Childhood Obesity in the African American Families - Term Paper Example

? Literature Review: Childhood Obesity in the African American Families Educational Literature Review: Childhood Obesity in the African American Families Childhood obesity is a matter of grave concern especially among the African Americans (AA) since it indicates unhealthy lifestyle as a cause of overeating and lack of physical activity. Childhood obesity increases the risk of overweight adults with related chronic diseases. Literature Review Physiological factors Grant et al. (2009) have talked about the replicated association between obesity and the single nucleotide polymorphism (SNP). They have based their research on the primary data obtained from 1,008 obese and 2,715 control AA children. They were all recruited from the Greater Philadelphia area from 2006 to 2007. Blood was drawn from all the participants, and DNA was extracted for genotyping. The result from this research has shown that obesity has no apparent association with SNP in the children (Grant et al., 2009). Obesity is considered a strong factor contributing towards cardiovascular disease (CVD). In this article Sharma et al. (2012) have presented the results obtained from 121 AA children between the age of 9 and 11 of whom 56 were boys and 65 were girls. Their Body Mass Index (BMI) was more than 85 percentile. Their body height, weight, and waist circumference were measured, and different cholesterols were examined using the vertical auto profile (VAP) cholesterol method. The result showed that many of the children had their plasma lipoprotein concentrations in the normal range. Girls belonging to this sample of obese children were in their advanced stage of puberty and as such had more body fatness than the boys. However, there was no difference in the lipoprotein concentration between the boys and the girls. These children were engaged in lifestyle modification program aimed at reducing the risk of type 2 diabetes mellitus. The research proved that therapeutic lifestyle helped levels of Lipoprotein (a) and High density lipoprotein cholesterol (HDL-C) to rise which causes Total Cholesterol (TC) and BMI to decrease. The authors have concluded that Lp(a) is not an independent risk factor for cardiovascular diseases in AA children (Sharma et al., 2012). From a study conducted it has been seen that 21% of American children of 4 year old suffering from obesity are African-Americans. Patients who have type 1 diabetes (T1D) tend to become obese, and diagnosis of type 2 diabetes (T2D) is increasing becoming possible among younger children as low as eight years old. Through this article, Keller et al. (2012) have put forward the results of medical records of 227 AA and 112 Hispanic American patients between the age of 2 and 18 diagnosed as T1D or T2D. Results show that 72% of T2D patients are female and 43% of TID patients are female. It is seen that obesity is a strong predictor of T2D in AA youths. While in the AA the female has the more possibility of T2D, in the Hispanic Americans BMI z-score is the strongest cause of T2D. From this the authors have concluded that maximum distinction between the two types of diabetes can be made by testing on race or ethnic specific patients (Keller et al., 2012). Childhood obesity is increasingly becoming a matter of concern more because pre-diagnosis for timely intervention is becoming difficult as the associated metabolic syndrome is different for different ethnic groups. This article by DeBoer (2011) is concerned with T2D’s association with obesity. It is more widely seen in AA and Hispanics. Because the African Americans have low dyslipidemia, they are less likely to be diagnosed with metabolic syndrome. The most common cause of obesity is T2D mellitus (T2DM) which is characterized by insulin resistance resulting in elevated blood sugar level. T2DM which is a major contributor of CVD is largely found in the AA. For preventive measure improvements clinical care is needed for the children to resist obesity because once obese these children are likely to remain the same as adults (DeBoer, 2011). High Blood Pressure (HBP) is considered to be a major contributor of obesity. From 2003 to 2004 studies showed that among 6-11 year olds there were 17% AA boys and 22.8% AA girls were obese. Among them, the majority was suffering from hypertension. This can lead to hypertension adults who can often develop CVD. Maternal obesity has been recognized as an important factor influencing on childhood obesity especially within the AA community. Although the researchers have assumed genetic linkage for hypertension, the environment remains a pivotal factor. Due to the social disparities, a large number of AA children live in poverty leading to the limited access to physical activities and low intake of nutritional food resulting in obesity and overweight (Taylor et al., 2009). Genetic composition as major factor There is a dramatic increase of obesity among the children in the United States in the last 10 years. There has been a drastic change in life with unlimited supply of unhealthy food and inactive lifestyle; yet, genetic composition is also maintained as major factor of obesity. Glessner et al. (2010) have addressed Genomic copy number variations (CNVs) in childhood obesity which is regarded