Childhood Obesity: The Link to Drinks

Childhood obesity rates have doubled throughout the past 30 years in the United States for children ages 2-5 and 12-19, and tripled in the age group of 6-11. Obesity for children is defined as a body mass index (BMI) at or above the 95th percentile for similar age and gender youths¹.

Social and Environmental Pressures

Many social and environmental pressures lead to greater obesity in children. Chief among these influences is the wide variety and availability of sugar-sweetened drinks that contain little to no nutritional value. These beverages include:

•    Soft drinks
•    Sports drinks
•    Fruit drinks
•    Flavored teas and coffees
•    Energy drinks

Throughout the past 10-15 years, these drinks have exploded on to the consumer scene, flooding grocery stores, gas stations, convenience stores and vending machines.

Americans have doubled their consumption of soda pop in the last 25 years, a trend that closely follows the obesity epidemic. The average American drinks 1.6 cans of soda pop a day, more than 500 cans a year. Soda drinking is particularly rampant among teenagers. Data indicates that soft drinks account for 13 percent of a teenager’s caloric intake – by far the largest source of calories in his or her diet. For decades, milk was the most common beverage consumed by children, but by the mid-1990’s, boys and girls were drinking twice as much soda pop as milk.

One recent, independent peer-reviewed study from Harvard demonstrated a strong link between consumption of sugar-sweetened beverages and childhood obesity². Although some studies conflict regarding the causality between sugar-sweetened beverages and obesity, a number of research studies confirm the Harvard group’s findings that increased soft drink and sugar-laden beverage consumption is a risk factor for obesity³.
Not only do sugar-sweetened drinks likely lead to obesity, they are also associated with tooth decay and weakening bones.

Energy Drink Emergence

In the past decade, energy drinks have exploded into the marketplace. In 2006 alone, 500 new energy drinks were launched. Energy drinks, which typically contain large amounts of sugar and caffeine, are equally if not more dangerous to children. Although the target market for energy drinks is young adults aged 18-35, teenagers are consuming significant quantities of these beverages.

Caffeine by the Can

The amounts of caffeine found in such drinks as Red Bull or Rock Star are about 10 grams per ounce. With that in mind, take a look at the amount of caffeine found in other beverages:

•    Red Bull (8.3 oz can) = 83 grams
•    Rock Star (16 oz. can) = 160 grams
•    Coca-Cola Classic (12 oz. can) = 34.5 grams
•    Pepsi-Cola (12 oz. can) = 38 grams
•    Coffee (8 oz. cup) = 57 grams

Most experts recommend that children consume well under 100 grams of caffeine per day.

Effects of Caffeine on Children

Pharmacologic effects of caffeine are notable in children, most commonly seen as hyperactivity, sleep disturbances and restlessness. Drinking large amounts of caffeine can also be associated with high blood pressure and frequent headaches.

Researchers have reported that a new practice among college-age students is the simultaneous consumption of energy drinks and alcohol, which allows greater consumption of alcohol since alertness is perpetuated by the energy drink⁴. In addition, the sugar content of energy drinks is comparable or higher than most soft drinks. For example, an 8 oz Red Bull contains 27 grams of sugar and a 16 oz Rock Star has 60 grams of sugar, while the typical non-diet soft drink contains 40-45 grams of sugar.

How to Combat the High-calorie Beverage Craze

So what can be done to limit the amount of nutritionally-poor liquid calories that children and adolescents are consuming? On an individual-basis, the best approach is simply to replace soda and sports drinks with water or low-fat milk in children’s diets. Water is the best hydrator available. Low-fat milk not only hydrates, but delivers calcium, protein and vitamin D.

Children should be monitored at home with their choice of liquids. A glass of 100 percent fruit juice per day is beneficial, but excessive soda, sport drinks or energy drinks is unhealthy. What happens at school may be out of the immediate control of a parent, but parents can petition the school to eliminate vending machines that sell soft drinks and energy drinks in favor of bottled water.

