Mexico tackles epidemic of childhood obesity

AppId is over the quota
AppId is over the quota
In this photo taken on Tuesday July 19, 2011, Elizabeth Sucilla combs the hair of her four-year-old granddaughter Anghella Torres before going out for a walk, at their home in Mexico City. Anghella weighs 66 pounds (30 kilos) - twice what she should. With the help of her grandmother, Anghella is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year. Anghella's mother, Livni Schroeder, 25, is pictured at left. (AP Photo/Alexandre Meneghini) In this photo taken on Tuesday July 19, 2011, Elizabeth Sucilla combs the hair of her four-year-old granddaughter Anghella Torres before going out for a walk, at their home in Mexico City. Anghella weighs 66 pounds (30 kilos) - twice what she should. With the help of her grandmother, Anghella is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year. Anghella's mother, Livni Schroeder, 25, is pictured at left. (AP Photo/Alexandre Meneghini) In this photo taken on Tuesday July 19, 2011, Anghella Torres, 4, relaxes on a bed as her mother Livni Schroeder, 25, fastens her sandal strap in preparation for a walk at a nearby park, in Mexico City. Anghella, who at 66 pounds (30 kilos), weighs twice what she should, is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year. Mexico, which claims to have the fattest kids in the world, is encouraging others to lose weight. Schools are banning junk food and requiring more physical education. (AP Photo/Alexandre Meneghini) In this photo taken on Tuesday July 19, 2011, Anghella Torres, 4, together with her mother Livni Schroeder, 25, play at a park, near their home in Mexico City. Anghella, who at 66 pounds (30 kilos), weighs twice what she should, is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year. Mexico, which claims to have the fattest kids in the world, is encouraging others to lose weight. Schools are banning junk food and requiring more physical education. (AP Photo/Alexandre Meneghini) In this photo taken on Tuesday July 19, 2011, Anghella Torres, 4, kisses her mother Livni Schroeder, 25, during play at a park near their home in Mexico City. Anghella, who at 66 pounds (30 kilos), weighs twice what she should, is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year. Mexico, which claims to have the fattest kids in the world, is encouraging others to lose weight. Schools are banning junk food and requiring more physical education. (AP Photo/Alexandre Meneghini) In this photo taken on Tuesday July 19, 2011, Anghella Torres, 4, plays at a park near her home in Mexico City. Anghella, who at 66 pounds (30 kilos), weighs twice what she should, is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year. Mexico, which claims to have the fattest kids in the world, is encouraging others to lose weight. Schools are banning junk food and requiring more physical education. (AP Photo/Alexandre Meneghini)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); MEXICO CITY (AP) — Anghella Torres is just 4 years old, but already she weighs 66 pounds (30 kilos) — twice what she should. Because of her excess girth, her little feet constantly hurt from bearing the extra weight.

Anghella knows she is obese and she doesn't like it. And now, even though she doesn't know how to read or count calories, she is on a diet. With the help of her grandmother and caretaker, Elizabeth Sucilla, Anghella is following a modest diet and exercise program established for her by a nurse at a local public hospital earlier this year.

"I have to stop eating candies," she said.

Her new regimen also requires her to cut down on the deep-fried potato wedges she ate every other day in the streets and spoonfuls of heavy cream she downed like yogurt.

Mexico, which claims to have the fattest children in the world, is trying to encourage others to follow Anghella's lead. Public schools have banned junk food and are requiring more hours of physical education while the federal government has launched a media campaign that invites families to enroll their kids in a public weight-loss program.

Yet three-quarters of Mexico City's 2,400 public schools don't have playgrounds or gyms for exercise. And 80 percent of the schools don't have water fountains. Experts stress the importance of drinking more water and fewer sugary drinks to prevent and reverse weight gain.

President Felipe Calderon said earlier this year that Mexico had the highest rate of obesity for children ages 5 to 19 in the world. And although he did not cite any source, University of North Carolina nutrition professor Barry Popkin, who has studied childhood obesity in many countries, agrees that it "is the highest I know of in the world."

While a large number of children in Mexico's poor, rural villages are still underweight, the country as a whole has seen the second-fastest growth rate for childhood obesity of nine countries examined by Popkin in a 2007 study, including the United States. The fastest growth rate of the nine is in Australia, according to the study, which compares health statistics in the countries over the past two decades.

