Childhood obesity and type 1 diabetes in African-American urban communities

Childhood Obesity and Diabetes

Association Between Childhood Obesity and Diabetes in Urban Neighborhood in Massachusetts

Topic Selection

Problem Description

Demographics

Sampling Technique and Data Collection Procedure

Ethics in Research

Obesity

Obesity and Diabetes

The obesity among the African-American children has been increased to an excessive level and it has become the general cause for the occurrence of chronic diseases in the adolescence of children. The current study is aimed to find the association between the obesity in childhood with the occurrence of type 1 diabetes mellitus in the children. The study has targeted the urban community of African-Americans from the Massachusetts. The cross sectional results of the study have provided evidence that the obese children possess the risk of type 1 diabetes mellitus during the lifecycle from the infancy to adolescence. The preventive measure and recommendations with respect to the reduction of childhood obesity are discussed in order to eradicate the risk of type 1 diabetes mellitus from the children.

American, Childhood obesity, Type 1 Diabetes Mellitus.

Introduction

The over-consumption of food causes the body fat to reach at excessive level which imposes adverse effects on health, increases the rate of morbidity and reduces the life cycle and the children who are encountered with the obesity tend to be more inclined towards the risk of chronic diseases (Gittelsohn & Kumar, 2007). However, the over-intake of food worsens the health condition for those individuals who refrain from engaging in physical activities in order to consume the extra energy that they intake and it is inferred by Speiser et al., (2005) that the children who are found obese are considered to be highly adhered towards obesity in their adulthood and the persisting level of obesity can also cause the occurrence of chronic diseases in childhood.

According to Whitaker and Dietz (1998), the obesity in parents can lead towards the increased weight of children at the time of birth and the extent to which the child is overweight at the time of birth results in the obesity throughout the lifecycle of an individual. The Body-Mass-Index of an individual helps in the identification and likelihood of one's being obese and BMI of observed to decrease till the age of 6 years and the children who were born overweighed starts getting obese during their adolescence. The children who are less indulged in the physical activities tend to be obese due to their increased time spent with activities that do not comprise of physical movements however, the intake of improper diet mainly comprising of junk food and imbalanced diet by means of excessive carbohydrates and sugar can also increase the extent of body fat in children and causes obesity which leads towards the risk of diabetes in adulthood. (Ebbeling et al., 2002).

The obesity in childhood has increased in two folds in children and according to the findings of Centers for Disease Control and Prevention (2012), more than one third of children are found to be encountered with obesity during the age of 6 to 11 years in United States and the obesity rate among these children is found to be tripled during the last forty years. The study conducted by Hannon et al., (2005) indicates that the children who are obese tend to encounter with diabetes-mellitus in adulthood. Therefore, it has become essential to address the issue of obesity with respect to be the occurrence of diabetes-mellitus in order to take preventive measures and eradicate the health hazards caused by such chronic disease.

Topic Selection

The prevalence of childhood obesity for American children has never been higher and it has been observed with prior studies that one in every seven of these children is meeting the criteria of obesity. The time has come for parents, educational institutions and media to realize the seriousness and hazards of childhood obesity. The study of childhood obesity in the United States is considered to be imperative due to its substantial impact on health in the long-term health impact with respect to the eradication of asthma, diabetes, coronary heart diseases, arteriosclerosis and other chronic diseases. Childhood obesity as becoming an epidemic in the United Stated and remains the top health concern for children in 2014 which rated at 55% across the country. Therefore, the current study aims to address the issue of increasing obesity in childhood and its adverse health effects by means of diabetes-mellitus are observed in the urban neighborhood in Massachusetts.

Background of the Study

The obesity in childhood is found to be a global concern with respect to be health related effects on childhood and its long-term effects on health during the adulthood and in accordance with the finding of Centers for Disease Control and Prevention (2014), 9.3% of the total population of United States, i.e. 29.1 million, is adhered to the diabetes mellitus and prior studies indicate that the children who are obese are found to be encountered with diabetes-mellitus in the late adolescence and adulthood, therefore the risk of chronic diseases in the young generation of the United States has been increased.

The antecedents of obesity in children under the age of 6 to 11 years include the genetic factors in which children possess the homozygous-mutation of gene which is encoded with leptin is found to be the genetically inherited by parents and cause newborns to be overweighed and obese in their adolescence. Moreover, the prenatal women who are found to be obese can also effect the obesity level of their child due to the increased maternal food consumption which results in the increased transfer of nutrients to the placenta and thus the appetite of the child increases (Whitaker & Dietz, 1998). However, the study conducted by Speiser et al., (2005) prevails that the deficiency of endocrine hormones causes the decreased extent of the utilization of calories and this deficiency also effects the physical growth of a child in a negative manner and the consumed food results in the obesity rather than a healthy procedure of metabolism. Moreover, the level of obesity in children is found to be more extreme with respect to the ethnic group of minorities in the United States and the rationale for this notion exists within the likelihood of poverty in these groups which reduces their access to healthy food, healthcare and fitness facilities. The children and adults of families who possess financial stability tend to be concerned about their health and avail the fitness facilities that are available to them.