as a strong cause of extreme obesity. They have tested children with BMI is the upper 5th percentile. They conducted survey on AA children (among whom 1479 were obese and 1575 were lean controls) and also on European American (EA) children (among whom 1080 were obese and 2500 were lean controls). The result of this survey disclosed genes overlapping with CNVs that are ethnically specific. The result specified that in both the ethnicities CNVs play a role in the genetic susceptibility of common childhood obesity (Glessner et al., 2010). The prevalence of obesity among the American children is an immense burden on the economy of the nation. The major negative effects of childhood obesity are orthopedic complications, sleep apnea, and psychosocial disorders. Along with the environmental factors, genetic factors also contribute greatly towards overweight. In this article Zhao & Grant (2011) have focused on the role of loci on the childhood obesity. Insulin-induced gene 2 was the first locus that was admitted as contributor of obesity. Attempts to replicate it provided confusing results. A common variant of the gene was detected as contributor of both childhood and adult obesity including the AA children. Discovery of this locus has established newer genetic pathways as factor of obesity. However, it also suggests existence of further loci yet unknown as risk of obesity (Zhao & Grant, 2011). Role of parents In the United States, obesity is increasing becoming common among minority children from low-income families in the last 30 years. Often the children experience this problem throughout their childhood years. However, children with normal weight are also not uncommon, and so the dietary behaviour of the children controlled by their parents is regarded as a critical indicator of obesity. Along with emotional support parents can positive influence the health of their children by determining their food habits. In this article Lim et al. (2011) have put down the result of survey conducted on 317 AA children aged between 3 and 5 years. The purpose was to study the influence of parents on the weight of the children. The study found that children with resilient caretakers even in adverse material conditions have more probability of normal weight than children with non-resilient caretakers. In their article Reifsnider et al. (2010) have described a faith-based community in research based intervention for reducing childhood obesity among particular ethnicities including AA. This community particularly engages parents for proper initiative (Lim et al., 2011; Reifsnider et al., 2010). Rate of childhood obesity has increased twofold in the last 30 years. The growth is even more apparent in the AA girls whose rate of overweight and obesity is twice than that of the EAs. Simons et al. (2008) in their article have drawn an association between childhood obesity and dysfunctional family relationships. Parents of the overweight children remain stressful because of their fear regarding the consequences of obesity making them worried about their children’s emotional and physical well-being. Such feelings may get exaggerated by negative remarks from family members and school officials. All these factors lead to disturbed parenting quality resulting in child maladjustment. By focusing on the behavior of both mothers and fathers, the authors can identify the different effects of obesity among AAs and EAs. The authors analysed warmth, monitoring, reasoning, and problem solving abilities of the parents. The results proved that childhood obesity in EAs is inversely proportional to parental quality while no such relation was found in the AAs. Regardless of body weight children get emotionally and physically affected by quality of parenting, and so this must be kept in focus for emotional and physical well-being of overweight children (Simons et al., 2008). Dietary intake as contributor Although in the United States obesity is prevalent in all socio-demographic strata, it is more common among the AA children and adolescents. They consume half of the recommended amount of dairy products and calcium on the daily basis. Dietary calcium consumption is regarded as having negative effect on body weight. 186 AA adolescents who showed possibilities of future obesity participated in this study. The purpose was to examine the role of calcium intake on their body composition. Tylavsky et al. (2010) have presented the result of the study in this article which states that 84% of extremely obese AA children and adolescents have metabolic disorders that contribute towards cardiovascular disease. Girls who have consumed lowest level of calcium had increased body fat. 25% of the participants consumed dairy product containing lactose without negative effects. This suggested that increasing the intake of calcium can contribute positively towards the body composition of the AA girl (Tylavsky et al., 2010). Wang et al. (2010) in their article have argued that family meals can be a restrictive factor for childhood obesity although there is limited research done on children with varying ethnic and socioeconomic background. The study has been conducted on low-income urban AA adolescents by measuring their daily dietary intake including energy and nutrients. It has been concluded that family meals act as