Childhood Obesity…..Is Sugar to blame? by: Julie Hiller

Childhood obesity rates have mirrored rates of sugar consumption rates over past years.

Reference 17

Sugar Stats

Sugar has been a public health concern for quite some time.  Why? Sugar has the potential ability to dilute or replace dietary nutrients.1 This has lead many to believe that sugar is one of the contributors to childhood obesity.1

How is it that children can become hooked on sugar so early? Are babies born with a “sweet taste”? Yes and it continues to grow throughout childhood.2  Early exposure to intense sweeteners can create a desire for sweetened foods.2

Sugar….what kinds?

The sugar consumed in the US and worldwide includes fructose, glucose, sucrose and the highly criticized, High Fructose Corn Syrup (HFCS).3 Because of changes in food technology over the past 30 years, HFCS has replaced sucrose in many foods.4 This replacement interestingly, has paralleled the increase in obesity in the US.4

How much sugar are Americans eating??

Reference 2,3

How does sugar contribute to obesity?

Fructose, the main component of sugar induces lipogenesis.  What is lipogenesis you ask? It is the metabolic formation of fat.5 Fructose is also thought to provoke visceral adiposity and decrease insulin sensitivity in obese humans.6

Fructose also has the ability to decrease leptin, the hormone that tells your brain that you are full.5 Without the ability to recognize when you are full, you overeat!  What could happen when a child overeats on a regular basis?  They gain weight.

Glucose, another form of sugar, can also contribute to weight gain.7 Food that contains elevated amounts of glucose causes your glycemic response to spike.7 Once your glycemic response has spiked, your blood glucose levels plummet.7 When glucose levels are low you feel hungrier and you are more likely to overeat.7

Again, children that do this same thing day after day begin to gain weight. Once they gain the weight, it is a struggle trying to lose the weight.7

What does Childhood Obesity look like?

Reference 18

Childhood obesity rates increased dramatically between 1970 and 2000.1 Doesn’t this sound similar to the growth pattern of sugar consumption? Estimates indicate that by 2025, 268 million children between the ages of 5 and 17, worldwide, may be overweight.8 Ninety-one million of these children will be obese.8

 

Childhood obesity can lead to other diseases such as type II diabetes, heart disease, metabolic syndrome and some types of cancer.1,9 We used to only associate these diseases with adults.  Now, projections show that an estimated 81 million children will suffer from one of these weight related diseases.8 Unfortunately many of these overweight children will become overweight adults.10

What are the psychosocial implications?

As you might expect, childhood obesity can lead to many psychosocial complications.11

Sadly, children as young as age 3 start to associate obesity with laziness, ugliness and unhappiness.11 Psychosocial complications can include stigmatization, low self-esteem, low respect for your body, altered cognitive performance and emotional disorders.11

In addition, many of these children experience depression and bullying.11

Obese children often experience higher levels of loneliness.11,12 Many children who are antisocial carry this same trait into adulthood.11 On a more positive note, obese children are more inclined to help others.11  This is most likely a result of them trying to earn approval from others and gain friends.11

Sugar can’t be the only contributor to childhood obesity, right??

Yes, there are other known contributors to the childhood obesity epidemic. Many, of which won’t surprise you.  Decreased physical activity, psychosocial stressors,

genetics  (good old genetics), prenatal and perinatal influences and parental eating habits are a few that are often blamed.12,13 Decreased physical activity and psychosocial stressors are two that seems to take more heat than others.

There is plenty of documentation that shows the strong relationship that exists between decreased physical activity and increased sedentary time.12 Screen time is a big contributor.12 Children that spend a large amount of time in front of the TV have higher BMI’s.12 More than 50% of obese children spend over two hours per day in front of the screen.12

There have been many studies done to evaluate the impact that psychosocial stressors have on childhood obesity.13 Many obese children experience stressors such as divorce, low family income, substance abuse and domestic violence.13 There is a strong association that exists between psychosocial stressors and the development of obesity.13 This link seems to illustrate that children experiencing these stressors turn to food for comfort.

So how do we address this epidemic?

Many obese children become obese adults.10 So what can we do to stop this from happening?  First and foremost, the establishment of healthy dietary choices needs to take place in the early years. The implementation of obesity prevention strategies needs to occur at government, school, community, and family levels.12

The US Department of health and human services has put forth suggestions for obesity prevention.12  Suggestions include reducing consumption of foods containing added sugars and beverages that are sugar sweetened.12 School based programs have shown success in preventing obesity by providing education on choosing foods with lower added sugar.12

Communities have joined the fight by increasing the amount of healthy foods available at public venues and limiting advertising of less healthy foods.12 At the family level parents can remove sugar-laden foods from the house and cease providing sugar filled snacks as reward.  In addition, TV viewing time needs to be limited to less than two hours per day.12

There is not one solution that will solve the childhood obesity problem. It must be a joint effort among many.  We know what we need to do. The key to success will be to implement and follow through.

