Severe Obesity in Teens Tied to Possible Kidney Problems

Nearly one-fifth of severely obese teens have poor kidney function, a small new study suggests.

The study included 242 severely obese teens taking part in research on weight-loss surgery.

Seventeen percent of the teens had protein in their urine, which is an early sign of kidney damage. In addition, 7 percent had indications that their kidneys were working too hard, and 3 percent showed evidence of progressive loss of kidney function, the findings revealed.

Girls were more likely than boys to have protein in their urine, while those with the highest body-mass index scores (BMI) -- an estimate of body fat based on height and weight -- and those with reduced insulin sensitivity were more likely to show signs of progressive loss of kidney function.

The study, scheduled for presentation Friday at a National Kidney Foundation meeting in Las Vegas, is believed to be the first to examine kidney function in a large group of severely obese teens.

"We plan to continue following them up after [weight-loss] surgery procedures. It will be very important to see whether their kidney function improves after surgical weight loss," study author Dr. Nianzhou Xiao, of Cincinnati Children's Hospital Medical Center, said in a kidney foundation news release.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Severe obesity is increasing and now affects 4 percent to 6 percent of U.S. children and adolescents," Dr. Beth Piraino, president of the National Kidney Foundation, said in the news release. "If untreated, obesity during adolescence is associated with a higher prevalence of chronic kidney disease and other serious conditions in adulthood, making obesity a huge public health burden," she added.

"This study indicates that kidney dysfunction is present in childhood obesity along with such complications as high blood pressure or diabetes. Lifestyle changes such as increased physical activity and healthy eating are critical to improving the overall health of the American population and need to start with our youth," Piraino noted.

Although the study found a connection between severe obesity and signs of kidney problems in teens, it did not establish a cause-and-effect relationship.

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Obesity : Questions and answers

Obesity can increase the risk of heart disease and diabetes among others The number of people with obesity in the UK has more than trebled in the last 25 years. Doctors now say that the condition is reaching 'epidemic' proportions. Why are they so concerned?

A person is considered obese if they are very overweight with a high degree of body fat.

Some experts believe obesity is responsible for more ill health than smoking. Being significantly overweight is linked to a wide range of health problems, including:

The most common way to assess if a person is obese is to check their BMI. BMI is calculated by dividing your weight in kilograms by your height in metres squared.

If your BMI is above 25 you are overweight. A BMI of 30-40 is considered obese, while above 40 is very obese. A BMI of less than 18.5 is underweight.

Another useful method is to take a waist measurement because fat in the centre of the body (apple-shaped obesity) is much more strongly linked to health risks than fat more widely distributed on the arms and legs. Women with a waist of 80cm or greater and men with a waist of 94cm or greater are more likely to develop obesity-related health problems.

A new way of calculating BMI has recently been proposed as the standard assessment is less accurate for extremes of height - the short and the tall. The new calculator hopes to correct this.

On average a physically active man needs around 2,500 calories per day, while a woman needs 2,000. If we eat any more, the extra energy is stored for later use, mostly as fat.

This mechanism was life-saving during our hunter-gatherer days when food was often scarce. However, the boom in plentiful, cheap food, coupled with a general decrease in physical activity, means that those stores of fat are rarely called on. Instead they continue to grow.

So why don't people just stop eating foods high in fat and sugar if they know they can cause physical problems? Scientists are still searching for the answers, but it appears that our brains have been wired to encourage the consumption of calorie-rich foods, even at the expense of good health. Quite simply, these foods bring us pleasure.

One recent study revealed that an area of the brain related to addiction and reward - the nucleus accumbens - lights up when a participant is shown calorie rich, fatty foods compared to healthy food.

Another area of the brain associated with pleasant tastes and reward, called the orbitofrontal cortex, is activated when we eat fatty foods.

At the same time, people are increasingly living more sedentary lifestyles and therefore burning fewer calories.

Studies have also shown that housewives in the 1950s were significantly slimmer than women today. This could be because their daily lives involved much more physical activity, including walking more and having fewer labour-saving devices.

Therefore, some scientists argue that the rise in obesity is a result of our bodies' inability to adapt to the changing environment.

According to the NHS, another reason obesity is on the rise is because unhealthy eating habits are often passed down through families, due to a lack of good food education.

Unless obesity is tackled, the government predicts that 60% of men, 50% of women and 25% of children in Britain will be obese by 2050.

Obesity expert Dr Tony Goldstone explains why fat is bad for your health, and how even small amounts of exercise can be good for you

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Childhood Obesity Adds Nearly $20K to Lifetime Medical Costs: Study

By Serena Gordon

Over a lifetime, direct medical costs for an obese 10-year-old will be nearly $20,000 higher than those of slimmer peers, according to new research.

That translates to a whopping $14 billion in additional direct U.S. medical costs over a lifetime for today's obese 10-year-olds, according to the study.

And, those costs only include direct medical costs, such as medications or medical procedures related to obesity. They don't include indirect costs, such as lost productivity and quality-of-life issues, the researchers said.

"Our findings show that the estimated direct medical costs incurred by the obese 10-year-old over his lifetime will be roughly $19,000 higher than that of a child who is normal weight, assuming that both children remain in their respective weight categories," said Wan Chen Kang Graham, a study co-author.

"When we account for the reality that a large proportion of normal-weight 10-year-olds will eventually become obese in adulthood, the difference in lifetime medical costs shrinks to $12,660," added Graham, a Ph.D. student at the Duke-National University of Singapore Graduate Medical School.

Currently, about 20 percent of U.S. children are obese, according to background information in the study. If those children remain obese into adulthood, they'll face higher risks of obesity-related conditions, such as type 2 DM, cardiovascular disease, sleep apnea and arthritis. Obesity is also a major cause of disability, lower productivity and higher medical costs, the study authors noted.

For the new analysis, the researchers reviewed available medical literature and found six studies that included obese children and estimates of their lifetime medical costs. Graham said that direct medical costs included "the costs of prescription medications, medical treatments, in- and outpatient care and surgical care."

The investigators found estimates of direct lifetime medical costs ranging from $16,310 to $39,080 higher for obese youngsters than for those of normal weight.

When the researchers adjusted the data to account for the very real possibility of many of the currently normal-weight children becoming obese as adults, the difference in direct medical costs over a lifetime dropped to between $12,660 and $19,630, according to the study.

Graham said these numbers could change if children are able to lose weight and keep it off.

"The magnitude of the direct costs that can be eliminated depends on how long we can keep that child in the normal-weight category over his lifetime," Graham explained.

Dr. Ruby Roy, a chronic disease physician at LaRabida Children's Hospital in Chicago, said data from this type of study "is helpful for insurance companies and policymakers. If we could save $19,000 on each child by paying for nutrition education, overhauling school menus and bringing gym back to all schools, you could see that those are good investments."

Study co-author Graham noted, "Helping children form lifelong habits of healthy eating and regular exercise from an early age is one of the best investments that parents can make in their children's future."

But, Roy also pointed out, "We didn't see this kind of obesity 25 years ago. It's not only about personal and family responsibility. Society needs to change, and we need to change multiple things. We need to work on safety and providing safe places to exercise, portion sizes need to come down and we have to take care of 'food deserts' [places where it's difficult to find fresh, healthy food] among other things."

Results of the study were released online April 7 and in the May print issue of Pediatrics.