Extremely obese children have 40 percent higher risk of reflux disease of the oesophagus 

LONDON – Extremely obese children have a 40 percent higher risk of gastroesophageal reflux disease (GERD) and children who are moderately obese have a 30 percent higher risk of GERD compared to normal weight children, according to a new Kaiser Permanente study published online in the International Journal of Paediatric Obesity.
 
This large population-based study establishes an association between obesity and GERD in children, an association that has been previously reported in adults. GERD can lead to decreased quality of life, chronic respiratory conditions, and increased risk for cancer of the oesophagus (the tube that carries food from the mouth to the stomach) if it persists through adulthood. 
 
Researchers used electronic health records to conduct a cross-sectional study of 690,321 children aged 2 – 19 years who were members of the Kaiser Permanente Southern California integrated health plan in 2007 and 2008.
 
About eight to twenty five percent of children in the U.S. may be affected by frequent symptoms of gastroesophageal reflux, depending upon their age and body mass index. GERD is a chronic condition in which the liquid content of the stomach flows up in to the oesophagus. This can inflame and damage the lining of the oesophagus. GERD may be responsible for an increased occurrence of coughs, asthma, and inflammation of the larynx. Left untreated, GERD may result in chronic oesophageal inflammation and lasting damage to the oesophagus. Cancer of the oesophagus is the nation’s fastest growing cancer and is expected to double in frequency in the next 20 years -- unlike most other cancers, which are decreasing in frequency. Researchers suspect this rise is due in part to the nation’s epidemic of obesity.
 
“Childhood obesity, especially extreme childhood obesity, comes with a high risk for many serious health consequences such as diabetes, cardiovascular disease and cancer. The takeaway message of our study is that GERD now also is one of the conditions associated with childhood obesity” said study lead author Corinna Koebnick, PhD, a research scientist at the Kaiser Permanente Southern California’s Department of Research and Evaluation in Pasadena, California. “Beyond counselling for weight loss, obese children who report symptoms of GERD may need to be treated for the underlying reasons to help avoid persistence of GERD into adulthood and to prevent its complications. “
 
“Even though some health conditions associated with extreme childhood obesity may not seem important early in life, they can be a significant burden for the patient and a link to other serious conditions later in life. We need to be aware of these links, search for obesity-related conditions and address childhood obesity as a family issue as early as possible,” noted Dr. Koebnick.
 
Previous research into the association between obesity and GERD was hospital-based instead of population-based, included mainly people with asthma, and did not address extreme childhood obesity. In this study, the percentile of the measure of a child's weight in relation to height for age was calculated according to the 2000 U.S. Centres for Disease Control and Prevention recommendation to assign a weight class (normal weight, overweight, moderate and extreme obesity).Children in the study had an average of 2.6 medical visits per year where height and weight were measured.
 
This study is part of the Kaiser Permanente Southern California Children’s Health Study, Kaiser Permanente's ongoing work to identify and treat childhood obesity through research and community programs.
 
Other study authors included: Darios Getahun, MD, Ning Smith, MS, and Steven J. Jacobsen, MD, PhD, from the Kaiser Permanente Department of Research and Evaluation in Pasadena, California.; Amy H. Porter, MD, from the Kaiser Permanente Baldwin Park Medical Centre; and Jack K. Der-Sarkissian, MD, from the Kaiser Permanente Medical Centre, Los Angeles.
 
About the Kaiser Permanente Department of Research and Evaluation
The Department of Research and Evaluation conducts high quality, innovative research into disease etiology, prevention, treatment and care delivery.  Investigators conduct epidemiology, health sciences, and behavioural research as well as clinical trials. Areas of interest include diabetes and obesity, cancer, HIV/AIDS, cardiovascular disease, aging and cognition, pregnancy outcomes, women’s and children’s health, quality and safety, and pharmacoepidemiology. Located in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population.

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