The problem in Mexico is especially pronounced in the capital, Mexico City, and near the U.S.-Mexico border, according to a study by Mexico's National Institute of Public Health.

Children and teenagers make up Mexico's largest age group, representing 39 percent of the country's 112 million people. More than 28 percent of children between 5 and 9, and 38 percent of preteens and teenagers ages 10 to 19, are overweight or obese, according to statistics from the Mexican Social Security Institute.

In the U.S., the Centers for Disease Control and Prevention says 12.5 million, or 17 percent, of children and adolescents ages 2 to 19 are obese. First lady Michelle Obama has tackled the issue with her "Let's Move" campaign, pushing for better school lunches, more access to fruits and vegetables and more physical activity. And Congress last year passed a new law requiring school lunches to be healthier.

In Brazil, a newly industrialized nation like Mexico, 19 percent of children ages 5 to 9 are overweight, and 15 percent are obese, according to government statistics. Officials did not have statistics available for teenagers.

Mexico's public health institute says the problem lies not just with children: Seventy percent of Mexican adults are overweight or obese as well. Officials have decided to target children and teens first, however, because they are the largest age group and fighting their habits now would prevent large numbers of diabetes cases and other illnesses in the future, the officials said.

"The earlier obesity shows up, the higher the risk the kid will become an obese adult and contract other diseases like diabetes, hypertension," said Leticia Martinez, chief nutritionist for Mexico's public health institute. "We see this as an emergency."

Health officials define obesity as having too much body fat. In Mexico, the U.S. and elsewhere, obesity is determined through BMI, a measure of body fat based on height and weight.

Mexico's childhood obesity spans social classes, though the poor are less informed and equipped to deal with the epidemic.

Starting this year, pre-kindergarten and elementary schools completely banned the sale of soft drinks and junk food and replaced previous breakfast programs with dishes rich in vegetables, such as squash blossoms and carrots. Middle schools are only selling sugar-free drinks, low-calorie snacks and small bags of chips that appear in new food guidelines approved by the departments of health and education.

During recess at the Republica Italiana elementary school, children run out of classrooms and form three lines, each one of which leads to a different food option.

Their choices include a turkey hot dog on a wheat bun with tomatoes and no mayonnaise; "nopales," or edible cactus paddles, with sliced peppers on a corn tortilla; sunflower seeds or a scoop of unsweetened lemon sorbet; and slices of cucumbers and carrots.

Principal Yamile Bobadilla says there's nothing she can do about vendors who still gather outside of the school gates to sell sodas, greasy pizzas and chips.

Some of the children, and even some parents, have complained about the junk food ban, she said, adding, "They see me as the witch."

The country's healthy-weight campaign has other challenges: Officials acknowledge there aren't enough dietitians in the public schools to help all of the children in need. They also note a prevailing cultural notion that a chubby baby is a healthy baby.

"Any efforts to improve the school environment are very important to combat the epidemic," said Chessa Lutter, a regional adviser on food and nutrition for the Pan American Health Organization.

Starting in the 2010-2011 school year, education officials began increasing the number of physical education hours from one to three per week based on their conclusion that some children are obese because they don't exercise. On a recent morning at Republica Italiana, several groups of kids were sent out to the school yard to run, play softball or twirl hula-hoops.

Bobadilla said some children still faint and suffer from extreme fatigue because of their weight problems.

Guillermo Ayala, who leads the food guidelines' task force at the Education Department, also heads an effort to have every child in Mexico City weighed and measured by a team of physical education coaches and nurses. Schools with a high number of children who have gained or not lost weight will face administrative sanctions, he said.

Outside the classroom, government-sponsored TV spots show kids struggling under heavy sacks of grain, symbols of the extra pounds (kilos) many are carrying around with them. The ads invite parents to enroll their children in a government-run program of diet and exercise. About 5.3 million children participate every year, but officials don't keep track of how many of them are overweight.

Anghella's grandmother Sucilla took her to a public hospital in May at the suggestion of the girl's day care providers, who said something would have to be done about the child's diet and exercise before she started school in August.

