During the last 3 decades, the rate of overweight children has increased with each age classification. The greatest increase has been among children ages 6-11, which nearly quintupled (4% to 19%). Among youth ages 12-19, the overweight rate tripled (5% to 17%). The rate for children ages 2-5 increased from 5% to 14%. Childhood overweight results from an energy imbalance which involves eating too many calories and not getting enough physical activity. Together, health behaviors and the environment play a large role in the childhood obesity epidemic.
Health Risks Associated with Childhood Obesity
Approximately 60% of overweight children ages 5-10 have at least one physiological risk factor for heart disease and stroke, such as elevated cholesterol, triglycerides, insulin or high blood pressure. For children born in the U.S. in 2000, the risk of being diagnosed with diabetes during their lives is 33% for males and 39% for females. The risk is directly related to diet and physical activity. Childhood obesity is also associated with sleep apnea, orthopedic complications and mental health problems.
Health Disparities Associated with Childhood Obesity
The rates of overweight Latino (37.4%) and African-American (43.9%) children are significantly higher than white children (21.1%). Every day there are health disparities experienced by some populations as the result of poverty, ethnicity, and/or marginalized social status. The Health Resources and Services Administration defines health disparities as "population-specific differences in the presence of disease, health outcomes, or access to health care."
Pediatric obesity researchers at Vanderbilt study the gaps in the quality of health and health care across racial, ethnic, and socioeconomic groups. What policies could reduce health disparities? How can factors that are present early in life, such as nutritional and environmental conditions, affect health in subsequent years, and what sorts of early interventions might best prevent future health problems?
Chief of Pediatrics, Dr. Shari Barkin, leads a team of pediatric obesity investigators at Vanderbilt.
Shari Barkin, M.D., M.S.H.S.
Dr. Barkin's research has focused on examining the effectiveness of pediatric office-based interventions and the development of connections from the office into the community to create sustainable effects on health. She is an NIH-funded researcher in the area of injury prevention and obesity prevention and early intervention.
In one NIH-funded study, she examined the use of a recreation center as the extension of a doctor's office to provide early intervention for childhood obesity for Latino preadolescents and their parents. With support from the Duke Endowment Grant, and a partnership with the Winston-Salem YWCA, she built the first Collaborative to Strengthen Families and Neighborhoods- a learning lab to test a new model of community engagement that allows community and academic partners to develop and test meaningful interventions to address pediatric obesity. A second site was launched in June 2008, The Nashville Collaborative, that reflects a partnership between the Vanderbilt University Medical Center and Metro Parks and Recreation. These community-based research sites allow for the development and rigorous testing of family-based, community-centered interventions to reduce pediatric obesity. Results from these research studies are presented to local, state, and national policy makers to impact sustainable evidence-based strategies.
Dr. Barkin's research studies often focus on underserved vulnerable populations. For example, in a national randomized controlled trial involving close to 5,000 families, she oversampled minority populations and developed culturally tailored approaches to test the effectiveness of a primary violence prevention intervention. In other randomized controlled trials, she worked with first and second generation Latino immigrant families to prevent obesity in early childhood through public health interventions. She is committed to policy-relevant issues related to the health and development of children, youth, and families.
Sabina B. Gesell, Ph.D.
Dr. Gesell's program of research is focused on reversing the trend of growing numbers of obese children by applying information emerging from social network studies to the development of new population-based behavioral interventions.
This line of research centers around disrupting the cycle of maternal-child health complications that begins with obesity in pregnancy. It also includes an examination of the effect of food insecurity on maternal weight and infant feeding patterns.
Dr. Gesell is the recipient of an American Heart Association Clinical Research Award for promising early career investigators. She is testing the feasibility of transmitting positive health behaviors through social networks to prevent obesity in women of childbearing age. This community-engaged randomized control trial is culturally tailored for recent immigrants from Mexico. Her approach of transmitting positive health behaviors through social networks is innovative and holds strong promise as a tool for initial and sustained behavior change with high potential for translation more broadly into maternal care services and community outreach.
Dr. Gesell is also partnering with the Maternal Infant Health Outreach Worker Program (MIHOW) to examine the use of community health workers (promotoras de salud) as a primary prevention strategy that aims to improve child health and development by improving maternal health around the time of pregnancy. Dr. Gesell has been involved in two other community-based pediatric obesity prevention studies designed for high-risk, under-resourced, multi-ethnic neighborhoods (PI: Barkin).