Poor, Obese Children Not Eating Enough

I was first turned on to this interesting article by my friends over at the Big Fat Deal blog.

Poor, Obese Children Not Eating Enough

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The post links back to a KansasCity.com news article of the same title.  That article on KansasCity.com would lead a casual reader to believe that the common calories in vs. calories out explanation for obesity had be soundly refuted by science.

However, the actual Journal article paints a slightly different picture than the one painted on KansasCity.com. Below is a reasonable facsimile of my comment of the BFD blog (altered for it to make sense in the context of this blog post).

I went out and read the article. The summary at KansasCity.com is only taking from the abstract of the actual study.

Before I comment on the article itself, I want to preface it by saying that I STRONGLY agree that some people are predisposed to being overweight. Unfortunately, after reading the actual Journal Article, the data collected in this case does not support that notion as strongly as KansasCity.com would lead us to believe.

The study, “Diabetes Risk, Low Fitness, and Energy Insufficiency Levels among Children from Poor Families,” goes much farther than just looking at macronutrient and caloric intake; it also looks extensively at fitness levels.

The data showed that only 11.1% of the children had acceptable fitness levels.

Fitness was measured using a “step test,” where basically the change in heart over baseline after stepping up and down onto a small stool for five minutes.

There are a couple of interesting observations in the “Discussion” section of the article; I will paste a couple of quotes below (with my commentary in () after each quote):

“There are several possibilities to explain the food insufficiency and obesity paradox. Individuals not having enough food at certain time periods may engage in binge eating or compromise the nutritional quality of their diets when food becomes available resulting in being overweight. Binge eating may promote fat accumulation due to the dramatic rise in postprandial lipid, glucose, and insulin levels. Following periods of fasting, the liver is primed to synthesize lipids and increase fat storage capacity.”

(this goes directly to some of the comments from the BFD blog, about how binging followed by fasting often triggers a fat storage mechanism)

“A second limitation was the use of children’s self assessment of dietary intake. Inaccurate reporting has been shown among populations from different age, sex, ethnicity, culture, education, social class, and nationality regardless if food records, dietary recalls, food frequency questionnaires, food weighed, and cafeteria menus were used. That study participants worldwide knowingly or subconsciously systematically misreport their dietary intake and that energy intake is consistently and significantly in opposite direction to BMI and body fat appears all too coincidental.”

(the children in this study were asked to recall everything they ate the previous day, and previous studies of suggested, basically, the higher the BMI or BF%, then the more likely the person is to underestimate their food intake)

“Could obesity in children be more closely related to low physical activity and low micronutrient intake than to excessive energy intake? Children in our study had low fitness levels and low calcium, magnesium, potassium, phosphorus, and folate dietary intake. The literature showing the relationship between inactivity and obesity is extensive…”

(I think that based on the data in this study, we cannot rule out the possibility. The dietary recommendations are based on a normal (acceptable) level of physical fitness, and the data here suggests that the vast majority of the children studied did not meet that standard. The “calories out” side of the equation is at least as off kilter as the “calories in” side).

So, that is the summary of the article. Hopefully it was helpful. It is just disappointing to me that KansasCity.com would put a certain spin on a scientific study without actually reading what the authors said.

I would be interested to know what you all think…

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Referenced Article:

Roberto P. Trevino, Donovan L. Fogt, Tammy Jordan Wyatt,
Liset Leal-Vasquez, Erica Sosa, Charlotte Woods.
Diabetes Risk, Low Fitness, and Energy Insufficiency
Levels among Children from Poor Families, Journal of the
American Dietetic Association, Volume 108, Issue 11,
November 2008, Pages 1846-1853,
ISSN 0002-8223, DOI: 10.1016/j.jada.2008.08.009.
(ScienceDirect.com Link)

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