals and the attitudes toward food for their offspring.After all, youngsters don’t drive themselves to fast-food restaurants—at least not until they are teenagers. The odds that an overweight child will grow up to be an overweight adult increase if one or both parents are overweight as well. In fact, even for kids under age 10 who aren’t obese, if their parents are, this more than doubles their risk of adult obesity.
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And when overweight kids become overweight adults, they tend to be dangerously heavy. A study published in 2003 found that those who were overweight at ages 12 or 13 were five times more likely to be severely obese as adults than those who were not overweight at these ages.
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Of course, this is a matter of genetics interacting with environment. If a child has parents who have the metabolic syndrome, then the child will be genetically “set up” to have the same body chemistry. Feed this child the typical high-carbohydrate American diet and watch his or her waistline expand and youthful arteries begin to clog. Often, the parents are on the couch watching TV and eating the same snacks next to the child. And then there are doting grandparents and other relatives who may press sweets and other poor-quality treats on a child as demonstrations of their love. Finally, there are caretakers who may use high-carb snacks to encourage good behavior. In sum, this scenario is a recipe for fattening American youth!

HEALTH RISKS OF CHILDHOOD OBESITY

More and more studies reveal that the origins of adult heart disease lie in being overweight as a child.A British study that went on for 57 years showed a direct link between being overweight as a child and dying from heart disease as an adult. Over the course of the study, the participants who were heaviest as children were 1.5 times more likely to die from any cause and twice as likely to die from heart disease as those who were normal weight as children.
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More frighteningly, a 37-year follow-up study of 227,000 Norwegian teens found that among the men whose BMI-for-age in adolescence was above the 95th percentile, the death rate was 80 percent higher than that for the men who were of normal weight. Among the women, the death rate was 100 percent higher.
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Another study showed that arterial plaque can start forming in early childhood.
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Because overweight and obese kids already show many of the classic risk factors for heart disease, it’s not surprising that they develop it at a much earlier age, often in their thirties and forties. In a study of 1,366 Taiwanese 12- to 16-year-olds, 70 percent of the boys who were obese already had one risk factor for heart disease, and 25 percent of them had two or more risk factors.
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THE CONSEQUENCES OF CHILDHOOD OBESITY

Children who weigh too much get a head start on chronic diseases that ordinarily only develop much later in life.To take just one example,up to 20 percent of obese kids have hypertension.
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A recent estimate based on NHANES III data says that among all kids ages 12 to 19, about 4.2 percent already have the metabolic syndrome. And among overweight adolescents, a staggering 28.7 percent already have it! That means that about 910,000 American teens are already at risk of heart disease, diabetes, and premature death.
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The problem is even more severe in minority communities. Among overweight Latino children, nine out of ten have at least one risk factor for heart disease and Type 2 diabetes, and three out of ten have three or more risk factors for the metabolic syndrome.
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Impaired glucose tolerance is now common among obese kids. In one study at Yale University, 25 percent of obese children ages 4 to 10 were glucose intolerant; 21 percent of obese teens were glucose intolerant.And in the course of the study, the researchers found that 4 percent of the teens already had diabetes and didn’t know it!
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Heart disease and diabetes aren’t the only health problems over- weight youth face. Such was the case with 10-year-old Samantha B., who came to Dr. Atkins suffering from allergies, sinus problems, almost daily migraines, palpitations, gas, and bloating. With a large appetite for carbohydrate foods, Samantha weighed 134.8 pounds at four feet three inches tall, giving her a BMI-for-age-and-gender of36.5, which placed her at the 95th percentile, making her overweight. Rather than putting her on a strict Induction-phase regimen, Dr. Atkins cut her carbohydrate intake just enough to stabilize her blood sugar and control her appetite. After four weeks Samantha’s headaches had diminished in frequency and intensity, and her parents related that her moods and energy level were much better. After eight months her weight was stable at 120 pounds, and she had no headaches and a significant decrease in gastrointestinal problems. Dr. Atkins felt that so long as she continues to control her carbohydrate intake at an appropriate level to meet her nutritional needs, she should grow into the excess weight she still carries.

Overweight children are also more likely to suffer from asthma due, in part, to the increase in inflammatory chemicals caused by elevated levels of insulin.
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They also often end up having bone and joint problems for the same reasons.
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Overweight girls tend to reach puberty and begin menstruating at a younger age. This means that they stop growing sooner than other girls—and end up as short, over- weight adults.
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They’re also likely to suffer from polycystic ovary syndrome (PCOS).
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The underlying metabolic imbalance, combined with a probable genetic component that causes PCOS, makes these girls much more likely to become diabetic as they get older.
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Children’s mental health can suffer as much as their physical health. Obese kids are at greater risk for emotional problems and low self-esteem, and can become isolated and depressed, especially if they’re teased about their weight.The flip side of this is that behavioral problems, such as being hyperactive or depressed, can lead to obesity. A study in 2003 showed that normal-weight kids diagnosed with a behavioral problem were five times more likely to become overweight over the next two years than youngsters without a problem.
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Why do these children gain weight? Dr.Atkins believed it’s because they’re “medicating” themselves with high-carb foods as a way to deal with stress and unhappiness—yet the very foods they use to comfort themselves only make the problems worse. And, according to a recent study, severely obese children (and their parents) rated their obesity as affecting their quality of life to the same extent as that experienced by children going through chemotherapy for cancer.
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CONTROLLING CARBS HELPS CHILDREN

The Atkins approach is beneficial to overweight kids, just as it is for overweight adults. (To make sure they’re getting proper nutrition and to monitor their progress, anyone under the age of 18 should do the weight-loss phases of the Atkins program only under the supervision of a physician.) Dr. Atkins knew that it works for youngsters because he helped hundreds of them lose weight. Not only does a controlled- carb program help overweight kids slim down or at least stop gaining weight, it helps restore their blood lipids to normal and cuts their risk of early heart disease.

In one study, a group of 16 overweight teens followed a controlled- carb approach for 12 weeks; a control group of 14 overweight teens followed a low-fat diet for the same time. At the end of the period, the controlled-carb teens had lost more weight than the low-fat teens— and triglyceride levels had plummeted.
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