A large US study found that compared to normal weight children, obese children have a higher risk of developing
gastroesophageal reflux disease (GERD), a condition where stomach fluid flows up into the food pipe or esophagus, damaging the
lining and possibly also raising the incidence of inflammation, asthma and coughs.
You can read about how the large population-based study established a link between obesity and GERD in children (a link that has already been reported in adults), in a paper published online in the 9 July issue of International Journal of Pediatric Obesity.
Left untreated, GERD may result in chronic inflammation of and lasting damage to the esophagus. It can impair quality of life, lead to chronic respiratory problems and raise the risk of cancer of the esophagus, if it continues into and through adulthood.
Experts suggest that part of the reason cancer of the esophagus is the fastest growing cancer in the US (its rate is expected to double in the next 20 years, unlike most other cancers where rates are expected to go down), is because of the nation's obesity epidemic.
Estimates put the proportion of American children affected by frequent symptoms of GERD at between 8 and 25 per cent.
Dr Corinna Koebnick, the lead author of the study, is a research scientist at the Kaiser Permanente Southern California's Department of Research and Evaluation in Pasadena. She told the press:
"Childhood obesity, especially extreme childhood obesity, comes with a high risk for many serious health consequences such as diabetes, cardiovascular disease and cancer."
She and her colleagues, also from Kaiser Permanente, found that obese children have a 40 per cent higher risk of GERD and moderately obese children have a 30 per cent higher risk, compared to children of normal weight.
"The takeaway message of our study is that GERD now also is one of the conditions associated with childhood obesity," said Koebnick.
For the cross-sectional study the researchers examined the health records of nearly 700,000 children included in the Kaiser Permanente Southern California integrated health plan in 2007 and 2008. The children were aged from 2 to 19 years.
They put the participants into categories of normal weight, overweight, moderately obese, and extremely obese, based on their body mass index and their age, and cross-matched to diagnosis of GERD in their health records.
The results showed that:
- Overall, GERD was diagnosed in 1.5 per cent of the boys and 1.8 per cent of the girls.
- Compared to normal weight children, moderately and extremely obese children aged 6 to 11 years were more likely to have a diagnosis of GERD.
- There was a similar link among 12 to 19 year olds.
- The links were the same when the researchers adjusted for sex and race/ethnicity.
- In contrast to the these results, no link was found between obesity and GERD risk in children aged 2 to 5 years.
"The association between childhood obesity and GERD may have important implications for their future risk of GERD-associated diseases, such as esophageal adenocarcinoma."
Koebnick commented that:
"Beyond counseling for weight loss, obese children who report symptoms of GERD may need to be treated for the underlying reasons to help avoid persistence of GERD into adulthood and to prevent its complications."
She said that even though some of the health problems of extremely obese children have may not seem important at the time, they can pose a serious threat later in life.
"We need to be aware of these links, search for obesity-related conditions and address childhood obesity as a family issue as early as possible," said Koebnick.
"Extreme childhood obesity is associated with increased risk for gastroesophageal reflux disease in a large population- based study."
Corinna Koebnick, Darios Getahun, Ning Smith, Amy H. Porter, Jack K. Der-Sarkissian, Steven J. Jacobsen
International Journal of Pediatric Obesity, Published online 9 July 2010.
Additional source: Kaiser Permanente.
Written by: Catharine Paddock, PhD