 

References

1. Song WO, Wang Y, Chung CE, Song B, Lee W, Chun OK. Is obesity development associated with dietary sugar intake in the U.S.? Nutrition (Burbank, Los Angeles County, Calif.). 2012;28(11-12):1137-1141. http://www.ncbi.nlm.nih.gov/pubmed/22817826. doi: 10.1016/j.nut.2012.03.008.
2. Kahn R, Sievenpiper JL. Dietary sugar and body weight: Have we reached a crisis in the epidemic of obesity and diabetes?: We have, but the pox on sugar is overwrought and overworked. Diabetes care. 2014;37(4):957-962. http://www.ncbi.nlm.nih.gov/pubmed/24652726. doi: 10.2337/dc13-2506.
3. Maier IB, Stricker L, Özel Y, Wagnerberger S, Bischoff SC, Bergheim I. A low fructose diet in the treatment of pediatric obesity: A pilot study. Pediatrics International. 2011;53(3):303-308. http://onlinelibrary.wiley.com/doi/10.1111/j.1442-200X.2010.03248.x/abstract. doi: 10.1111/j.1442-200X.2010.03248.x.
4. Bernadette P Marriotts, Nancy Cole, Ellen Lee. National estimates of dietary fructose intake increased from 1977 to 2004 in the united States1-4. The Journal of Nutrition. 2009;139(6):1228S. https://search.proquest.com/docview/197456578.
5. Crescenzo R, Bianco F, Falcone I, Coppola P, Liverini G, Iossa S. Increased hepatic de novo lipogenesis and mitochondrial efficiency in a model of obesity induced by diets rich in fructose. Eur J Nutr. 2013;52(2):537-45. https://une.idm.oclc.org/login?url=https://search-proquest-com.une.idm.oclc.org/docview/1287865431?accountid=12756. doi: http://dx.doi.org.une.idm.oclc.org/10.1007/s00394-012-0356-y.
6. Johnson RJ, Nakagawa T, Sanchez-Lozada LG, et al. Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes. 2013;62(10):3307-3315. http://www.ncbi.nlm.nih.gov/pubmed/24065788. doi: 10.2337/db12-1814.
7. Welsh JA, Cunningham SA. The role of added sugars in pediatric obesity. The Pediatric Clinics of North America. 2011;58(6):1455-1466. http://www.sciencedirect.com/science/article/pii/S0031395511001131. doi: 10.1016/j.pcl.2011.09.009.
8. Astrup J. Tackling the childhood obesity crisis. Community Practitioner. 2016;89(11):12-13. https://une.idm.oclc.org/login?url=https://search-proquest-com.une.idm.oclc.org/docview/1862135430?accountid=12756.
9. Kokkvoll A, Jeppesen E, Juliusson PB, Flaegstad T, Njølstad I. High prevalence of overweight and obesity among 6-year-old children in finnmark county, north norway. Acta Paediatrica. 2012;101(9):924-928. doi: 10.1111/j.1651-2227.2012.02735.x.
10. Glasper A. Childhood obesity plan: The government declares war on sugar. British Journal of Nursing. 2016;25(17):984-985. https://search.proquest.com/docview/1836563291. doi: 10.12968/bjon.2016.25.17.984.
11. Laura Mihaela T, Dana Teodora A, Ingrith M, Lucian Laurentiu I. Psychosocial implications of childhood obesity. Revista de Cercetare si Interventie Sociala. 2015;49:205. https://search.proquest.com/docview/1690993551.
12. Vos M, Welsh J. Childhood obesity: Update on predisposing factors and prevention strategies. Curr Gastroenterol Rep. 2010;12(4):280-287. http://www.ncbi.nlm.nih.gov/pubmed/20563673. doi: 10.1007/s11894-010-0116-1.
13. Faye Flam. How childhood obesity became a crisis (posted 2013-09-27 19:51:57). The Washington Post. Sep 27, 2013. Available from: https://search.proquest.com/docview/1437697239.
14. co.uk website. http://www.diabetes.co.uk/ . Accessed October 17,2017.
15. com website. https://en.wikipedia.org. Accessed October 17, 2017.
16. National Heart, Lung and Blood Institute. National Institutes of Health website. https://www.nhlbi.nih.gov/. Accessed October 17, 2017.
17. https://www.truemomconfessions.com/wp-content/uploads/2017/07/o-CHILDHOOD-OBESITY-FACTORS-facebook.jpg.
18. https://www.nydailynews.com/life-style/health/big-study-childhood-obesity-shows-40-new-york-city-students-heavy-article-1.438634.