Factors leading to childhood Obesity

July 22nd, 2009

Obesity in childhood and adolescence has been related to an increase in the incidence of mortality in adulthood.

Childhood obesity has increased in both developed and developing countries although the pace and patterns of spread of this global health problem differs from country to country.

There are no universally accepted markers of obesity to monitor the secular trends of the epidemic and the impact of interventions in different ethnic populations.

We need a fundamentally different approach to developing and validating measures of obesity in children.

Main causes of childhood obesity:

Environment: Obesity is encouraged by such “obesogenic environment” conditions that promote overeating and inactivity either are already present or emerging in most populations.

The prevalence of television commercials promoting unhealthy foods and eating habits is a large contributor.

Beverages such as carbonated soft drinks and juice boxes also contribute to the child obesity.

Lack of physical activity: The growing use of computers, increased time watching television and decreased physical education in schools, all contribute to children and adolescents living a more sedentary lifestyle.

Heredity and family:
Science shows that genetics plays an important a role in obesity. It has been proven that children with obese parents are more likely to be obese. Estimates say that heredity contributes between 5 to 25 percent of the risk for obesity.


Dietary patterns:
Over the past few decades, dietary patterns have changed significantly. The average amount of calories consumed per day has dramatically increased.


Socioeconomic status:
Educational levels contribute to the socioeconomic issue associated with obesity.

Parents with little or no education have not been exposed to information about proper nutrition and healthy food choices. This makes it difficult to instill those important values in their children.

Treating Childhood Obesity:

Treating obesity in children and adolescents differs from treatment in adults. Involving the family in a child’s weight management program is a key element to treatment. Treatment of pediatric obesity is not accomplished by just dieting. The various treatments of obesity in children and adolescents include:

Dietary therapy: It is often recommended that children have a consultation with a dietitian who can address the child’s needs. Dietitians can help children understand healthy eating habits and how to implement them in their long-term diet.

Education on how to identify healthy food, cut back on portions, eat smaller bites at a smaller pace is generally the information given to change a child’s eating habits.

Physical activity: Another form of obesity treatment in children is increasing physical activity. Physical activity is an important long-term ingredient for children.

Increasing physical activity can decrease, or at least slow the increase, in fatty tissues in obese children. It is recommended that children get at least 60 minutes of physical activity each day.

Individualized programs are available and possible for those children or adolescents that are not able to meet minimum expectations.

Behavior modification:
Lifestyles and behaviors are established at a young age. It is important for parents and children to remain educated and focused on making long-term healthy lifestyle choices.
There are several ways that children and adolescents can modify their behavior for healthier outcomes, such as:

  • Changing eating habits
  • Increasing physical activity
  • Becoming educated about the body and how to nourish it appropriately

Engaging in a support group activity and setting realistic weight management goals.

Gastric Cancer

September 23rd, 2008
Introduction

Stomach cancer is the fourth most common cancer worldwide. It is a disease with a high death rate making it the second most common cause of cancer death worldwide after lung cancer.

It is associated with high salt in the diet, smoking, and low intake of fruits and vegetables. Infection with the bacterium H. pylori is the main risk factor in about 80% or more of gastric cancers. Helicobacter pylori (H. pylori) live deep in the mucous layer that coats the lining of the stomach. H. pylori infection frequently occurs in childhood and can last throughout life if not treated. It’s the primary cause of stomach ulcers. Gastric cancer shows a male predominance in its incidence as up to 3 males are affected for every female. Estrogen may protect women against the development of this cancer form.

Symptoms

• Indigestion or a burning sensation (heartburn)
• Loss of appetite, especially for meat
• Abdominal pain or discomfort in the upper abdomen
• Nausea and vomiting
• Diarrhea or constipation
• Bloating of the stomach after meals
• Weight loss
• Weakness and fatigue
• Bleeding (vomiting blood or having blood in the stool), which can lead to anemia
• Dysphagia; this feature suggests a tumor in the cardia or extension of the gastric tumor in to the Oesopagus.

Tests that examine the stomach and esophagus are used to detect and diagnose gastric cancer.

Upper GI Endoscopy: A procedure to look inside the esophagus, stomach, and duodenum (first part of the small intestine) to check for abnormal areas. An endoscope (a thin, lighted tube) is passed through the mouth and down the throat into the esophagus.

Fecal occult blood test: A test to check stool (solid waste) for blood that can only be seen with a microscope.

Barium swallow: A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. A biopsy of the stomach is usually done during the endoscopy.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.

Staging

If cancer cells are found in the tissue sample, the next step is to stage, or find out the extent of the disease. Stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, a CT scan, a PET scan, an endoscopic ultrasound exam, or other tests to check these areas. Blood tests for tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) may be ordered, as their levels correlate to extent of metastasis.

Treatment

Like any cancer, treatment is adapted to fit each person’s individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Other treatments for stomach cancer may include chemotherapy, and/or radiation therapy.

Surgical Treatment of Gastric Cancer

Individuals with gastric cancer are frequently treated with surgical removal of the stomach called a gastrectomy, to remove the cancer and prevent recurrence of the cancer. Lymph nodes (parts of the body’s lymph system) around the stomach are also removed and examined to determine whether or not the cancer has spread to these areas.

Endoscopic Surgery

Early cancers, stage 0 and I, can often be removed through an endoscope passed through the esophagus. Another procedure, called laparoscopic surgery, is performed through an endoscope passed into the abdomen through a small incision. Laparoscopic resection of early gastric cancer has been shown to be safe and effective. The primary advantage of laparoscopic surgery is more rapid recovery after surgery.

Radiation therapy

Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing.

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Welcome !

September 23rd, 2008

Dr. Deep Goel is Head of Surgical Specialties at Artemis Health Institute, Gurgaon, India. His main area of interest is Minimal Invasive Surgery which includes gastro-intestinal malignancies, obesity (weight loss surgery) and other non-malignant diseases like gall bladder stones and hernias.

Dr. Deep Goel has been trained extensively in India (Sir Ganga Ram Hospital), England (Royal London Hospital), USA (Mount Sinai Medical School New York) and France (Bagatelle Hospital- Bourdaux). He is member of various prestigious societies like Endo Laparoscopic Society of Asia (ELSA), Eurasian Colorectal Technologies Association (ECTA), Minimal Access Surgeons of India, Indian Association of Gastroendo Surgeons and Indian Association of Colorectal Surgeons.

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