Moderation in guiding children, of course, is appropriate. Children who are constantly deprived of treats are more likely to binge eat or drink. Also, parental modeling is important. Studies suggest that children who are raised by parents who exert excessive dietary restraint may be more likely to become obese⁵.

Children possess the ability to internally regulate their caloric intake. If they see their parents struggle with alternating dis-inhibited eating (abandoning the effort to control food or drink intake) and restrained eating (conscious decision to restrict intake to control weight), they may pattern their own eating and drinking behavior after their parents instead of allowing their internal energy regulation to guide them. This in turn seems to lead to greater obesity in children.

Conclusion

Parents should adopt healthy eating and drinking patterns, limiting consumption of soft drinks and other sugar-sweetened drinks, and to do so without obsession. Helping children develop a love for the refreshing taste of water or a cold glass of milk will pay immediate health rewards for children as well as dividends for their future health and weight control.

This article first appeared in the OAC News Vol.5/ Issue 1 October 2009.  Reproduced with permission from Obesity Action Coalition. Please visit www.oac.org

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Join us for a free seminar or take a weight loss quiz to help you get started.

References:

•    Childhood Obesity in the United States: Facts and Figures, Fact Sheet 2004, Institute of Medicine.
•    Ludwig et al, Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001; Feb 17; 357 (9255):505-8.
•    Wolff et al, Medscape J Med 2008; 10(8):189.
•    Malinauskas et al, Nutrition Journal 2007; 6:35.
•    Hood et al, International Journal of Obesity 2000; 10:1319-1325.

Research has long linked obesity to such negative health conditions as high blood pressure, sleep apnea and type 2 diabetes. One commonly overlooked, yet very serious, risk of obesity is cancer. A pivotal study released in 2003 followed more than 900,000 adults for sixteen years¹. When these men and women were enrolled in the study they were cancer free, but over the duration of the study, more than 50,000 cancer deaths occurred. The study concluded that those with a body mass index of 40 or more, those considered morbidly obese, had death rates from all cancers that were 52% higher for men and 62% higher for women compared to people of normal weight. Based on this data, the researchers estimated that 14 percent of all deaths from cancer in men and 20 percent of those in women could be directly linked to obesity. Obesity related cancers include esophagus, colon, rectum, liver, pancreas and kidney cancers. For women, there is also an increased rate of breast, uterus and other gynecologic cancers.

Seven years have passed since the publication of that study and much headway has been made in the treatment and prevention of obesity in the United States. Although the obese population continues to climb, options such as weight loss surgery and medically supervised diets are widely available. This June, the Journal of the American College of Surgeons published a report that bariatric surgery appears to decrease the risk of cancer in obese women.

The study followed 1,482 severely obese (BMI over 30) women who had undergone bariatric surgery and compared them to a group of severely obese women who had not undergone surgery. Although the results of the study were not conclusive, the obese women who did not have surgery had a significantly higher cancer diagnosis². These findings may be the first step toward bariatric surgery being a preventative treatment for obesity related cancers.

Certainly more research needs to be done to evaluate the numerous factors contributing to weight loss. Still, for the morbidly obese, weight loss surgery, such gastric bypass or laparoscopic gastric banding, has proven to be a more effective means of weight loss than diet and exercise alone.

1. EE Callee, C Rodriguez, K Walker-Thurmond, M Thun Overweight, Obesity and Mortality from Canter in a Prospectively Studied Cohort of U.S. Adults, NEJM 348: 1625-1638, April 24, 2003, No. 17
2. Cancer in Obese Women: Potential Protective Impact of Bariatric Surgery, 17 April 2009

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Join us for a free seminar or take a weight loss quiz to help you get started.

Type 2 diabetes is a disease in which the body does not produce or properly use insulin, a hormone necessary to convert sugar and starches into energy. Its exact cause is unknown, but genetics, obesity, and lack of exercise are all contributing factors.

Glucose intolerance should not be taken lightly. But, unfortunately, it is not the only concern. Nearly 60-70% of people with diabetes develop some form of nervous system damage including the loss of ability to feel pain. Nearly 30% of adults ages 40 and over with diabetes suffer from neuropathy, impaired sensation of the feet. This means that those with neuropathy can develop blisters or sores on their feet that they may not be aware of.

