Monday, February 15, 2010

Childhood Obesity Kills Native Americans

Despite the wide-spread concern about the health impact of the childhood obesity epidemic, there is actually not much data that directly shows how this excess weight may affect mortality.

Such data is now available at least for native American kids, from a study by Paul Franks (National Institutes of Health, Phoenix, AZ) and colleagues, just published in the New England Journal of Medicine.

The researchers analysed data from a cohort of 4857 American Indian (Pima or Tohono O’odham Indian) children without diabetes (mean age, 11.3 years) born between 1945 and 1984.

During a median follow-up period of around 24 years, death rates from endogenous causes among children in the highest quartile of BMI were more than double those among children in the lowest BMI quartile.

Similarly, rates of death from endogenous causes among children in the highest quartile of glucose intolerance were 73% higher than those among children in the lowest quartile and childhood hypertension was significantly associated with a 60% increased risk of premature death from endogenous causes.

Thus, at least in native Americans, childhood obesity is a significant risk factor for premature death – certainly a warning for those who believe that early obesity is something you can simply grow out of.

Given the raging epidemic of childhood obesity amongst the First Nations, Inuit, and Métis populations in Canada, these data should certainly prompt decisive action to address obesity amongst its native peoples.

Edmonton, Alberta

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6 Responses to “Childhood Obesity Kills Native Americans”

  1. Anonymous says:

    This is so important.

    Dr Judith Beck in “The Beck Diet Solution” (2008) talks about her child being on a diet to control a severe disease. For 6 years her little boy ate 3 meals of mostly fat and NO snacks. (This was a doctor prescribed diet for a rare disease, but a method she used to help her son stick to the diet can also be used in a weight loss program)


    When parents and child know the child’s life is at stake, they can follow the most extreme diet.

    Denial that obesity really affects a child’s health is a major problem.

    I’m from Atlantic Canada, with high obesity rates, like those Natives studied. We’re oblivious to the DANGER of obesity. Fat starts to look normal when many kids are overweight.

  2. Arya M. Sharma, MD says:

    Your are so right “Anonymous” – getting more people to realise what exactly is at stake is what this site is all about

  3. Pierre William Trudel says:

    This article gives a direct message about the importance of dealing with Obesity quickly.Dr.Sharma puts it out there. We need solutions, not discussion. We need to use what we have available, not invent some new pill. There are solutions to mobilize all if only we can get people motivated to act.
    Is anyone listening out there?
    Pierre Willian Trudel
    From The Thee Quest team

  4. Arya M. Sharma, MD says:

    > Pierre< The problem with mobilizing everyone is that most people still think the people who have the problem are to blame and so deserve to be fat. We need to recognize that we are all to “blame” for creating the obesogenic environment we live in.

  5. Amy says:

    Minnesota, where I live, has a huge Native American population (duh), not only on reservations scattered all over the state, but in the city — there’s even an urban reservation called Little Earth. The problems endemic to these communities are overwhelming and seemingly relentless — homelessness, drug addiction, alcoholism, chronic illness, depression, unemployment and poverty. Statistically, I think NAs comprise more of the homeless and chemically-dependent populations here than any other ethnic group. I have a feeling that for most NA families, the weight of their children is a pretty low priority compared to keeping their kids fed, or clothed, or with a roof over their heads…or, for that matter, keeping their kids off meth and crack.

    I’d be really curious to know (and I say that honestly, not sarcastically) how a doctor, nurse, nutritionist or other medical professional would even begin to talk to a community like this about obesity when there are so many basic elements of Maslow’s Hierarchy missing. Or when many of these individuals don’t seek medical care for anything — or at least don’t seek traditional, Western medicine. Is it perhaps possible that this is a case of superimposing well-intentioned “white man’s values” on an ethnic group that just doesn’t have the resources to respond to them yet?

  6. Arya M. Sharma, MD says:

    When you say “The problems endemic to these communities are overwhelming and seemingly relentless — homelessness, drug addiction, alcoholism, chronic illness, depression, unemployment and poverty.” you pretty much nailed it.

    As I have said before, we need to look behind what is causing the unhealthy behvaiours and then it is easy to see how poverty, poor self esteem, and the many mental problems you mention are really the root cause of the obesity epidemic.

    Of course obesity is not a priority nor will it be of any use to “educate” on healthy living till the root causes are dealt with – probably not something doctors and nurses can help with.


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