Childhood obesity and carbohydrate intake: review of a recent study

I think it’s safe to say that we all know that obesity is a problem in this country. Sometimes we can deny what a huge problem it is, but once you pay attention and look around you realize that we have an epidemic on our hands. This is going to cripple our nation in terms of rising health care costs, inability to work, and a general lack of joy and vitality in life. It’s not just expensive, it’s just sad.

The even scarier situation on the horizon is the thousands of children who are now facing this terrible scenario at such a young age. Children are now being diagnosed with prediabetes, high blood pressure, and high cholesterol. This is often in direct correlation to your weight. It’s not just the older kids either. Children as young as 3 or 4 years old are seeing these elevated numbers on their lab results. The question is: what do we do about it?

I worked in the WIC (Women, Infants, and Children) clinic for some time after I graduated from graduate school. My job was to advise parents with their young children, as well as high-risk pregnant women, on healthy nutrition. For some, this was the only time they would receive such one-on-one education. It was a rewarding experience. Unfortunately, we often saw young children quickly climb their growth charts. These people would be flagged by the system and reminded at each visit to discuss ways to reduce caloric intake. Often, it was a recommendation to switch to low-fat milk, reduce portion sizes, or drink less juice. Sometimes these responses worked and sometimes they didn’t. Honestly, we didn’t always know what the right solution was. The main objective was to somehow make these parents understand that something had to change. A simple directive like “eat healthy” was not going to cut it.

That’s why this new study that came out recently caught my attention. It brought me back to those WIC days and got me thinking about how I would approach these clients differently if I had known a more direct and positive recommendation to do with known health outcomes. You see, people often forget that when you’re working in public health, recommendations need to be simple and easy to remember. I’m not saying people are dumb or don’t care, but they’re not necessarily in my office of their own free will and will. They have to be there, so I hold them captive for a few short minutes. If we can simply and firmly convince them with solutions that work, that’s a take-home message they could employ.

So let’s get back to the studio. The premise was to see if changes in the types of sugars eaten, without changes in the overall macronutrient or calorie composition of the diet, could affect basic biochemical markers of health. Some of the markers they looked at before and after the diet included fasting blood glucose levels, fasting insulin levels, cholesterol levels, and liver enzymes AST and ALT.

The study design was this. They took a group of children, aged 6 to 18 years, with a high BMI and at least one other comorbidity (hypertension, hypertriglyceridemia, impaired fasting blood glucose, hyperinsulinemia, elevated alanine aminotransferase, or severe acanthosis negricans) and assessed their typical macronutrient intake. . and caloric intake. The goal was to keep this, along with her weight, stable throughout the study.

Fasting blood samples and an oral glucose tolerance test were administered on day 1 of the study. Subsequently, they had to start with a diet of food provided only by the clinic. These foods matched, as noted above, their precise macronutrient intake. The only change was swapping out added sugars, mainly fructose, and substituting other types of carbohydrates from things like bagels, cereal, fruit, pasta, and bread. Total dietary sugar and fructose were reduced to 10% and 4% of total calories, respectively. Would this be enough to see any change in overall health?

As I’m sure you can guess, there was a significant impact. Not in 3 months, not in 1 month, but in 10 short days. That’s why this study caught my attention so quickly. If this is true, as I suppose it probably is (hopefully follow-up studies will continue to confirm it), then this is an immediate and easy-to-take-home message that we can give to parents and older children themselves. Cut back on added sugars, eat other types of carbs instead (with colorful brochures included, of course), and see an improvement in your risk of diabetes and cardiovascular disease.

Also, I found it interesting that the researchers had difficulty keeping the study participants’ weights perfectly stable—that is, they lost a small percentage of their total weight—which the researchers noted may have skewed the final results ever so slightly. So you have to wonder in a real-world setting, with the diet implemented but not being told that they had to monitor identical macronutrient intake so closely, if weight loss wouldn’t be a natural byproduct of simply altering the types of carbohydrates one consumes.

I won’t dive into all the precise numerical findings here, but feel free to peruse them and read the entire study yourself via the link provided at the beginning of this article. It’s worth reading.

I think the take home message is this. The types of carbohydrates we eat do matter, and they definitely do with our young children. We need to get added sugars out of our diets. I’m not saying that bagels and cereals are the answer, but we can’t ignore the problem that refined sugar has become in our diets and especially in the foods and products that are marketed to our youth. For those of us in public health, we can use this study as a shining example of a simple and tangible way to make a difference in someone’s health. It may not solve every problem, but it can empower a client to get on the path to better health.