protective factor for AA boys. The study has highlighted that black boys tend to be heavier when family meals are less frequent (Wang et al., 2010). Childhood obesity is associated with a number of CVDs. This paper evaluates the effect of energy food intake and cardio metabolic risk factors in high BMI AA children between the age of 9 and 11. Nutrients were accessed based on three-day food intake. Based on the data collected from this study, it is concluded that carbohydrate intake should be discouraged as it has high energy content (Sharma et al., 2009). Lifestyle pattern as contributory factor Spruijt-Metz (2011) in this article has provided an overview of progress in obesity research on children and adolescents in the last 10 years. Survey data have shown that obesity in AA children between the age of 4 and 12 has increased by more than 120% between 1986 and 1998. More recent study has shown that the genetic factors among the AA are superseded by adiposity. Behavioral patterns like sedentary lifestyle, including watching TV and computer use, can cause obesity which can be prevented by physical activity. Social-environmental influences like access to recreational activities, availability of healthy food and parental control over dietary habits can resist obesity. The author has stressed upon that effective intervention to resist the obesity among children is a major challenge in the next decade. Vos and Welsh (2010) in their article also stressed on the sedentary lifestyle and decreased physical activity as causes of childhood obesity. Feeding practice by parents (like restricting or pressuring) are also the factors for obesity. Strategy for the preventive measures must be implemented on schools, families, childcare and government levels through proper counseling by physicians (Spruijt-Metz, 2011; Vos & Welsh, 2010). The minority girls of AA community are disproportionately affected by obesity. This article by McClain et al. (2011) has stated the results of a study conducted on AA females between the age of 8 and 11. Their physical activity and dietary intake were measured. This study examined the independent impacts of physical activity and diet on fat mass in peri-pubertal AA girls. The result showed that lean mass and physical activity are the only correlates of adiposity in AA girls after considering the age, energy intake, and sedentary lifestyle. The findings reflected the inverse physiological relation between fat and lean mass (McClain et al., 2011). Childhood obesity is increasing at the alarming rate worldwide with America alone having 17% obese children and adolescent between the age of 2 and 19. Although genetic compositions are still regarded as major contributor, obesity among children has almost doubled in recent years indicating change in lifestyle as an important reason. Study has been conducted on a minimum of 30 students from 134 high schools of America, classified according to region, size, ethnicity, and curriculum. This study evaluated the influence of physical activities, sedentary activities, and dietary habits on AA childhood obesity. Results, as recorded by Dodor et al. (2010) in this article, state that low physical activities and high sedentary lifestyle increase body weight and obesity in the adolescents. Also, greater intake of fruits and vegetable reduce obesity. However, this study did not establish any relation between hours of sleep and obesity which is peculiar since pre-existing theory states insufficient sleep can cause obesity (Dodor et al., 2010) Obesity intervention program Obesity which is a major health concern in America is widely prevalent among the AA. The purpose of this paper by Kumanyika et al. (2007) is to define a blend of efforts to build a research program for obesity prevention in AA. Although energy imbalance is the main criteria for obesity, eating habits and physical inactivity are also major factors. Some research recommendations specifically for this community have been set up which are determining the food habit and lifestyle of the AA, understanding their cultural changes, increasing the number of effective and obesity qualified researchers to promote sustainable and community-based programs. The programs must establish interventions with consideration of obesity related social and health priorities (Kumanyika et al., 2007). Newton et al. (2010) study the effect of environment on the prevention of obesity in AA children. For this purpose seventy-seven (50% boys) 2nd to 6th grade students were selected. Their BMI was calculated, and their lunch intake over three days was photographed. Their physical activity and sedentary behavior were also measured. The result was that the body fat of boys increased for 12 months and after that made a steep decrease while the body fat of girls increased steadily. It can be concluded that a year long preventive measure worked more on boys than girls (Newton et al., 2010). Racial/ethnic and gender associations Childhood obesity causes metabolic complications which can develop T2D and CVD. It can also lead to reduced insulin sensitivity and elevated blood pressure. A study was conducted on children belonging to different ethnicities like AA, Hispanic American (HA) and EA (EA). The purpose was to evaluate the ethnic association of adipose depots on cardiometabolic