Sunday, August 27, 2017

Screening for Childhood Obesity

The United States Preventive Services Task Force (USPSTF) is an organization consisting of experts in primary care who review health information. And based on their reviews, the task force makes recommendations for clinical preventive services. The organization has recommended childhood obesity screening as follows:

"The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status."

Childhood obesity continues to receive a lot of attention. This is because reducing childhood obesity will lower the number of adults who experience obesity, since obesity in childhood increases the risk of obesity in adulthood. Further, obesity often leads to type 2 diabetes, hypertension, some forms of cancer, and other illnesses.

Therefore, it makes sense to screen a child for obesity, because signs of adult obesity may appear early in life. And screening for obesity can arm a provider with information that can be useful in guiding the provider. The provider can use the information to counsel parents on what actions to take to reduce the risk of their child experiencing obesity later in life.

The parents can take appropriate actions to motivate their children to follow a healthy diet and increase physical activity. This might include many new and different types of diets and physical activities. For example, past research has shown that some video games might actually provide an avenue for kids to get more exercise. And there may be specific diets that can entice children to be more inclined to engage in health eating.

At any rate, the USPSTF's recommendation to screen children for obesity can be an important step in the fight against childhood obesity. Not just because of the recommendation, but because of the rating given to the screening recommendation.

The task force gives grades of A, B, C, D, and I to its recommendations. Recommended clinical activities given a grade A or B are required to be covered by insurance companies as directed by the Affordable Care Act. The task force gave a grade of B to the childhood obesity screening recommendation, therefore the screening should be covered. Further, because of the "B" rating, under the USPSTF guidelines, the patient is not required to pay any percentage of the cost of the treatment.

In a nut shell, screening children for obesity will benefit both the children and the provider. The screening will benefit the children because the screening will increase the children's chances of improved health. And screening will benefit the provider because he or she will know that appropriate actions are being taken to improve the current and future health of the children.

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Monday, August 14, 2017

Determining the Best Diet for a Person with Prediabetes or Type 2 Diabetes



It is becoming more and more apparent that no single weight loss or weight maintenance approach will work for everybody. For example, no type of exercise that works for one person will necessarily work for another. An anti-obesity drug that causes one person to lose weight might not cause someone else to lose weight. And a diet that enables one individual to lose weight may actually cause someone else to gain weight. So biomarkers that indicate what might work for a specific person would be valuable for designing personalized weight loss and weight maintenance approaches. And these types of biomarkers are being looked at. With respect to diet, fasting plasma glucose and insulin may be biomarkers that can aid in diet personalization.

A study was done at the University of Copenhagen to determine if fasting plasma glucose and fasting insulin could be used to predict the diets that would lead to weight loss for specific people. The researchers looked at 1200 subjects in three clinical trials. And the researchers concluded that “for most people with prediabetes, a diet rich with vegetables fruits and whole grains should be recommended for weight loss and could potentially improve diabetes markers. For people with type 2 diabetes, the analysis found that a diet rich in healthy fats from plant sources would be effective for achieving weight loss. These diets could also be effective independent of caloric restriction.”

As always, more research is needed, and the researchers at the University of Copenhagen will continue to investigate fasting plasma glucose and insulin. And if further research indicates that these two biomarkers and other biomarkers can indeed provide insight into which diets would be the most beneficial for specific individuals, it would be an important tool in the fight against weight loss and diabetes.

These kinds of predictive mechanisms should be embraced by primary care physicians and other providers engaged in providing obesity medicine. Indeed, these types of biomarkers should be of particular interest to obesity medicine specialists.

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