Caesarean section delivery may double risk of childhood obesity: May be due to different gut bacteria

ScienceDaily (May 23, 2012) — Caesarean section delivery may double the risk of subsequent childhood obesity, finds research published online in the Archives of Disease in Childhood.

See Also:Health & MedicinePregnancy and ChildbirthObesityGynecologyDiet and Weight LossInfant's HealthChildren's HealthReferenceBreech birthBirth weightBody mass indexNutrition and pregnancy

Caesarean section delivery has already been linked to an increased risk of subsequent childhood asthma and allergic rhinitis, and around one in three babies born in the US is delivered this way.

The authors base their findings on 1255 mother and child pairs, who attended eight outpatient maternity services in eastern Massachusetts, USA between 1999 and 2002.

The mums joined the study before 22 weeks of pregnancy, and their babies were measured and weighed at birth, at six months, and then at the age of three, when the child's skinfold thickness, a measure of body fat, was also assessed.

Out of the 1255 deliveries, around one in four (22.6%; 284) were by caesarean section, and the remainder (77.4%; 971) were vaginal deliveries.

Mums who delivered by c-section tended to weigh more than those delivering vaginally, and the birthweight for gestational age of their babies also tended to be higher. These mums also breastfed their babies for a shorter period.

But irrespective of birth weight, and after taking account of maternal weight (BMI) and several other influential factors, a caesarean section delivery was associated with a doubling in the odds of obesity by the time the child was 3 years old.

Just under 16% of children delivered via c-section were obese by the age of 3 compared with 7.5% of those born vaginally.

Children delivered by c-section also had higher BMI and skinfold thickness measurements by the age of 3.

The researchers speculate that one possible explanation for their findings is the difference in the composition of gut bacteria acquired at birth between the two delivery methods.

They highlight previous research showing that children born by c-section have higher numbers of Firmicutes bacteria and lower numbers of Bacteroides bacteria in their guts. These two groups make up the bulk of gut flora.

Other research has also suggested that obese people have higher levels of Firmicutes bacteria.

It may be that gut bacteria influence the development of obesity by increasing energy extracted from the diet, and by stimulating cells to boost insulin resistance, inflammation, and fat deposits, say the authors.

"An association between caesarean birth and increased risk of childhood obesity would provide an important rationale to avoid non-medically indicated caesarean section," write the authors.

Mums who choose this delivery option should be made aware of the potential health risks to her baby, including the possibility of obesity, they say.

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Major overhaul of US life urged to cure obesity: experts

"Two overweight women walk at the 61st Montgomery County Agricultural Fair in 2009. Two-thirds of American adults are too fat, and a major overhaul of US policies -- from schools to restaurants to urban planning -- is needed to stem the epidemic, medical experts said. (AFP Photo/Tim Sloan)" title

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Treating childhood obesity: A family affair

ScienceDaily (May 1, 2012) — With nearly one-third of American children being overweight or obese, doctors agree that there is an acute need for more effective treatments. In many weight management programs, the dropout rate can be as high as 73 percent, and even in successful programs, the benefits are usually short term.

See Also:Health & MedicineStaying HealthyObesityChildren's HealthDiet and Weight LossWorkplace HealthFitnessLiving WellReferencePediatricsOverweightDiabetes mellitus type 2Body mass index

Although family-based approaches to pediatric obesity are considered the gold standard of treatment, theories of the family and how it functions have not been incorporated into effective interventions, according to a study published in the May issue of the International Journal of Obesity by researchers at Wake Forest Baptist Medical Center.

"The field of family studies provides an innovative approach to the difficult problem of pediatric obesity, building on the long-established approach of family-based treatment," said Joseph Skelton, M.D., assistant professor of pediatrics and director of the Brenner FIT (Families in Training) Program at Wake Forest Baptist, and lead author of the study. Skelton and his research team reviewed medical literature published between 1990 and 2011 to identify the use of prominent family theories in pediatric obesity research. Of the 76 manuscripts found, 13 were selected for the study.

Wake Forest Baptist researchers found limited use of family theories in the study of pediatric obesity, particularly in weight management treatments. Family behavioral theories can provide valuable insight into the complexities of families, and increased use of these theories in both research and practice may help in the development of more effective treatments for childhood obesity, the study found.

"Traditionally doctors looked at the patient as the one in the family to focus on, but now we have to look at the entire family as the patient," Skelton said.

"One of the problems we found was that there wasn't even a clear definition of family in the literature. A two-parent household with a stay-at-home mother and working father is no longer the norm. Inability to define the family makes it difficult to apply a straightforward model of family function to child health and weight management."

In the clinic setting, families are often represented by a child and a parent, typically the mother. However, this often does not accurately reflect family complexity and it doesn't define which family members should be included in treatment, Skelton said. A common theme in the field of family studies is that families are a system, made up of interdependent units. Intervening with one unit, such as a mother and a child, will influence other units. These interpersonal relationships influence the health behaviors of the child and the family as a whole, according to the study.

"The challenge is to find ways to incorporate the entire family in the process, while allowing for different schedules and different age kids with different health needs," Skelton said. "If we don't find more effective treatments and this epidemic continues, these children will likely go on to become obese adults, resulting in an entire generation with lower life expectancies than their parents' generation."

Skelton and his team at Brenner FIT have begun incorporating theories of the family into their research and in their treatment approach, and are finding ways to engage more members of the family in treatment.

Funding for the study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Duke Endowment and the Kate B. Reynolds Charitable Foundation.

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