A nurse at the hospital suggested that Anghella start taking regular walks, drinking a lot of water and eating more whole grains, vegetables and fruits.

She goes often to visit the nurse, who weighs her regularly.

At home, when her small hand tries to reach for a sweet roll on the table, Sucilla slaps it and says, "You know why, my little girl."

Anghella said she doesn't like it when adults say she's fat.

"No, sweetheart. You are cuddly," Sucilla tells her. But she then adds, "I worry because I don't want my little girl to be an obese girl."

Associated Press

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HEALTH MANAGEMENT. Reference to the cause of childhood discovered hydrocephalus

Scientists at The Scripps Research Institute have found what may be a major cause of congenital hydrocephalus, one of the most common neurological disorders of childhood that produces mental debilitation and sometimes death in premature and newborn children.
The research appears in the journal Science Translational Medicine.
Hydrocephalus, which involves excess buildup of cerebrospinal fluid in the brain, affects about 1 in 500 children in the United States. Currently only symptomatic treatment exists - the surgical placement of a shunt to drain away excess fluid. Researchers want to know the condition's causes, so they can figure out how to prevent and treat it. Scientists have known for some time that hydrocephalus was linked to bleeding events in the developing brain, but the reason for that linkage has not been clear.
The new study now suggests that hydrocephalus can be triggered by abnormal levels of lysophosphatidic acid (LPA), a blood-borne lipid that can enter the brain in high concentrations during bleeding events, with profound effects on developing brain cells. The study showed that both blood and LPA itself acted through the same receptor (receptors are proteins to which one or more specific kinds of signaling molecules bind) to produce defects in the brains of developing mice that led to severe hydrocephalus; genetic removal of a specific LPA receptor or pre-treatment with a compound that blocked the receptor largely prevented the condition.
"This provides proof of concept for the medical treatment of this disease," said Jerold Chun, MD, PhD, a professor at Scripps Research and its Dorris Neuroscience Center, and senior author of the new study, "and it also hints that this mechanism involving LPA could be relevant to other neurological conditions associated with altered brain development."
A Eureka Moment
Chun's laboratory specializes in the study of lipid-signaling molecules involved in the developing brain, including LPA. LPA is normally produced in the fast-growing fetal brain, and appears to be important for the normal development of neural "progenitor" cells. But when the researchers added abnormally high concentrations of LPA to the brains of fetal mice, they found an unexpected effect on brain development. "When we looked at their condition as newborns, we were surprised to see that they uniformly had big, fluid-filled brains," said postdoctoral fellow Yun Yung, PhD. "It was a Eureka moment, because we realized that LPA might help explain hydrocephalus."
Reviewing the medical literature on the condition, Chun and Yung noted that it was often linked to brain-bleeding events in the womb and typically also featured some improperly developed brain structures. "Our experiments with LPA connected both sets of findings," said Yung, "because LPA is involved in blood clotting and can reach very high concentrations during hemorrhages; plus, our LPA-exposed mouse brains had structural abnormalities like those reported in human cases."
Cerebrospinal fluid cushions the brain, provides it with basic nutrients, and is normally produced by the membrane-like choroid plexus within the fluid-filled chambers of the brain known as ventricles. Ependymal cells that line these ventricles have hair-like extensions that are thought to promote the normal flow of fluid. "In our LPA-exposed mice, there were patches in the ventricular lining where these ependymal cells were missing, which could have led to a disruption of the normal cerebrospinal fluid flow," said Yung. Structures in the ventricles that normally permit the proper drainage of fluid also appeared to be partly blocked by the improper overgrowth of cells, which might have further contributed to the brain-damaging fluid buildup.
The researchers were able to repeat these effects using the normal LPA-containing fluid fractions of blood, thus showing that bleeding events plausibly can lead to hydrocephalus by increasing the brain's exposure to LPA.
To investigate how LPA exerted this effect, the team produced mice that genetically lack one or both of the two receptors - LPA1 and LPA2 - to which LPA can bind on ventricle-building fetal progenitor cells, finding that the LPA1 receptor was required to produce hydrocephalus. "The idea here is that excess LPA causes these ventricular progenitor cells to get the wrong developmental signals via their LPA receptors, and so the ventricles and brain develop abnormally," said Chun.
In a final demonstration, the team pre-treated normal fetal mice with a compound that blocks the activation of LPA1 receptors, and found that even after LPA exposure, their signs of hydrocephalus were greatly reduced.
Looking Ahead
LPA1-blocking drugs currently are being developed for other conditions including lung fibrosis, and the new finding from Chun's lab may lead biotech or pharmaceutical companies to study their use in hydrocephalus. "If you had an unborn baby who was at risk from an injury to the mother, an infection, or evidence of bleeding then, in principle, you could treat with a short-acting LPA1 blocker to prevent or reduce hydrocephalus," said Chun.
The discovery that excess LPA can wreak havoc in the developing brain could have broader implications as well. Abnormally high concentrations of LPA may be generated by fetal brain cells themselves, also producing abnormal LPA signaling. Moreover, schizophrenia, autism, and other developmental brain disorders have also been linked to fetal bleeding events and infections as well as ventricular abnormalities.
"It's something that we need to investigate further," said Chun, "but it may be that excess LPA exposure in an unborn child's brain can have a variety of adverse effects on development, depending on the part of the brain that's exposed, the stage of brain development, and the duration of the exposure."
This work was supported by the National Institutes of Health, the National Science Foundation, and the Hydrocephalus Association.
Article adapted by Medical News Today from original press release.
Visit our  neurology / neuroscience section for the latest news on this subject.
Additional Chun lab members contributing to the study, "Lysophosphatidic Acid Signaling May Initiate Fetal Hydrocephalus," were Tetsuji Mutoh, now at the Nara Institute of Science and Technology; Mu-en Lin; Kyoko Noguchi; Richard R. Rivera; Ji Woong Choi, now at Gachon University of Medicine and Science in Korea; and Marcy A. Kingsbury, now at Indiana University.

