Childhood Obesity Could Lead to GERD, Cancer

Findings published in the current issue of International Journal of Pediatric Obesity conclude that the association between childhood obesity and Gastroesophageal Reflux Disease (GERD), may lead to risk of other diseases such as esophageal cancer.

Prior to this study, data for obese children relating to GERD had been scarce.  Obesity in adults has proven to be a cause of GERD. The objective of this study was to investigate whether GERD in children is associated with childhood obesity.

The study lead author Corinna Koebnick, a research scientist at Kaiser Permanente Southern California's Department of Research and Evaluation in Pasadena, says "Although we know that childhood obesity, especially extreme obesity, comes with risks for serious health conditions  such as diabetes, cardiovascular disease and cancer, our study adds yet another condition to the list, which is GERD.”

Methodology used for this population-based, cross-sectional study, measured weight and height and diagnosis of GERD were extracted from electronic medical records of 690 321 patients, aged 2–19 years, who were enrolled in an integrated prepaid health plan between 2007 and 2008. Weight class (normal weight, overweight, moderate and extreme obesity) was assigned based on body mass index (BMI)for-age.

Determining weight classifications for children and adolescents (aged 2–19 years), is more complicated than in adults as children’s bodies are changing and developing at varying rates. Currently, BMI value is the measuring tool used in conjunction with Center for Disease Control (CDC) growth charts to determine the corresponding BMI-for-age percentile, based on the 2000 CDC growth charts for the US and expert committee.

*Overweight" is defined as a BMI at or above the 85th percentile and lower than the 95th percentile.

*Obesity" is defined as a BMI at or above the 95th percentile for children of the same age and sex.
BMI categories used for adults are not used for children.  A child's weight status is determined based on an age- and sex-specific percentile.  Classifications of overweight and obesity for children and adolescents are age and sex-specific because children's body composition varies as they age and develop, and varies between boys and girls.

According to the study, overall, GERD was diagnosed in 1.5% of boys and 1.8% of girls. Moderately and extremely obese children, age groups 6–11 years and 12-19 years, were more likely to have a diagnosis of GERD compared with normal weight.  Research results for young children, aged 2-5, did not support an association between obesity and GERD.

What is GERD?

Mayo Clinic defines it as “a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms.”

GERD signs and symptoms:

*A burning sensation in your chest (heartburn), sometimes spreading to the throat, along with a sour taste in your mouth
*Chest pain
*Difficulty swallowing (dysphagia)
*Dry cough
*Hoarseness or sore throat
*Regurgitation of food or sour liquid (acid reflux)
*Sensation of a lump in the throat

Lifestyle and home remedies that might help reduce the frequency of heartburn:

*Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If your weight is healthy, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help devising a weight loss strategy that will work for you.
*Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.
*Avoid foods that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, alcohol, chocolate, mint, garlic, onion and caffeine may make heartburn worse.
*Don't lie down after a meal. Wait at least two to three hours after eating before lying down or going to bed.
*Elevate the head of your bed. An elevation of about six to nine inches puts gravity to work for you. Placing wood or cement blocks under the feet of your bed at the head end. If it's not possible to elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores.
*Don't smoke. Smoking decreases the lower esophageal sphincter's ability to function properly
When to seek medical attention:
Make an appointment with your doctor if you experience severe or frequent GERD symptoms. If you turn to over-the-counter medications for heartburn more than twice per week, see a health care professional.
Serious complications:
*Narrowing of the esophagus (esophageal stricture). Damage to cells in the lower esophagus from acid exposure leads to formation of scar tissue, narrowing the food pathway, causing difficulty swallowing and possible choking.
*An open sore in the esophagus (esophageal ulcer). Stomach acid can severely erode tissues in the esophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
*Precancerous changes to the esophagus , referred to as Barrett's esophagus, causes color and composition of the tissue lining the lower esophagus to change, and are associated with an increased risk of esophageal cancer.
Even though many complications from childhood obesity will not be made evident in the current or near future, these children are at risk for a very painful and sickly adulthood.

Laura Lamp King