Monday, December 5, 2016

Ticking bomb: watching our children die


From http://stateofobesity.org/disparities,
accessed on November 18, 2016
Whereas chronic conditions associated with obesity such as high blood pressure, metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease, and heart conditions may develop and present relatively fast after establishing of obesity, cancers associated with obesity may have a latency of 10 years and longer. Despite this latency, considering that overweight/obesity among our children is at its highest levels, we may witness our own children being diagnosed with, and die from, cancer before us.

This scenario is not a product of my imagination.


A recent report revealed that colorectal cancer incidence has increased among 20- to 34-year olds in the past 35 years and, if the trend continues, there will be up to a 90% increase in colon cancer and 124.2% in rectal cancer incidence in this age group by 2030 (Bailey CE, et al. Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010 JAMA Surg 150: 17-22; 2015).

 

The authors of the study have suggested that the dramatic shift in age of incidence is likely due to the increasing obesity among children and adolescents (Ogden CL, et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 311: 806-14; 2014; Singh KE, et al. Colorectal cancer incidence among young adults in California. J Adolesc Young Adult Oncol 3:176-184, 2014). 

Above is the diagram of how many of our children were overweight or obese in 2012.
 

Indeed, considering that colon cancer progression takes 5 to 20 years, a simple calculation suggests that colon cancer diagnosed at age of 20 to 34 might be initiated in school-age children.

Additional reports on the increasing incidence of colon cancer among the younger generation support the findings of Bailey et al. (Mozes A. Colon cancer rates rising among Americans under 50. Health Day, January 30, 2015; Myers EA, et al. Colorectal cancer in patients under 50 years of age: A retrospective analysis of two institutions’ experience. World J Gastroenterol 19: 5651-5657, 2013).
 

Most recently, a statistically significant correlation between the increasing obesity according to New York State data (1987-2013) and the increasing colorectal cancer incidence in the New York State Cancer Registry (taking into account a 10-year latency period) was reported (Gdoura B, Richardson H, Yang J, Sardo Molmenti CL. 25th AICR conference 2016, Washington DC Obesity and young onset colorectal cancer: a review and time-trend analysis).  

By the way, obesity does not increase the risk for colorectal cancer only. There are 13 other types of cancer that are associated with obesity, and among them are liver, pancreatic, thyroid, esophageal, kidney, endometrial, ovarian, gallbladder cancer, and others.

Therefore, there is an urgent need to implement a policy that helps our children to maintain a healthy weight. However, as previously discussed, waiting for the government to help you is not wise


It is better to educate yourself and take steps.
 

Here are the four anti-obesity rules by Dr. Robert Lustig for children:

1. Get rid of every sugared liquid in the house. Children should drink only water. 


2. Provide at least five servings of vegetables and/or fruit a day (this equals about five handfuls). This rule increases fiber in the diet.


3. Serve individual portions. Serve a second portion only if the child still claims to be hungry after waiting for 20 minutes.

 
4. Children should have at least 60 minutes of physical activity every day.


If you would like to know the reasoning behind these recommendations, watch “Sugar, the bitter truth”, a presentation by Dr. Lustig available on YouTube.


Also, my advice to you, mom and dad, is to be an example for your children. Therefore, the rules above apply to you as well.

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