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HEALTH MANAGEMENT. White House childhood obesity task force must focus on the treatment for minority children

The White House task force on childhood obesity, created by the President as part of the first lady "Let's move" campaign, is resolved to be the epidemic of obesity within a generation rising the land at a rate of 5 percent by 2030, what began in the late 1970s the rate before obesity by the year.
A recent U-M study, published online before using print in obesity journal researchers evaluated the balance of prevention and treatment, for the objectives, by the task force may 2010-report ordered.
Is a shared emphasis on the prevention of obesity and treatment strategies required to achieve this goal, according to researchers. Prevention programmes solely deal with according to the epidemic, the children, who are already obese, especially minorities. Obesity treatment strategies have an important part of the equation.
"There are many discussions on the prevention of obesity for children." This is certainly important, but it is not the whole story. "Because so many children are already overweight, it need greater efforts focused on treatment, if we succeed", Joyce M. LEE, MD, mph, Assistant Professor of Pediatrics and communicable diseases at the U-M medical school and a U-M c.s.. clinician says Mott Childrens Hospital.
Rates of obesity in the United States are much higher for minority children, with 20% black and Mexican-American children affected, with only 15 percent for white children childhood. Because the burden of obesity is so high, the study includes prevention strategies alone will not help, the task force, be to achieve objective.
"Effective treatment strategies, in particular targeted minority children, in particular are needed," says Lee, the lead author of the study.
The research suggests that healthy hunger-free kids act of 2010, reverse progress efforts to the obesity epidemic can help recent legislation, including the. The law increased financial support for the national school lunch program, offering free or reduced price meals to students with low income.
However, the researchers say that the law the affected by obesity can have a greater impact on the prevention of obesity in healthy children, instead of reducing obesity in children.
"It is not enough only to develop new, culturally relevant and effective treatment strategies focused on minority children be." "We the financial obstacles to these treatment strategies for children in households with low income, of which there are many racial / ethnic minorities, must reduce", says Lee.
Only ten States include offered obesity nutritional and behavioral therapy by programs such as Medicaid. Given the number of disadvantaged children, which are likely to be more obese, but is it important to say that this scheme for all authors available.
"The health care reform bill passed an important role in the cover for overweight children, can play in 2010 as requires it, new health plans to cover obesity screening and counseling for children," says Lee.
Source: University of Michigan health system
Articles from medical news today adapted from original press release.
Visit our paediatrics & child health section for the latest news on this topic.
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