(28-09-12) Obesity Linked to Impaired Brain Function in Adolescents

By Janice Wood Associate News Editor


A new study links obesity and metabolic syndrome (MetS) with cognitive and
brain impairments in adolescents.

Researchers at New York University School of Medicine say pediatricians should
take their findings into account when considering the treatment of childhood
obesity.

As childhood obesity has increased in the U.S., so has the prevalence of
metabolic syndrome, a constellation of three or more of five health problems,
including abdominal obesity, low HDL (good cholesterol), high triglycerides,
high blood pressure and pre-diabetic insulin resistance.

Lead investigator Dr. Antonio Convit, a professor of psychiatry and medicine
at NYU School of Medicine, and his colleagues have previously linked metabolic
syndrome to neurocognitive impairments in adults, but this association was
generally thought to be a long-term effect of poor metabolism. Now, the
research team has revealed even worse brain impairments in adolescents with
metabolic syndrome.

?The prevalence of MetS parallels the rise in childhood obesity,? Convit said.
?There are huge numbers of people out there who have problems with their
weight. If those problems persist long enough, they will lead to the
development of MetS and diabetes. As yet, there has been very little
information available about what happens to the brain in the setting of obesity
and MetS and before diabetes onset in children.?

For the study, researchers compared 49 adolescents with metabolic syndrome to
62 teens without the disorder. Of those who were not in the MetS group, 40
percent were considered overweight or obese, so while they were not in ideal
health, they did not have three out of the five health issues needed to fall
into the MetS group.

The research team balanced each group according to age, socioeconomic status,
school grade, gender and ethnicity to ensure things like cultural differences
in diet and access to quality healthcare did not cloud the data. They then
conducted endocrine, MRI, and neuropsychological evaluations on the adolescents
and found that those classified as having MetS showed significantly lower math
and spelling scores, as well as decreased attention span and mental
flexibility.

They also showed differences in brain structure and volume, presenting with
smaller hippocampal volumes, which is involved in the learning and recall of
new information; increased brain cerebrospinal fluid; and reductions of
microstructural integrity in major white matter tracts in the brain. The more
MetS health problems the participants had, the more profound the effect across
the board, according to the researchers.

?The kids with MetS took longer to do tasks, could not read as well and had
poorer math scores,? Convit said. ?These findings indicate that kids with MetS
do not perform well on things that are very relevant to school performance.?

The researchers concluded that even a few years of problems with metabolism
may cause brain complications. They suggest the adverse impact of MetS on brain
function in children could be used by pediatricians as a powerful motivator to
get families more involved in meaningful lifestyle change.

?Only now are pediatricians becoming aware of some of these issues,? Convit
said. ?Many pediatricians don?t even take a blood pressure, and they certainly
are not taking cholesterol levels and testing insulin resistance.?

He added that about one third of children who are obese have abnormal
cholesterol levels and more than 40 percent of those who are really obese have
insulin resistance.

?Obesity in kids is sky high,? he said. ?Nearly 40 percent of the U.S.
population is considered obese. Parents need to understand that obesity has
medical consequences, even in children, and some of those consequences may be
impacting more than just the long term health of the cardiovascular system. We
need to do what our grandmothers have told us all along: ?Eat well, don?t
overeat and try to move as much as possible.??

Convit added that simple changes in daily routine, such as walking more or
taking the stairs, would go a long way in preventing MetS. Future research is
needed to determine whether the reductions in cognitive performance and
structural brain abnormalities are reversible with significant weight loss, he
added.

?The take home message is that just being overweight and obese is already
impacting your brain,? Convit said. ?Kids who are struggling with their weight
and moving toward having MetS may have lower grades, which could ultimately
lead to lower professional achievement in the long run.?

?These are run-of-the-mill, garden-variety kids, not kids that came into the
hospital because they were sick. It is imperative that we take obesity and
physical activity seriously in children. In this country, we?re taking away gym
class in order to give children more class time in an effort to improve school
performance, but that effort may be having the exact opposite effect.?

The study, funded by the National Institutes of Health, appeared online in
Pediatrics.

Source: New York University School of Medicine

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