outcomes. All the participants were selected by the same dietitian. Their body composition and blood pressure were measured. Their glucose and lipids were analyzed. Their geographic and socioeconomic statuses were also considered. The result showed that AA children had greater lean mass, higher systolic blood pressure, and lower fasting glucose than those of other ethnic groups (Casazza, 2009) Williamson et al. (2011) in their article have reported on cross-sectional studies that prove temporal increases in prevalence of childhood obesity in both genders and different racial communities. This rise has reduced in recent reports. Prevention measures for childhood obesity suggest that overweight children have the tendency to lose weight and vice versa. This was proved by a test in which 451 children participated. Each child’s BMI percentile score was calculated. The results showed that over a period of 28 months the BMI percentile for AA girls increased while it remained stable for AA boys. This supports the theory that overweight children lose weight and non-overweight children gain weight (Williamson et al., 2011) The research suggests that some minority groups like AAs will remain obese over time. Wang (2011) in this paper has focused on obesity level difference in various groups and related trends, including prevalence and change over a selected time in distribution of body fat measurements based on age, sex, ethnic and socioeconomic status. According to the researcher, healthy lifestyle will not only reduce obesity but will also prevent CVDs (Wang, 2011). Obesity in preterm children Gaskins et al. (2010) selected 312 preterm children of 11 years of age mostly from AA community to study obesity and overweight. Many of these children were obese or overweight with prenatal polydrug and postnatal environmental risk factors. The resulting figures did not show higher rates of obesity compared to the national estimates. However, the study showed that obese children had BMIs higher than national estimates, and this difference was more than that in the overweight children. This suggests that obese children carry greater potential obesity related diseases (Gaskins et al., 2010) Cardiovascular regulation as predictor Graziano et al. (2011) conducted a study on 141 girls and 127 boys to evaluate how childhood obesity can be predicted by cardiovascular regulations. A racial study suggested that only AA children displayed association between cardiovascular regulation, BMI growth, and childhood obesity. The current study showed that poor cardiovascular regulations can be a serious risk factor for the development of obesity; however, the complete mechanism of this link cannot be assessed by this study (Graziano et al., 2011). Infant feeding practice as contributory factor The article by Horodynski et al. (2011) deals with infant feeding practice as a factor of childhood obesity. Compared to the mothers belonging to other socioeconomic groups, it is found that low-income mothers have less knowledge about infant feeding resulting in early introduction of solid food, sweetened beverages, and misinterpretation of feeding cues. So, it is necessary to establish preventive infant feeding measures. Study was conducted on infants of different ethnicities including AA infants between 6 and 12 months old. It was successful and can be effective in helping mothers to develop proper infant feeding practice, thus, to reduce the risk of childhood obesity especially among vulnerable populations like the AA communities (Horodynski et al., 2011). In recent years obesity is taking an epidemic form especially among the children. The majority of the obese adolescents is growing up to become the obese adults. Obesity and its associated CVD and other chronic diseases are major causes of death in the United States. References Casazza, K. et al. (December, 2009). Intrabdominal fat is related to metabolic risk factors in Hispanic Americans, African Americans, and in girls. Acta Paediatr, 98(12), 1965-1971. DeBoer, M.D. (March, 2011). Ethnicity, obesity and the metabolic syndrome: implications on assessing risk and targeting intervention. Expert Re. Endocrino Metab, 6(2), 279-289. Dodor, B.A., Shelley, M.C. & C.O. Hausafus. (2010). 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(July, 2009) Genetic and Environmental Risks for High Blood Pressure Among African American Mothers and Daughters. Biol Res Nurs, 11(1), 53-65. Tylavsky, F.A. et al. (September 10, 2010). Calcium Intake and Body Composition in African-American Children and Adolescents at Risk for Overweight and Obesity. Nutrients, 2, 950-964. Vos, M.B. & J. Welsh. (August, 2010). Childhood Obesity: Update on Predisposing Factors and Prevention Strategies. Curr Gastroenterol Rep., 12(4), 280-187. Wang, Y. (2011). Disparities in Pediatric Obesity in the United States. Adv. Nutr., 2, 23-31. Wang, Y. et al. (September, 2010). Dietary Intake Patterns of Low-Income Urban African American Adolescents. J Am Diet Assoc, 110(9), 1340-1345. Williamson, D.A. et al. (March, 2011). Longitudinal Study of Body Weight Changes in Children: Who is Gaining and Who is Losing Weight. Obesity (Silver Spring), 19(3), 667-670. Zhao, J. & S.F.A. Grant. (April 6, 2011). Genetics of Childhood Obesity. 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