Schools Do Help In War On Childhood Obesity, Yale Study Finds
Main Category: Obesity / Weight Loss / FitnessAlso Included In: Pediatrics / Children's Health
Article Date: 05 Feb 2009 - 2:00 PST
A team of Yale University researchers has found that school-based programs for obesity prevention and reversal are generally effective and are an important component in battling what many regard as a national obesity epidemic among young people.
In recent years, health professionals have questioned the utility of school-based intervention for obesity control, and the topic has been actively debated because clear evidence of their effectiveness was lacking.
"Our paper shows that schools can, indeed, be part of the solution-and therefore should be because the only alternative is to be part of the problem," said David L. Katz, M.D., adjunct associate professor at Yale School of Public Health and director of Yale's Prevention Research Center. Katz was lead investigator of the study appearing in a recent issue of International Journal of Obesity,
However, Katz noted, "It is unreasonable to expect that schools can be the entire solution. There is a flood of obesity-causing influences into our daily lives from every direction, in the form of tempting calories and barriers to physical activity. Interventions in schools are like one sandbag in a levee to hold back these flood waters."
To learn how effective school-based strategies are in preventing or controlling obesity, the researchers conducted a systematic review and meta-analysis of studies published on the topic. A meta-analysis combines the data from separate but related studies to evaluate the pooled results. The research team considered school-based intervention studies published in peer-reviewed journals between 1966 and 2004. They searched for studies that tried to help children manage their weight or prevent unnecessary weight gain, and that used strategies involving nutrition, physical activity, reduced TV watching, or some combination of these.
Based on the meta-analysis, the Yale research team found that combined nutrition and physical activity interventions led to significant reductions in body weight. When looked at individually, the nutrition interventions and TV reduction were also effective; programs based on physical activity alone generally did not lead to weight reduction.
"Everyone should recognize the urgency of the obesity epidemic in children," said Katz. "We are watching children develop what was, not long ago, 'adult onset' diabetes, now called type 2. We are seeing signs of heart disease risk in ever-younger people. The need to fix this is extreme, but the means of doing so have proven elusive."
Katz advises that future studies should examine different combination of intervention components to determine the optimal way to blend different approaches.
Researchers from Hunter College and Griffin Hospital also participated in the study.
Link:
David L. Katz, M.D.
http://publichealth.yale.edu/faculty/katz.html
YALE
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Obesity
posted by Dan on 5 Feb 2009 at 4:34 amThoughts about Obesity
Obesity has been defined as when excess body fat accumulates in one to where their physical overgrowth makes the person unhealthy to varying degrees. Obesity is different than being overweight, as others determine obesity to be of a more serious concern.
As measured by one’s body mass index (BMI), one’s BMI of 25 to 30 kg/m is considered overweight. If their BMI is 30 to 35 kg/m, they are class I obese, 35 to 40 BMI would be class II obese, and any BMI above 40 is class III obesity.
Presently, with obesity affecting children progressively more, the issue of obesity has become a serious public health concern.
Approximately half of all children under the age of 12 are either obese are overweight. About twenty percent of children ages 2 to 5 years old are either obese are overweight. The consequences of these stats on our children are very concerning, considering the health issues they may or likely experience as they get older.
Worldwide, nearly one and a half billion people are either obese or overweight. In the United States, about one third of adults are either obese or overweight.
Women of low socioeconomic status are likely to be twice as obese compared with those who are not at this status. It is now predicted that, for the first time in about 150 years, our life expectancy is suppose to decline because primarily of this obesity problem.
Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed. Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected. Some if not most of these co-morbidities are life-threatening.
One solution beneficial in many cases of morbid obesity if one’s obesity is not eventually controlled or corrected is what is known as gastric bypass surgery. This is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine.
Patients for such surgeries are those with a BMI of greater than 40, or a BMI greater than 35 if the patient has co-morbidities aside from obesity. This surgery should be considered for the severely obese when other treatment options have failed. The standard of care illustrating as to whether this surgery is reasonable and necessary should be clarified.
There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize. Generally, these surgeries are procedures related to gastric restrictive operations or mal-absorptive operations.
Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese. There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
It is believed that the results of this surgery to correct morbid obesity greatly limits or prevents such co-morbidities associated with those who are obese. Yet about two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur. However, the surgery reduces the overall mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies at times.
Age of the patient should be taken into consideration, as to whether or not the risks of this surgery outweigh any potential benefits for the patient who may have existing co-morbidities that have already caused physiological damage to the patient. Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
Many feel bariatric surgery such as this should be considered as a last resort when exercise and diet have failed for a great length of time.
If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is: http://www.asmbs.org,
Dan Abshear
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