Despite several visits to specialists across the state and multiple treatments, Steven’s wound on his foot did not get better. Finally, the doctors suggested amputation, and Steven realized that he had to get rid of the diabetes in order to save his leg.

In December of 2006, Steven had laparoscopic gastric bypass surgery performed by Dr. Tom Lavin of the Surgical Specialists of Louisiana. This minimally invasive, one-hour procedure creates a smaller stomach pouch that allows food to bypass a large portion of the small intestine so the patient absorbs fewer calories. Interestingly, gastric bypass, also called Roux-en-Y gastric bypass surgery, also affects the hormones that may be behind diabetes. Studies show that 83.8% of patients often resolve their diabetes within days of bariatric surgery.

Since his surgery, Steven has lost 185 pounds and is no longer diabetic. Best of all, his wound was healed and he was able to keep full use of his foot and leg.

Dr. Lavin believes that, by treating the core problem, many obese individuals can solve most of their related health problems. Steven is excited about his weight loss success, but beyond the numbers on the scale he is thrilled to have regained his health.

1. American Diabetes Association. All about diabetes. Available at: http://www.diabetes.org/ about-diabetes.jsp. Accessed Nov 15, 2009

2. National Diabetes Information Clearinghouse (NDIC). A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH. National Diabetes Statistics, 2007. Available at : http://diabetes.niddk.nih.gov/DM/PUBS/statistics/. Accessed Nov 15, 2009.

3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery: A Systematic Review and Meta-Analysis. JAMA 2004;292(14):1724-37.

Many patients undergoing bariatric surgery often wonder if they will need plastic surgery to remove excess skin after they’ve lost weight. This is not always the case. Depending on your age and the elasticity of your skin you may see your body return to a somewhat normal state. Others, however, will see an excess of saggy skin around their midsection, thighs, arms or breasts. This can present both physical and emotional concerns. Hanging skin can be uncomfortable and can cause hygiene problems. And patients who worked hard to reach their weight loss goals may find themselves, once again, embarrassed by their physical appearance. Plastic surgery could be the solution.

Body contouring after massive weight loss is on the rise. In fact, according to the American Society of Plastic Surgeons (ASPS) nearly 67,000 body contouring procedures after massive weight loss were performed in 2007. This accounts for roughly one-fourth of all bariatric surgery patients.

The most commonly performed procedures for bariatric surgery patients are panniculectomy, abdominoplasty, breast lift, brachioplasty, and vertical thigh lift.

• Panniculectomy: a procedure that reduces the size of the pannus, or the excess skin that hangs in the abdominal region. This procedure is often covered by insurance companies to improve physical function.

• Abdominoplasty: this procedure, like the panniculectomy, also removes excess abdominal skin but also tightens the muscle.

• Breast lift: also known as a mastopexy, this is the most common plastic surgery procedure for weight loss surgery patients. Because the breast volume may have decreased with weight loss, implants are often used to lift and shape the breast.

• Brachioplasty: this technique, to remove excess hanging skin from the arm, cannot be performed without creating a large scar. Many patients however, find this trade off well worth it.

• Vertical thigh lift: a procedure that removes the excess tissue extending from the groin to the knee. Like the arm lift, it generally leaves a large scar.

If you are considering body contouring after your weight loss procedure, it is best to wait at least one full year after your bariatric surgery or until you have reached a stable weight. Having plastic surgery prematurely may not give you the results you are looking for and may mean revisional surgery later on. It is also advisable to reach a healthy weight. Surgery, cosmetic or otherwise, carries risks. These risks can be minimized as your Body Mass Index (BMI) decreases and any weight-related health conditions begin to resolve themselves.

Many plastic surgeons are now specializing in procedures for weight loss surgery patents. The Surgical Specialists of Louisiana can provide you with a list of recommended plastic surgeons and connect you with patients who have undergone body contouring. Additionally, the ASPS is a great resource for detailed information about these and other procedures. You can reach their site at www.plasticsurgery.org.

