A&T tied to weight gain in children
Netherlands researchers examined the association of adenoidectomy and tonsillectomy with overweight in 2,100 children, whom
they followed from birth until 8 years old. They collected data on the two surgeries along with height and weight, lifestyle,
and various aspects of health and disease. The children were divided into those who had neither procedure, just adenoidectomy,
or tonsillectomy with or without adenoidectomy. At the age of 8, the subjects had a medical exam, and weight and height were
measured.
Cumulative incidence up to the age of 8 was 12% for adenoidectomy only, and 15% for tonsillectomy with or without adenoidectomy.
In the latter group, 70% had both procedures during the same year, 26% had both at different ages, and 4% had only tonsillectomy.
Boys were more likely than girls to have had the surgeries.
Prevalence of overweight and obesity at 8 years old was significantly higher in the group who underwent tonsillectomy with
or without adenoidectomy, even after adjustment for confounders, such as birth weight, smoking in the home, breastfeeding,
maternal education, overweight, and smoking during pregnancy. Adenoidectomy alone also was associated with overweight, but
weakly. Investigators found these associations were not explained by overweight that existed before the procedures (Wijga
AH et al: Pediatrics 2009;123:1095). Commentary:
Children who underwent adeno/tonsillectomy were twice as likely to become obese as children who had neither. The authors hypothesize
that in the preoperative period these children reset their metabolism to adjust for frequent infections, poor appetite, poor
sleep quality, and difficulty breathing. When they are returned to good health, these adaptations may become liabilities,
predisposing to excessive weight gain. Parents and physicians should be alert to this.
Drinking water lowers total caloric intake
We all know that consumption of sugar-sweetened beverages (including soda, sport drinks, fruit drinks and punches, low-calorie
drinks, and sweetened tea) is considered a contributing factor to obesity in childhood. Now a new study has estimated that
the net caloric impact of replacing soda or other sugar-sweetened beverages with water is associated with an average reduction
in total calories of 235 kcal/day.
Investigators analyzed 24-hour dietary recall data on two nonconsecutive days for about 3,000 youngsters from 2 to 19 years
of age who were polled by the National Health and Nutrition Examination Survey. Average total energy intake (2,118 kcal) increased
with age and was higher in boys than girls. A full 91% had at least one sugar-sweetened beverage on either or both recall
days; older age groups tended to consume more beverages, especially those that were sugar sweetened.
Each serving of a sugar-sweetened beverage was tied to a net increased intake of 106 kcal (about an 8-oz glass of soda) on
that day, with no compensatory reduction in intake of other foods or beverages. The same general principle held true for several
other beverages: whole and reduced-fat milk (associated with a net increase of 169 and 145 kcal/day, respectively) and 100%
fruit juice (123 kcal/day). No net increases in total energy intake were observed for water or diet drinks.
Substituting water for sugar-sweetened beverages was related to a significant decrease in total energy intake, with each 1%
of replacement associated with 6.6-kcal lower total energy intake. No compensatory increases in other food or beverages negated
this reduction (Wang YC et al. Arch Pediatr Adolesc Med 2009;163:336).
Commentary:
Substituting water for sugar-sweetened beverages decreases caloric intake by about 235 kcal/day. That's 85,775 calories per
year!
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