Ebbeling et al., (2002) infers that the change in the lifestyle of children has also paved way towards the obesity in which children are provided with soft-drinks that contain excessive carbohydrates which increases the provision of calories in the body and the consumption of fast food has caused the intake of more fat, more sugar and less nutrients which has ultimately made their diet inappropriate for healthy life and has caused obesity. Moreover, the outburst of media advertisement towards the attraction and retention of fast food and soft-drinks has increased the consumption of this diet among the children. Moreover, a study conducted by Strauss (2000) indicates that obese children tend to have low self-esteem than the children who are physically fit and in this way, obesity not only effects the health of the children but also adversely effects their social life and shows negative impact on the way in which they interact and interrelate in the society.

The change in the dietary life-style has caused the obesity which increases the health risks with respect to the chronic diseases related coronary heart disease in which the excessive production of lipids and insulin which causes the morbidity among the adults and the occurrence of chronic heart and cardiovascular diseases is found to be prevailed in them. Moreover, the adults who have been obese since their childhood are observed with high blood pressure and are encountered with diabetes-mellitus (Freedman et al., 2001). Moreover, the overweighed children also face breathing problems which further modifies in asthma with the passage of time in the adulthood.

The diagnosis of the obesity takes place throughout the lifecycle of children with respect to the periodic observation of their Body-Mass-Index (BMI) with in accordance with their respective age-bracket and gender. Moreover, the children who seem to be less involved in the physical activities are observed and the early diagnoses with respect to the observed BMI and physical activeness for the occurrence of diabetes-mellitus is conducted in order to find their sensitivity and resistance towards the insulin so that the future prospects for the diabetes-mellitus can be observed. Therefore, the extent of obesity can be used to diagnose and predict the occurrence of diabetes-mellitus and can ensure safeguard against this chronic diseases when then the obesity level is observed periodically (Hannon et al., 2005). Moreover, the obese children are found to be more insulin resistant during their adolescence which increases the occurrence of diabetes-mellitus.

Problem Description

The children who are engaged in physical activities and possess the proper and balance intake of nutrients are found to be physically fit in their childhood which also ensures their likelihood of fitness in adolescence and in adulthood which ultimately ensures their better health conditions and refrains them from many chronic diseases like high blood pressure, cardiovascular diseases and diabetes mellitus (Sallis et al., 2000). Therefore, the physical activity and proper intake of nutrients can help in the reduced prospects of chronic diseases and eradicates the obesity but this ideal situation can only be accompanied by parents by means of controlling the eating habits of their children. Moreover, the healthy eating practices as intervened by educational institutions and parental guidance makes the children invulnerable towards the health related risks and causes them to be physically active which not only increases their self-esteem but provides them with healthy life.

The extent of obesity in children has been increased in the world and 42 million of the childhood population is accounted for obesity (World Health Organization, 2013). The obesity level is found to be higher in the developing countries where the health and fitness facilities are unavailable and people are not capable to indulge in self-fitness activities due to their low income whereas, according to the Centers for Disease Control and Prevention (2014), the obesity rate in children is found to be at 55% of the total children population. Moreover, Dietz (1998) infers that the acceptability of obesity in African-American women has reduced their likelihood of healthy lifestyle and has increased the potential of prenatal obesity among these women which has resulted in the overweighed new born children.

The unhealthy eating habits adopted by parents influence the eating habits of children due to which children lack proper nutrients that are required for their proper growth and eat junk food which consists of excessive calories and fats. The home environment is also found to be changed since the last two decades in which the trend of periodic or continuous visit to restaurants and the trend of watching TV while eating have been increased. The food that is served in restaurants contains high calories and fats which are usually above the daily required level of calories which in turns forms the excessive body fats and cause obesity (Ebbelem et al., 2002). The study conducted by Powell et al., (2014) indicates that the increased children's access to TV and the high commercialization of junk food and excessive calorie soft drinks and food items has imposed its increased utilization in the regular diet of children and has made them obese. Furthermore, the African-American children are more adhered towards the consumption of such edibles by being effected from the TV commercials.

