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Avoiding the path toward obesity

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the number of very young children at risk of becoming overweight adults is a striking feature of my daily consultations in primary care pediatrics in Beijing. The problem for the doctor, is that few parents seem to be actually concerned about the matter (they virtually never consult primarily for a weight concern) and it seems, on the other hand, very difficult to undo years of overgrowth. The prospect at the society level looks bleak too, as more children not only are overweight or frankly obese earlier in life, they now develop diseases considered in the past typical of mature adult, like type II diabetes.

The problem of excessive weight gain is also a challenge to science. Nutritional science is historically oriented towards making sure that children and adults get all the nutrients that were found necessary for health, often from a deficiency prospective as lack of nutrients were usually the issue in the past in the now developed world, a problem still very real in many parts of the globe.This approach is very helpful in famine or disease states, much less when plenty is an issue. One of the issues is the impossibility to produce studies that are blinded to experimenters and participants, therefore limiting the information produced, in particular the inference of causality between a parameter and an observed effect. Useful information is in short supply and this limits advocacy for the type of intervention required.

 
However complicated it is, the poor effectiveness of dealing with the problem of weight excess, the number of people affected and the cost in term of morbidity in suffering and, consequently, as a burden on the health systems make attempts to prevent obesity an urgent and important issue.

I have just come across a research study in Xian where 201 hospitalized children with diarrhea and 53 children without diarrhea were checked for rotavirus, norovirus and adenovirus infection.

The results show that among the 201 children with diarrhea 68.7% (138/201) had a rotavirus infection, 20.4% (41/201) had a norovirus infection, and 5.0% (10/201) had an adenovirus infection. This is interesting, because it means that in the study group of children hospitalized with diarrhea, 94 % of them were infected by one of these three viruses!

For those 53 hospitalized children without diarrhea, the figures are slightly different: 13.2% (7/53) with rotavirus, 35.9% (19/53) with norovirus, and 9.4% (6/53) with adenovirus. Without more details in the abstract, it is difficult to interpret further, but we can certainly see that norovirus has a greater proportion of infection not leading to diarrhea. It may also remind us that these diseases are extremely contagious, including in hospital setting for children admitted for an other reason. That is a reason for trying not to hospitalize children with diarrhea, which in turn means a necessary focus on adequate home management of childhood diarrhea.