Diabetes, Obesity, Milk Allergy or Anorexia, Bran & Brain Power, Pregnancy & Fish. Plus: Migraine, MMR, 'Designer Babies'

YOU ARE WHAT YOU EAT

It has been a week where diet has dominated the health news – both yours and your child’s – do you feel confident that your child is well fed? We unravel the science behind the health scares so you can make up your own mind.

DIABETES

Diabetes has been in the news this week and for all the wrong reasons. Doctors in Bristol announced that they have four children with type two diabetes. This is shocking news as it is the first time this type of diabetes has been found in children and has long term implications for the health of our population.

There are two types of diabetes: type one, also called insulin dependent diabetes, often occurs in childhood. It may be caused by an autoimmune reaction or a viral infection in a genetically susceptible individual. It usually starts with dramatic weight loss, drinking a lot of fluids and passing a lot of urine. You can read about it in our article on diabetes.

Type two diabetes however, which was found in these children, usually occurs in older people, often after retirement age and is strongly linked with being overweight. It is more common in some racial groups but relatively rare in Caucasians, which makes the news that the four affected children were white even more alarming. In type two diabetes it is thought that as you age you produce less insulin, and in people who are overweight the amount of insulin produced is not sufficient for that person’s large body mass. These people also have a ‘resistance’ to insulin so it does not work so effectively. It is often treated initially with diet and weight loss, which can control it. More serious cases are treated with pills by mouth to reduce the level of sugar in the blood, but insulin is almost never needed (unlike type one diabetes where the insulin producing cells of the pancreas are destroyed and so insulin has to be given by injection several times a day).

The shock of this diagnosis is that the children must be severely overweight not to be producing enough insulin. Type two diabetes, although it comes on slowly, has serious long-term effects on the body, including kidney failure, blindness, heart disease, infections and leg ulcers. The children in this study in the Archives of Disease in Childhood were only aged 13 to 15 years and if this type of diabetes can produce such severe long term effects in patients diagnosed in their sixties the children must be at risk of life threatening problems as they grow older. These children will be treated initially with a calorie controlled diet, exercise and the long-term introduction of a healthy eating plan, as well as drugs if needed, but the alarming fact is that their diagnosis, although the tip of the iceberg, must mean that there is a real risk to the nation’s health from increasing obesity.

Read ‘Diabetes risk for obese teenagers’ from the Daily Telegraph.

IT’S NOT JUST PUPPY FAT

If you ask most mothers about their five year olds’ diets you will often hear ‘oh, they burn off all the calories I give them’ and ‘it’s just puppy fat’. This was probably true for our parent’s generation, who got a lot more exercise than our children do, but an alarming report from Plymouth this week found that nearly a third of five year old girls were already obese, with have an increased risk of developing type two diabetes in later life.

There have been a number of reports showing that obesity is increasing in schoolchildren: this has been blamed on lack of exercise (couch potatoes, an increase in electronic games and worries about stranger danger) and poor diet (an increase in low-fibre high-fat food and children eating fewer portions of fruit and vegetables). We already know that poor diet, as well as causing obesity, increases the risk of bowel cancer, causes heart disease and strokes and can also cause constipation.

This week’s report looked at 307 five year olds in Plymouth and found that an astonishing 31% of the five year old girls were overweight and that these girls had an increased risk of being insulin resistant – a predictor for type two diabetes in later life. The boys did not exhibit this insulin resistance and the authors think that this is because of they do more exercise. Alarmingly the affected girls also had higher levels of blood fats so as well as being at risk for diabetes they have an increased risk of heart disease.

If you have any concerns about your child’s diet you should discuss them with your doctor or health visitor and also read our article on obesity. Your child’s weight and growth should be monitored regularly and compared to normal by looking at growth charts – they can be quite difficult to interpret particularly if your child is taller or shorter than average; for more detailed information on growth charts and their usefulness read our article on growth charts.

Read ‘Overweight girls aged five are in diabetes danger’ and ‘Has obesity become an epidemic?’ from the Times and ‘Obesity 'killing 30,000 a year’ from the Daily Telegraph.

MILK ALLERGY OR ANOREXIA?