Therefore, children are living sedentary life styles with less physical activities and are bombarded with the advertisements that urge them to consume foods that are high in fat and calories and, are learning bad eating habits due to their parents (Oliver et al., 2007). Overweight and obese children are not only putting themselves at risk for many health problems, but are also increasing the chance of rejection from their peer group. According to Freedman et al., (2005), the children who are overweighed at the age of two are considered to be obese in their adulthood and are observed to encounter with the chronic disease of diabetes mellitus. Therefore it is necessary to conduct the epidemiological study with respect to the increasing rate of obesity in children and the potential risk of these children to be encountered with diabetes mellitus.

Theoretical Framework of the Study

The children are encountered with obesity due to low involvement in physical activities with respect to the growing trend of video games, TV and computer usage which ultimately makes them less involved in the activities that require physical movements and help in the calorie combustion (Oliver et al., 2007). Moreover, the exclusive and intimating advertisement of mass media for the food that is considered to possess high calories and improper nutrition has caused the increased intake among the children and has made the obese. The imbalanced consumption of diet and sedentary life-style of parents has influenced the life-style of children and has made them to follow the unhealthy eating habits that are adopted by their adults. The lack of intervention from parents and educational institutions has made the situation worse because the children are not provided with the adequate measures with respect to health and fitness to overcome their obesity (Ebbeling, 2002). The obesity in childhood has also effected the social life of children in which they are often rejected by their peers and the persistent obesity causes the adverse effects on their children with they reach adulthood. The obese children tend to encounter with diabetes mellitus in their early adulthood and thus, the increase in obesity has become the greater concern for the United States where 55% of the children are observed to be obese which has threatened their future health prospects and healthcare of the country. The theoretical framework of the current study is illustrated in Appendix -- 1.

Objectives of the Study

The current study consists of the following objectives:

To identify if there exists any association between the obesity level of childhood and the occurrence of type 1 diabetes mellitus.

Hypothesis of the Study

The current study is aimed to testify the following hypothesis:

HO1: Childhood obesity is not associated with the type 1 diabetes mellitus in children.

H1: Childhood obesity is associated with the type 1 diabetes mellitus in children.

Methodology

The current study is aimed to consider the following parameters in order to assess the association between the childhood obesity and the potential risk of type 1 diabetes mellitus in obese children.

Demographics

The association between the obesity and type 1 diabetes mellitus will be observed among the African-American children due to the fact that the prevalence of childhood obesity is higher among non-white population than white. The children who will be observed in this study are aged between 2 to 19 years which covers the early childhood, early adolescence and late adolescence lifecycle of the children and the sample of children consist of both genders i.e. male and female. The observed children are belonged from the urban communities due to the association of obesity with environmental factors and socioeconomic status.

Research Strategy

The current study is considered to be the descriptive study in which the trends and patterns of the specific population i.e. Urban African-American children are being observed. Furthermore, the study also conducts the cross sectional study of the gathered data in which the association between the childhood obesity and the occurrence of type 1 diabetes mellitus will be analyzed with respect to the gathered data from the specified population

Sampling Technique and Data Collection Procedure

The study has focused the African-American community of Massachusetts and the random sampling technique has been used in this study for the data collection in which the samples are selected randomly from the population of urban African-Americans. The primary data for the study has been gathered from the telephonic interview whereas, the secondary data used in the literature of this study is acquired from the reliable journals and articles mainly consisting of JSTOR, EMERALD, WHO, CDC and PEDIATRICS.

Measurements

The data of the study will be measured instantly for the identification and diagnosis of obesity with the calculation of BMI and all the factors of the study will be analyze at the same time to determine the strengths between the risks factors such as type 1 diabetes associates childhood obesity.

Ethics in Research

The current study has followed the ethical code of conduct which is described as follows:

The data has been used in this study with the consent of individuals and they are provided with the clear objective of the study which depicts that this study is used for the healthcare prospects and trends in the community.

The community from where the data is gathered will be shared with the results of the study in order to take preventive and suggestive measures in accordance with the results of the study however, the personal information and results will not be shared with any internal or external associates.

The current study will not be used for the harmful publicity of the community with respect to the results and the results will entirely be used for the health care services. The community will not be criticized for the results that will be obtained in this study.

The results of the study will be in compliance with the U.S. federal regulations in which the maximization of the benefits obtained from the acquired results is ensured and the data collection from the community members is made confidential.

Results

The results of the current study with respect to the childhood obesity and its association with diabetes are discusses bellow:

Obesity

The extent to which the obesity is found among the African-American children is observed excessively high. The children who are aged between 2 to 19 years are found 35.2% obese from the total sample with the Confidence-Interval of 95%. The obesity among boys out of the total obesity of 35.2% is found to be 34.4% which is slightly lower than the obesity in girls with the percentage of 36.1.

