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SALEM COMMUNITY HOSPITAL...Childhood obesity boosts the risk of getting GERD

July 18, 2010
Salem News

Obesity has been linked to increased acid reflux disease in adults, but a new study published in the International Journal of Pediatric Obesity suggests that obese children may be at a higher risk for this disease as well.

The study, which was conducted by Kaiser Permanente, discovered the connection between obese children and gastroesophageal reflux disease, commonly known as GERD.

"The burping, heartburn, and spitting up associated with GERD are the result of the stomach's acidic contents moving backward into the esophagus," explained Pediatrician Karla McNair, M.D. "This occurs because the muscle that connects the esophagus with the stomach relaxes at the wrong time or doesn't close properly."

Heartburn is the most common symptom of GERD in children and teens, and it can last up to two hours and tends to be worse after meals. In infants and young children, GERD can lead to problems during and after feeding, including: frequent regurgitation or vomiting especially after meals; choking or wheezing if the contents of the reflux get into the windpipe or lungs; wet burps or wet hiccups; spitting up that continues beyond the first year of life; irritability or inconsolable crying after eating; refusal to eat at all or in limited amounts; or failure to gain weight.

Impact on Obesity

According to the Centers for Disease Control, childhood obesity has tripled over the last 30 years, and about one in five children and teens are obese. Obesity is defined as having a Body Mass Index - a measure comparing height and weight - of 30 or higher.

"When people eat more calories than they burn off, their bodies store the extra calories as fat," Dr. McNair said. "If this pattern of eating more calories continues, additional fat builds up in the body. A large amount of body fat can have a negative effect on a person's health, and the terms 'overweight' or 'obese' describe when someone is at greatest risk of developing weight-related health problems."

This study found that children aged 6 and older with signs of obesity were associated with an increase in acid reflux disease, more so than compared with adults. In fact, extremely obese children have up to a 40 percent higher risk of GERD, while those who are moderately obese have up to a 30 percent higher risk of developing it, compared with children who are at a normal weight range. This finding held true for children ages 6 to 19, but not for children 2 to 5, the researchers noted.

"Childhood obesity, especially extreme obesity, comes with risks for serious health conditions, such as diabetes, cardiovascular disease, orthopedic problems, emotional issues and cancer," Dr. McNair advised. "With the increasing epidemic of childhood obesity, GERD may also become more of a health issue. This disease can cause chronic heartburn, nausea and the potential for respiratory problems such as persistent cough, inflammation of the larynx and asthma. Untreated, GERD can result in chronic inflammation of the lining of the esophagus and, on rare occasions, to lasting damage, including ulcers and scarring."

"In addition, obesity affects every organ system in the body and poses clear risks for the future health of our children. However, because many of these problems occur later in life, it is hard to convince people that they need to be addressed now. Parents can work together with their child's pediatrician to manage the medical complications associated with obesity such as GERD, asthma, sleep apnea, high blood pressure and hip or knee problems."

"If your child is already obese, one of the first goals is to slow down the rate of weight gain. Weight loss is often harder to achieve, but yields the best long-term result.When a child's weight is controlled, his or her reflux symptoms often improve considerably."

Healthy Habits

Weight loss is most likely to be successful when people change their habits, replacing old, unhealthy ones with new, healthy behaviors.

Exercise: "Regular physical activity burns calories and builds muscle," Dr. McNair advised. "A minimum of one hour of physical activity per day is recommended for children." "The challenge is finding activities that your child really likes there are now interactive video game systems that get children and adults moving."

Reduce screen time: Limit screen time- the amount of time spent watching TV, looking at the computer, or playing video games- to two hours or less per day.

Eat five servings of fruits and veggies a day: Fruits and vegetables contain vitamins and minerals as well as fiber. When you fill up on fruits and veggies, you're less likely to overeat when it comes to high-calorie foods like chips or cookies.

Watch out for portion distortion. "Serving sizes have increased over the past 10 years, and these extra calories contribute to obesity," Dr. McNair concluded. "You can also control portion sizes and food ingredients such as salt, fat and sugar by eating at home rather than at a fast food restaurant."

Another key factor in weight gain is that more people drink sugary beverages, such as sodas, juice drinks, and sports drinks. Choosewater or low-fat milk instead. Natural sweeteners like agava nectar and stevia are good alternatives.

Don't skip breakfast. Breakfast kick-starts your metabolism and gives you energy to do more during the day. Children who skip breakfast often feel so hungry that they eat more later on in the day. In fact, people who skip breakfast tend to have higher BMIs than those who eat breakfast.

Pediatrician Karla McNair, M.D., is affiliated with Salem Community Hospital's active medical staff. Her office is located at the Salem Pediatric Care Center, which is in the Salem Medical Arts Building, Suite C, 2020 East State Street, in Salem. Appointments with Dr. McNair may be made by calling 330-332-0084.



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