Examination of the determinants of overweight and diabetes mellitus in United States children
Overweight and type 2 diabetes are complex, multifactor chronic disorders that have increased at alarming rates in U.S. children and adolescents over the last two decades. Despite the advances in the diagnosis, management and treatment available in adults, we are just now on the cusp of understanding the progression of these conditions in children. Until the full effect is known, it is critical to identify factors contributing to obesity and T2DM so efforts can be developed to prevent the obesity- and diabetes-related complications. The purpose of this study is to ascertain the determinants and predictors of overweight and type 2 diabetes in a nationally representative sample of U.S. children.
Thirty-one percent of U.S. children are either at-risk for overweight or overweight with 16% presenting as overweight. These two groups of children had significantly greater measures of body adiposity than normal weight children with this weight being located throughout their bodies. Both overweight and at-risk for overweight children presented with significantly greater insulin levels than normal weight children resulting in an increased likelihood for the development of atherosclerosis and diabetes. Gender, age, poverty-income ratio, added sugar, waist, calf, arm and thigh circumference, tricep skinfold, systolic and diastolic blood pressure and HDL significantly predicted BMI-for-age percentiles, explaining 76% of the variance in BMI percentile. Data indicated that approximately 4% of U.S. children have pre-diabetes or diabetes. Children with pre-diabetes had significantly higher BMI percentiles than normoglycemic children and had significantly higher subscapular skinfold and BMI z-score measures. The levels of blood insulin were significantly higher in children with pre-diabetes and diabetes as compared to their normoglycemic counterparts and they had significantly higher glucose, uric acid, and glycohemoglobin values and significantly lower HDL values than normoglycemic children. The epidemic of obesity in U.S. children is continuing to rise despite Healthy People 2010 goals to reduce this prevalence to less than five percent. These children are not only overweight, but they appear to be manifesting metabolic abnormalities which may progress to chronic disease in adulthood. Approximately 4% of children aged 12–18 years are in a state of pre-diabetes (2.0%) or diabetes (1.9%)and they are also beginning to show signs of metabolic disturbances that may progress to chronic complications in early adulthood. (Abstract shortened by UMI.)
Children & youth
0573: Public health