The children who are aged between 2 to 5 years are found to be 21.9% obese in the total population; however the gender distribution of children shows small difference in the obesity of boys and girls which is found to be 22.2% and 21.6% respectively.

The children under the age of 6 to 11 years are considered to be more obese than the previous age bracket and indicates the 38.1% overall obesity whereas, the boys are found to be obese with the 39.3% which is higher than the obesity in girls which is found 36.9%.

The children between the age of 12 to 19 years found with the total obesity of 38.9% and the obesity in boys is found to be decreased with the 37.3% whereas results indicates the higher obesity in this age bracket with the percentage of 42.5.

The overall obesity results indicate that the children are less obese in their early childhood, aged between 2 to 5 years and, the obesity is found to be increased with their age and is extremely high during their adolescence. The detailed illustration of obesity with respect to the age brackets in African-American children is shown in Appendix -- 2.

The total obesity among the children from the age 2 to 19 years is found to be 16.9% out of the total sample whereas the obesity decreases during the age 2 to 5 years and only 8.4% children are found obese in this age however, during the age of 12-19 years, the obesity is found to be the highest in the youth lifecycle and 20.5% children are found to be obese. The detailed illustration of obesity in percentage is illustrated in Appendix -- 3.

The African-American children are found severely obese with the 10.1% obesity whereas the total obesity accounts 20.5% for the girls and 19.9% for boys. The detailed percentage of severe obesity is illustrated in Appendix -- 4.

Obesity and Diabetes

The null hypothesis of the study is rejected because the analysis of the gathered data has indicated that there exists positive association between the childhood obesity and type 1 diabetes mellitus. Therefore, the children who are obese during their childhood tend to possess higher risk for the occurrence of type 1 diabetes mellitus under the age of 20. Moreover, the children who are obese up to the age of 9 years are found to prevail 0.57% type I diabetes mellitus, whereas the children between the age of 10-19 years are found to be in prevalence of type I diabetes mellitus is 2.04%. Moreover, 15.7% children are diagnosed with the type I diabetes mellitus up to the age of 9 whereas the incidence of type I diabetes found same with the age bracket of 0.9 years. The detailed illustration of the result is presented in Appendix -- 5.

Conclusions and Recommendation

The current study has made an attempt to address the increasing rate of obesity in the African-American children from the urban community of Massachusetts. The study infers that the children are encountered with the unhealthy food in their daily life and due to the intake of soft drinks that contain excessive carbohydrates has caused the increased consumption of sugar and calories in the body. Moreover, the lack of physical activity in children causes the increased uptake of calories to be transferred in body fats rather than the metabolic combustion and the obesity among the children has increased. The results of the study indicate that the children are found to be obese in their early childhood which prevails the prenatal or genetic obesity due to the fact that African-American women have largely accepted the obesity in their lifestyle and thus the prenatal obesity causes the placenta to consume excessive food which makes the children obese in the early childhood. In accordance with the results of the study, the children are found with the decreased weight during the age of 6 to 11 but the obesity increases again in the adolescent age. The consumption of unhealthy and junk food that has been imposed and advertised by media causes the teenagers to consume this food in their regular practices which in turn increases the obesity level. The results of the study further provides the evidence between the association of childhood obesity and type I diabetes mellitus and infers that the children who are obese in their childhood tend to adhere with the type 1 diabetes mellitus under the age of 20.

In order to reduce the rate of obesity so that the occurrence of chronic diseases can be reduced from the youth, the preventive measures are suggested to be followed by the concerned authorities that are discussed as follows:

The family interventions are required so that the healthy eating habits can be followed by the family members. The home environment and the effects of unhealthy food and obesity should be shared with the family members and adults should be provided with the adequate knowledge about the health hazards that threaten the life of their children.

The children should be provided with the appropriate dietary counseling so that the children know about the health benefits and can make their regular diet healthy and nutritious.

The educational institutions and schools should provide students with the appropriate physical activities so that the disposition of glucose and excessive energy takes place and children become physically active and in this way they will become insulin sensitive which will improve their metabolism. Furthermore, the educational institutions should provide students with healthy and nutritious food in the cafeteria in order to refrain from the consumption of junk food.

The maximized outburst of media for the advertisement of junk food and beverages should be decreased so that the children's consumption of junk food can be minimized.

The prenatal obese mothers should be provided with the adequate counseling with respect to their obesity and weight so that preventive measures with respect to food and nutrients can be practiced since the birth of child in order to decrease the childhood obesity and the occurrence of chronic diseases.