Obese kids have hard time sticking to low-carb diet

NEW YORK Wed Mar 14, 2012 4:09pm EDT

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NEW YORK (Reuters Health) - When it comes to managing children's obesity, cutting portion sizes and cutting carbohydrates can work equally well -- though carb control is tough for many kids, a new clinical trial finds.

Many adults have tried to win the battle of the bulge by shunning carbohydrates, especially highly refined or starchy carbs like white bread and potatoes.

But much less has been known about how those eating plans work for kids, including whether they are safe and nutritionally sound -- since low-carb diets tend to be relatively high in fat.

For the new study, researchers randomly assigned 100 obese 7- to 12-year-olds to one of three eating plans: one that followed the conventional wisdom of portion control; a low-carb diet; or a “reduced glycemic load" plan that cut down on certain carbs that typically cause surges in blood sugar -- like white bread, sweets and white potatoes.

Over one year, all three plans worked equally well in controlling kids' weight gain. The difference, researchers found, was that the low-carb plan was tough to stick with.

"All of these plans can work," said lead researcher Shelley Kirk, of the Heart Institute at Cincinnati Children's Hospital Medical Center.

"But the low-carbohydrate one was really challenging for kids to follow," Kirk told Reuters Health. The diet still helped control kids' weight, she said, because they followed it to an extent -- reducing carbs and calories, but not to the strict limits of the low-carb plan.

All of that, Kirk said, suggests that a modified version of low-carb could work well for at least some kids.

And the diet based on reduced glycemic load was essentially that: Certain carbs were "unrestricted" -- including fruit, vegetables low in starch and 100-percent whole grains. More limits were placed on starchy carbs, but they were still allowed.

Over one year, children in all three diet groups had similar improvements in their body mass index (BMI), a measure of weight in relation to height, after accounting for the fact that they were still growing.

Typically, a child will grow 2 inches per year before puberty. So for an obese child, simply maintaining the same weight over a year is a "success," Kirk said.

A growing child might not see a big weight loss, but what matters is improving "weight status" and overall health, Kirk said.

In this study, published in the Journal of Pediatrics, kids in all three diet groups ended up with healthier cholesterol levels. The low-carb group had a dip in triglycerides, another type of blood fat. And kids who focused on portion control or cutting glycemic load had signs of better blood sugar control.

The bottom line, according to Kirk, is that there are options.

For instance, kids could start by trimming carbs to "jumpstart" their weight loss, then switch to portion control for the longer haul -- which means more freedom in the foods kids eat, but keeping overall calories in check.

In the end, it comes down to “negative calorie balance," or burning more calories than you consume.

So kids need not only a healthy eating plan, but daily exercise too, Kirk said.

The children in this study were part of a hospital-based weight loss program. And it's not clear if their results would translate widely into the “real world."

But other hospitals across the U.S. offer programs for obese children, Kirk noted. And in other cases, your family doctor may be able to help.

In any case, Kirk said, parents should get some kind of professional guidance in managing their kids' weight, rather than going it alone.

And parents should also be prepared to make diet and lifestyle changes themselves.

"One of the hardest things is that families need to change," Kirk said." So think about the eating plan that the entire family can follow and stick with."

SOURCE: bit.ly/A0Lu39 Journal of Pediatrics, online March 1, 2012.

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Comments (2)
Darliene wrote:
I would like to recommend the free NAAFA Child Advocacy ToolkitSM (CATK) and other written guidelines/resources to assist you looking at programs.

A Yale Rudd Center report reviewed existing research on weight stigma in children and adolescents, with attention to the nature and extent of weight bias toward obese youths and to the primary sources of stigma in their lives, including peers, educators, and parents. As a result of weight bias and discrimination, obese children suffer psychological, social, and health-related consequences. http://www.yaleruddcenter.org/resources/upload/docs/what/bias/StigmaObesityChildrensHealth.pdf

Rebecca Puhl of the Rudd Center further brings to light the stigmatization of large children in the following article.

The NAAFA Child Advocacy Toolkit shows how Health At Every Size® takes the focus off weight and directs it to healthful eating and enjoyable movement. It addresses the bullying, building positive self-image and eliminating stigmatization of large children. The CATK lists resources available to parents, educators or caregivers for educational materials, curriculum and programming that is beneficial for all children. It can be found at:

Mar 14, 2012 11:10pm EDT  --  Report as abuse
RockyBob wrote:
One more time!! Any “portion control” diet automatically is a carbohydrate reducing diet! Think about it! Portion control is the new way of saying calorie restriction which is the genteel way of saying “leave the meal while you are still hungry”. And if calories are restricted, what things are first to disappear? High sugar drinks and other empty calorie foods always top the list. So the real issue is not “low carb is hard to follow”, the real issue is “is it easier not eating carbs or leaving the table hungry?” The record for “leaving the table hungry” is essentially 99.9% failure. Low carbing takes time to adjust, especially after a lifetime of carb addiction, but it can be maintained indefinitely. As studies have shown, calorie restriction causes the body to adapt by lowering metabolism, so that it is eventually self-defeating anyway.

Mar 18, 2012 11:32am EDT  --  Report as abuse
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