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  • Denise Scott

Fighting the Childhood Obesity Epidemic (and Preventing Type 2 Diabetes in Children) - Part 3

The prevalence of type 2 diabetes (T2D) in youth has grown over the past thirty years. In this country, 4 in 1000 adolescents, ages 12-19, are affected. T2D in youth is increasing about 2.5 times faster than type 1 diabetes. 


Picture of an overweight adolescent female measuring her waist. This child is at risk for Type 2 diabetes which is more likely to affect pubertal girls.


First, let’s distinguish between the two types of diabetes.


Type 1 diabetes (T1D) is an autoimmune disease that affects the pancreas. An affected person cannot make enough insulin and develops high blood sugar because the insulin-making cells in the pancreas are destroyed by antibodies. A person with type 1 diabetes must take insulin by shot to control their blood sugar. 


Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is not an autoimmune disease. It is a disease of insulin resistance. A person makes high amounts of insulin to maintain normal blood sugar, but the insulin is not as effective. The person becomes resistant to insulin. This condition is usually treated with diet, oral medication, and sometimes insulin. 


If you think your child may be at risk for type 2 diabetes, please discuss this with your child’s doctor. Blood tests can screen for this. Being proactive is the first step. If your child has prediabetes, losing weight and having more physical activity can delay or prevent T2D. 


T2D develops gradually, unlike T1D, which comes on more quickly. High sugar levels can lead to the following symptoms in either type:

  • Increased thirst

  • Increased urination

  • Increased hunger

  • Fatigue

  • More frequent infections, such as skin and bladder

  • Blurred vision

  • Darkened areas of the skin under the armpits and the back of the neck (more common in T2D and insulin resistance) 

  • Weight loss (unintended) - more common in T1D


There are numerous known risk factors for developing T2D in children.


  • Obesity or being overweight

  • Diets high in processed foods and sugary beverages 

  • Inactivity

  • Family history of T2D

  • History of gestational diabetes in mother

  • Age and sex - T2D occurs after age 12 and during puberty in girls more often than boys 

  • Race/ethnicity - This is more common in Hispanic, Native American, and Black populations


Why is this trend alarming?


T2D leads to many complications that affect most of the body’s organs. These complications include:

  • Heart disease

  • High cholesterol

  • Stroke

  • Liver disease

  • Kidney damage

  • Nerve damage

  • Eye disease


If a child develops T2D, complications will occur at a much younger age, which can lead to a shorter lifespan.


Parents are the ones who are in charge of making changes that are good for the entire family. Children who are overweight, especially those with insulin resistance, are at risk for progressing to T2D. You can’t change your inherited factors, but you can change your lifestyle factors. You also can control what you purchase and bring into your home. If highly processed, sugary foods aren’t available, they can’t be eaten.


A visible sign of insulin resistance is darkened and thickened skin behind the neck and under the armpits. This is called acanthosis nigricans and is a sign of insulin resistance. If you notice this, please bring it to your doctor’s attention so they can test for insulin resistance and T2D. 

A photo of acanthosis nigricans - a visible skin sign of insulin resistance that can be seen under the arms and on the back of the neck.



Here are my Top Ten suggestions:


  1. Know what you are buying by reading labels. Look for products with a short (5 or fewer) ingredient list. Better yet, buy items that don’t need a label - fresh produce. Shopping the perimeter of the store offers the most nutrient-dense foods. Avoid foods with added sugar and ingredients you can’t pronounce (typically chemicals and additives).


When checking the nutrition label on a food item, sugars are listed under carbohydrates, and the amount is given in grams. 


An example of a nutrition label which shows total carbohydrates under which is listed sugars.


Added sugars are listed under total sugars.


2. We all like our sweets but learn which are healthier, with lower sugar, with fiber, and made with fruit or vegetables. See the Sweet Tooth article from 8/10/22 for ideas and search online for delicious recipes that make desserts from veggies. Eat more fruit as sweets and limit baked goods to a once-in-awhile treat.


3. Start your child’s day with a healthy, hearty breakfast with protein and fiber. Take ten extra minutes in the morning to ensure a healthy start to their day. See The Problem with Breakfast post, 12/7/22, for many breakfast ideas.


4. Incorporate healthy fats into your dietary repertoire with plant-based cooking oils, like olive and avocado oils, nuts, seeds, fatty fish, and avocado. See the post on Fats in the macronutrient section from 6/28/22.


5. Decrease consumption of refined grains with simple substitutions:

  • Brown rice instead of white rice

  • Whole wheat or whole grain bread and crackers rather than those made with white flour

  • Almond or oat flour for baking

  • Whole wheat or vegetable pasta instead of regular pasta

  • Increase your variety of grains with quinoa, farro, barley, oats, buckwheat, and more


6. Eat seafood twice a week.


7. Strive for several plant-based meals weekly - substitute beans, lentils, chopped mushrooms, or tofu for meat.


8. Use more spices and less salt when cooking. Buy fresh, frozen, low-salt, or no-salt items.


9. Fill half of your child’s plate with fruit and vegetables.


10. Stop buying sodas, juices, dessert coffee drinks, and sugar-sweetened beverages. 


You decide what to buy and bring into your house. If junk food isn’t there, it can’t be consumed, at least not in your home. Make one change a week to allow everyone to transition. 


Habits and palates CAN be changed!


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