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One in Two Children Has Chronic Health Issues
Date:2/16/2010

But study also found most conditions, such as obesity, asthma and ADHD, did not persist

TUESDAY, Feb. 16 (HealthDay News) -- One in every two U.S. children now grapples at some time with a chronic health condition, such as asthma, attention-deficit hyperactivity disorder (ADHD) or obesity, new research suggests.

The good news is that for many of those children, their chronic childhood illness won't persist. Just over 7 percent of those who reported a chronic condition at the beginning of the study still had the condition six years later.

"Over time, we found the rates of chronic conditions and obesity in U.S. children increased, but quite a few of these conditions resolved on their own," said study author Dr. Jeanne Van Cleave, a pediatrician at MassGeneral Hospital for Children in Boston.

The findings are published in the Feb. 17 issue of the Journal of the American Medical Association.

A chronic health condition is one that lasts at least 12 months, according to the study. Some of the conditions included asthma, type 1 diabetes, type 2 diabetes, epilepsy, cystic fibrosis, heart problems, allergic conditions, learning disabilities, hyperactivity, sinus infections, ear infections and more. Obesity was defined as a body-mass index in the 95th percentile or higher for the child's gender and age.

The researchers conducted the study using three different groups of children. The first cohort, which included 2,337 children, was interviewed during 1988 to 1994; the second, which included 1,759 children, was interviewed during 1994 to 2000 and the final group, which included 905 children, was interviewed from 2000 to 2006.

At the beginning of each period, the children were between the ages of 2 and 8; chronic conditions were confirmed by reports from parents.

At the end of each study, the prevalence of chronic illness or obesity was 12.8 percent in the first (earliest) group, 25 percent for the second group and 26.6 percent for the third (and most recent) group. The third group also had the highest prevalence of reporting a chronic condition at any time during the six-year study period, with 51.5 percent reporting a chronic condition at some point during the study.

The risk of having a chronic condition was higher for males, and for children who were black or Hispanic. Kids who had overweight mothers were far more likely to be overweight themselves, according to the study.

What surprised the authors, however, was that the chronic conditions weren't always lasting. Overall, only 7.4 percent of the children who had a chronic condition at the start of the study still had that same condition at the end of the research period.

"We've always thought of chronic conditions as quite permanent, so these findings give a lot of hope for kids with chronic conditions and obesity," said Van Cleave.

She said these findings also raise a number of research questions, as well as point to the need for good health care, including prevention and education services.

"It's likely that a lot of these conditions resolved because families made lifestyle changes, such as eating healthier foods, reducing screen time and becoming more physically active," she said.

"The burden of chronic disease in children is pretty high," said Dr. Geetha Raghuveer, a cardiologist and an associate professor at Children's Mercy Hospital in Kansas City, Mo.

Raghuveer said she isn't sure how much of the fluctuation in chronic conditions is real, because they're based on parental reports. "Some of the major issues here, like established childhood obesity, don't fluctuate and go away in our experience without a rigorous attempt. Although it's probably reassuring that at least some of these conditions may go away in time," she said.

But the bottom line, she said, is that U.S. children need better health habits. "This is just another study emphasizing what many already knew. And, if we don't eradicate the root causes, such as bad eating and little exercise, we'll continue to see a lot more morbidity in children," Raghuveer said.

"I'm seeing more and more kids with high cholesterol and insulin resistance that already have blood vessel damage in them. They're already like a 45-year-old in terms of blood vessel health. We need a basic change in how we live and how we eat. Prevention is key," she stressed.

More information

To learn more about raising healthy children, visit the U.S. Centers for Disease Control and Prevention.



SOURCES: Jeanne Van Cleave, M.D., pediatrician, MassGeneral Hospital for Children, Boston, and instructor, Harvard Medical School, Boston; Geetha Raghuveer, M.D., M.P.H., cardiologist, and associate professor, Children's Mercy Hospital, Kansas City, Mo.; Feb. 17, 2010, Journal of the American Medical Association


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