From
StayCurrentMD
Exercise Journal Club: Pediatric Obesity 2017
With Dr. Jody Dimanta · hosted by Dr. Em Gootee
Chapter 1 of 3 · Evidence & Research
Study overview
Study presentation: Summer versus school-year obesity prevalence growth
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
In clinical practice, calculating total weekly structured activity minutes from PE class, recess, and extracurriculars reveals that some kids have as little as 100 minutes per week while others have as much as 500 minutes per week
Activity planning is very individual and requires constantly evaluating what works for each family at a particular time
In the Choosing Healthy and Active Lifestyles for Kids program, schools can control kids during the school year and most kids eat breakfast and lunch at school, but there is not great control during summer
In Maine, physical activity is the behavior that isn't changing as much as desired over the last 10 years of tracking
There is a significant correlation between obesity and ADHD, with decreased dopamine activity proposed as a common underlying pathway contributing to both conditions
Stimulants act to increase dopamine activity, and taking a break from stimulant medication puts patients in a position where they are seeking more input, which might be from food or other environmental stimuli
For weight management, the recommendation is to take stimulant medication every day with no breaks, including weekends and summer, because it helps with functioning in every realm of life
Beta blockers and antihistamines are medications known to aggravate obesity
Some children on ADHD medications struggle to maintain weight and may need medication breaks, particularly when side effects include blood pressure issues or personality changes
For children with obesity whose main ADHD manifestation is impulsivity, which can affect eating habits, staying on medication regularly is more likely to be recommended
The study sample consisted of 13,006 children from 846 schools after excluding children with missing covariates and children from year-round schools
Children's height and weights were measured each fall and spring for a total of 6 occasions, with fall measurements taken 5-7 weeks after the first day of school and spring measurements taken 8 weeks before the last day of school
Obesity prevalence increased from 8.9% to 11.5% and overweight prevalence increased from 23.3% to 28.7% over the study period
All increases in obesity and overweight prevalences occurred during the two summer vacations with no increases during any of the three school years
During summer 1 and summer 2, both overweight and obesity prevalences increased by approximately 1% point per month
Over the average summer vacation of 2.6 to 2.7 months, there was a 2-3% rise in overweight and obesity points
During the school year, there was a decrease in obesity prevalence during kindergarten and second grade years
The standard deviation of BMI growth is approximately 3 times greater during the 2 summers than during the 3 school years
Children tend to sleep less and watch more screen time during summer
School-based interventions that tried to carry things over into the summer for families did not show any positive effect
In Minnesota, the requirement for gym class is 1 year out of 4 years of high school, with only half of that year being gym and the other half being health