The Times this week reports that many people are shunning dairy products in the mistaken belief that they are allergic to them. True dairy allergy is extremely rare and can be life threatening (read anaphylaxis). Lactose intolerance is a milder problem which occurs when someone does not produce enough of the enzyme lactase in their guts to break down the sugar lactose in milk; it is commoner than dairy allergy but still relatively rare – it can occur in children temporarily after a bout of diarrhoea (read diarrhoea and vomiting in babies and young children) and produces loose stools a swollen tummy and wind.

There is a popular but medically unfounded diet being promoted at the moment which cuts out wheat and dairy as an aid to weight loss but is trying to give itself credibility by claiming that it is being done in response to food allergy or intolerance. Children need fat and calcium to develop normally and parents should be particularly wary of teenage girls who use allergy as an excuse for being picky about their food as this may be the start of an eating disorder such as anorexia. If your daughter is manipulating her diet do ask for medical help as there is a lot of evidence that early intervention produces better results and reduces the death rate from anorexia. There is also concern that these children may not be getting enough calcium in their diets – this can be assessed by a dietician.

Read our article on food intolerance, and also see ‘Don't cancel the milk’ from the Times.

DOES BRAN INCREASE YOUR BRAIN POWER?

Kellogg’s have funded research into the effects of high-fibre breakfast cereals on mood, energy and concentration. They found a slight lowering of fatigue and less ‘emotional distress’ in people who ate their high-fibre breakfast cereals compared to their normal breakfast. The participants had 14 days of high-fibre breakfast cereals and 14 days of their normal breakfast – however the outcomes measured are impossible to quantify accurately and the participants weren’t supposed to know which cereal they were having (although it is presumably hard to hide from someone which cereal they are eating). A scientific critique of the article can be read ‘Bran is good for your brainpower’ at the NeLH Medicine in the News Project site.

Fibre in the diet is known to slow digestion of sugars and so be useful in the treatment of diabetes; it also decreases the risk of bowel cancer in later life and the symptoms of irritable bowel disease in adults. It also makes people feel full and can be used to reduce hunger and calorie intake in people who are overweight. Also read ‘Killer cereals?’ from the Sunday Telegraph.

And finally on the diet front some news for

PREGNANT WOMEN – ARE YOU EATING ENOUGH FISH?

An intriguing study published in this week’s British Medical Journal looks at pregnant women who eat a lot of fish and found that they had fewer premature births and low birth weight children than mothers who don’t eat fish. There have already been reports linking the consumption of fish oil to a reduction in premature delivery in mothers who have had a previous premature baby. I assumed that the fish in the study would be the oily fish so often cited to have health benefits – particularly as the picture on the cover of the journal is of oily mackerel; however the study, which was done in Denmark cited the main ways of eating fish there as a hot fish sandwich or cold fish with salad or pasta. The fish also included prawns, crab and mussels. In this study they found a strong association between mothers who didn’t eat fish and babies’ low birth weight as well as with premature delivery. The authors do conclude that fish oil may be just as effective as eating fish – will doctors in the UK be recommending hot fish sandwiches to pregnant mothers? Do any Tigerchild parents know which sort of fish is eaten commonly in Denmark? We’d love to hear – send us an e-mail.

Read ‘Eating fish improves pregnancy outcomes’ from the British Medical Journal.

POST SCRIPT: OTHER MEDICAL NEWS IN BRIEF

Migraine

Doctors in America think that there may be a genetic basis for migraine which would explain why it runs in families – read our article on migraine.

MMR

A survey done last week, which says that three out of four parents favour single jabs for MMR, shows that 75% of British parents would like access to separate jabs for measles, mumps and rubella as an alternative to the combined MMR – read our discussion of the separate vaccines and the MMR controversy with links to all the relevant scientific papers. Also see our ‘This Week in Health’ archive for more on the MMR debate.

‘Designer Babies’

Thalassaemia is a genetic disease where the child gets severe anaemia; the parents are usually in normal health. It is treated with regular blood transfusions which unfortunately lead to liver and heart damage, diabetes and other endocrine diseases, eventually resulting in death. The only cure is bone marrow transplant from a matched donor. One family in Britain has been allowed to genetically engineer a baby to provide a healthy bone marrow donor for their affected son, read ‘British couple win landmark legal ruling on test-tube birth’ from the Daily Telegraph. Do you think people should be allowed to create a designer baby? What would you do in the same situation? Let us know on our message boards.