Most weight loss surgeries, such as gastric bypass, adjustable gastric banding (LAP-BAND® and REALIZE Band), or gastric sleeve are all aimed at hunger control. They limit the amount of food one can eat giving patients the tool they need to lose weight.

But once surgery turns the physical hunger off, other psychological issues may surface. Many patients find that they have a complicated relationship with food and that their new approach to eating causes anxiety. Others have used food as a coping mechanism for negative emotions and must learn other ways to deal with these feelings. Surgery alone cannot repair these issues.

We at Surgical Specialists of Louisiana understand and are here to help. Since 2000, we have been helping our patients address the psychological side of bariatric surgery before and after their procedure.  Our team of weight loss specialists sees patients frequently for the first year after surgery to ensure they have the necessary skills to deal with physical and emotional changes. We continue to guide them through their weight loss journey as they are our patients for life.

Our patients also have unlimited access to bariatric support groups in Metairie, Slidell, Lafayette, and Covington, Louisiana, and can call the clinic staff as needed. We encourage all our patients to attend support groups as an excellent peer-to-peer forum, support network, and educational opportunity.

Ultimately, we believe that a comprehensive approach is necessary to ensure weight loss success. This is why we have a team of highly skilled surgeons, experienced patient advocates, nutritionists and psychologists available for our patients. We understand that nobody is perfect, but with ongoing commitment and communication we can help you succeed!

For many, health insurance will cover weight loss surgery.  But, despite the medical evidence correlating bariatric surgery and improved health, some health insurance programs still do not cover laparoscopic bariatric surgery, claiming that it is elective or cosmetic or both.  In these situations, patients often feel they have exhausted their options.  This is not the case!  You have many other choices.

For example, there are several national lenders who offer a broad range of financing options to patients who want to pay for their weight loss surgery procedure when insurance coverage is not available.  Some even choose to finance their co-pay.  The weight loss surgery financing section of our website lists our preferred providers.  These companies offer convenient payment options and low interest loans to those who qualify. You can also contact our Patient Advocates for more information.

In addition, you can check with your local bank about a personal loan.  Your bank will determine how much you may borrow and at what rate, as well as the terms of repayment.

Whether you are having gastric bypass, LAP-BAND, or one of our new incisionless procedures, we want to make your bariatric surgery as affordable as possible.  Surgical Specialists of Louisiana is committed to reasonable cash pay prices for those patients who do not have insurance coverage.

Weight loss surgery may be the best investment you every make.  We’re happy to guide you through the insurance maze or financing process and see you come out healthier and happier! Contact one of our Patient Advocates today to learn more.

Since 2000, The Surgical Specialists of Louisiana have been offering weight loss programs that suit the needs of every person interested in losing weight, improving their health, and enhancing the quality of their life.

Our experienced surgeons have performed over 3,000 advanced laparoscopic weight loss surgeries such as gastric bypass, adjustable gastric banding (LAP-BAND® and REALIZE™ Band), gastric sleeve and duodenal switch. We are also now offering groundbreaking incisionless bariatric procedures such as ROSE (Restorative Obesity Surgery, Endoscopic) and POSE (Primary Obesity Surgery, Endoscopy), which are performed entirely through the mouth without making any external incisions in to the body.

But we’re not only experts in Bariatric Surgery. MyWeight, our new non-surgical weight loss and wellness program, can help you succeed whether you have 5, 50 or 150 pounds to lose. This medically supervised weight loss program is tailored to your individual needs and provides one-on-one coaching from clinical specialists.

With offices in Covington, Metairie, Slidell, and Lafayette, Louisiana, we’re just around the corner—no matter where you are! Our seven full time patient advocates are eager to help you learn about your weight loss options or help you navigate the weight loss surgery insurance hurdle.

We encourage you and your loved ones to follow this blog and explore everything our new site has to offer. And check out the new inspirational videos from five of our successful bariatric patients – Nina, Katie, Claire, Melissa, and Stacy.

We’re looking forward to helping you achieve your weight loss and wellness goals!