Of Tummies and Trouble

The waist circumference -- or, tummy size, if you will -- of children in the United States has been rising steadily and swiftly over recent years, according to a new study in today's issue of the journal Pediatrics.

Not all body fat is created equal when it comes to health risks, so this is an important finding. Fat that accumulates around the middle is the most dangerous variety -- associated with insulin resistance and an increased risk for diabetes.

Waist circumference is measured by wrapping a tape measure around the waist at roughly the level of the navel. Scientists have observed in adults that waist circumference is a much stronger predictor of diabetes and heart disease than the body mass index (BMI). The BMI is what doctors usually use to measure obesity trends.

Now, scientists have evidence in children that waist circumference may be a better measure of the health risks associated with obesity.

Scientists used data from the National Health and Nutrition Examination Survey, a nationally representative group of thousands of children and adolescents, ages 2 to 19.

They found that abdominal obesity -- excess weight around the middle -- increased between 65 percent and 70 percent in both boys and girls between 1988 and 2004. Doctors used the 90th percentile for the age- and sex-specific waist circumference to define abdominal obesity.

Today's finding that waist circumference is rising in children is consistent with what we know about the health effects of obesity in children.

The rates of insulin resistance, often a pre-diabetic state, and of type 2 diabetes have both been rising sharply in children. Less than a generation ago, type 2 diabetes was called 'adult onset' diabetes, and was by and large a disease of mid-life.

Parents Must Be Vigilant

Epidemic childhood obesity and as shown in this new study, abdominal obesity in particular, is the underlying cause of this deadly trend. The primary message in this study is for health care providers who should routinely monitor waist circumference as well as BMI in both their adult and pediatric patients. But there is an important message for parents, too.

Believe it or not, studies indicate that the 'eyeball test' -- namely, just a good look -- is about as accurate in diagnosing obesity as any fancy technology we have.

So, a parent's job is to look at children with a loving, but careful and honest eye. If their bellies are beginning to bulge, talk to a doctor. Blood tests can reveal the threats of insulin resistance or diabetes, and a doctor can offer advice on how to avoid these dangers.

But it all begins with a parent's vigilance.

Childhood obesity is an extremely common problem. There is no shame in admitting it has found its way into your home. But there is certainly danger to your children in overlooking it.

Keep a watchful eye.

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