ELI 82 (3): Advanced ESL Reading
Name:
RC #1
Date: September 30, 2009
Overweight Children: Living Large
By Alice Park
http://www.time.com/time/magazine/article/0,9171,1813962,00.html
1.
Cholesterol, soaring blood pressure, a fatty liver, dangerously elevated insulin levels.
Even a first-year medical student could recognize the signs of a middle-aged patient
struggling with weight problems and diabetes and probably heading for a heart attack.
2.
And in most cases, that med student would be right. But increasingly, the same
deadly mix of problems is appearing in a startlingly younger population: teens and
adolescents barely through their second decade of life. While the obesity epidemic is
starting to show signs of waning, doctors are bracing for the more lasting legacy it leaves
behind--a cohort of kids who are getting sick earlier or, at the very least, are a whole lot
likelier to develop serious problems later. "We are seeing conditions that we as
pediatricians are not used to seeing in children," says Dr. Seema Kumar of the Mayo Clinic
in Rochester, Minn. "And we are seeing these a lot more."
3.
The comparative novelty of such early-onset diseases makes them particularly tricky
to treat, since extensive studies on the long-term consequences of childhood obesity just
don't exist yet. But doctors know enough from work on adults to be worried. Overweight
people of any age are at risk of not only better-known ills like cardiac disease but also
arthritis, joint damage and sleep apnea. Adults who were overweight as children have
nearly twice the risk of dying from any cause in their 70s than are adults who were of
normal weight as youngsters. Early evidence also suggests that heavier children are even
35% more likely to develop cancer in their later years. "If you are a fat kid, you know you're
in trouble," says Dr. Robert Lustig, a pediatrician at the University of California, San
Francisco, "and you know you need to do something about it now and not later."
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ELI 82 (3): Advanced ESL Reading
Name:
RC #1
Date: September 30, 2009
4.
Of all the ills overweight kids risk, the two that may be the most complex and thus
earn a lot of new research attention--concern breakdowns in the function of the liver and
pancreas. Mess with these organs, and you mess with some very fundamental metabolic
systems that govern how well the body recruits and uses energy--a system wide disruption
that causes system wide harm.
5.
To understand the damage that obesity can do, investigators first have to
understand the very dynamics of fat, and that knowledge has been slow in coming. The
accepted wisdom had long been that we're all born with a fixed number of fat cells, and
gaining or losing weight is simply a matter of filling or emptying them. But things are more
complicated than that. As children develop, they continue to add fat cells to their body--at
least until a certain age. Scientists don't yet know if kids who eat more food accumulate
more cells, but studies in the 1960s pointed in that direction. However many fat cells you
have, it becomes increasingly hard, as that fat bank grows, to pare it down, even in
adulthood.
6.
And far from being inert, excess fat, researchers now know, is actually an active
participant in the body's biological ballet--particularly if it's visceral fat, which can
surround and even suffuse organs like the liver. Relatively shallow subcutaneous fat, which
sits just under the skin, imposes a weight burden on the body but remains biologically
dormant--more a repository for energy than anything else. Visceral fat cells can secrete
hormones and cytokines that help control inflammation and guide energy use by all the
body's other cells. Normally this regulation of cellular fueling is maintained by a wellbalanced relay of metabolic signals. As food calories are absorbed, the pancreas secretes
insulin, which prompts the liver to convert sugars into fat. Fat cells then release leptin, a
hormone that puts the brakes on eating. Leptin does this by passing along the message that
the body is satisfied with the deposit of calories it has received.
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ELI 82 (3): Advanced ESL Reading
Name:
RC #1
Date: September 30, 2009
7.
Overloading the body with too many calories and keeping insulin levels high short-
circuits this loop and can lead to insulin resistance and Type 2 diabetes, in which organs no
longer respond to changing insulin levels. The result: a brain and body that are constantly
hungry and in need of more food. Disrupting the insulin threshold usually takes decades-which explains why this form of diabetes was generally more common in adults over age
30 and why the more genetically driven Type 1 diabetes was more prevalent among
children. Before 1994, only about 5% of school-age children with a diabetes diagnosis had
Type 2, but today anywhere from 30% to 40% of diabetic kids are told they have Type 2.
And use of insulin-controlling medications to treat the disease in children rose 150% from
2001 to 2007.
8.
Even more alarming to doctors are the changes that excess weight can wreak on
the liver. It's this organ, after all, that orchestrates the breakdown and distribution of fats
and sugars from the diet. When too much of either comes in, the liver starts to keep some of
the excess for itself, converting sugars from soft drinks and the ubiquitous high-fructose
corn syrup into fat that remains within its tissues.
9.
Many overweight children already show abnormal levels of liver enzymes, and
fully one-third suffer from fatty liver, a condition in which the organ becomes streaked
with fat. "I worry about the outcome of these children 10 to 20 years from now," says Dr.
Miriam Vos, a pediatrician and liver expert at Emory University. "In adults, we know that 3%
to 5% of those with fatty-liver disease will progress on to cirrhosis or to an advanced stage
where you might need a liver transplant." While not all cases reach such a dangerous state,
Vos notes that in about 23% of children with fatty-liver disease, excess fat can lead to
inflammation and scar tissue in the organ--the first signs of trouble.
10.
During the early stages of these liver changes, however, there is hope. Vos' work
shows that just as fat can be recruited into the liver, it can also be coaxed out, as long as the
child eats properly and stays active enough to keep calorie input in line with what's burned
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ELI 82 (3): Advanced ESL Reading
Name:
RC #1
Date: September 30, 2009
off. Kumar says the key to reversing liver abnormalities--not to mention all the additional
burdens excess fat places on the heart, bones and other organs--is to detect signs of weight
gain in kids early. "We don't want to get to the point where children are so overweight,
they have trouble moving," she says. "If that happens, we've lost the battle." As any parent
of an overweight child knows, in the war on obesity, every battle counts.
VOCABULARY LIST: N (Noun), V (Verb), A (Adjective), Adv (Adverb)
1. Insulin (N): A hormone that most people produce naturally in their body and which
controls the level of sugar in their blood Ex: In diabetes the body produces
insufficient insulin.
2. Epidemic (N): A particular disease OR (Problem) in a large number of people at the
same time Ex: Crime and poverty are epidemic in the city.
3. Cohort (A): A group of people who share a characteristic, usually age Ex: This study
followed up a cohort of 386 patients aged 65 + for six months after their discharge
home.
4. Cardiac (A): Of or relating to the heart Ex: Cardiac muscle is the muscle out of which
the heart is made.
5. Apnea (N): Temporary absence of breathing or inability to breathe Ex: The patients
with obstructive sleep apnea syndrome can undergo surgery safely.
6. Pediatrician (N): A doctor who has special training in medical care for children Ex:
under the pediatrician’s good care, the baby recovered quickly.
7. Subcutaneous (A): Located, found, or placed just beneath the skin Ex: A
subcutaneous layer of loose connective tissue containing a varying number of fat
cells.
8. Visceral (A): relating to or affecting the viscera Ex: Visceral pain is often described as
generalized aching or squeezing.
9. Resistance (N): A force that tends to oppose or retard motion Ex: I can never resist
temptation.
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ELI 82 (3): Advanced ESL Reading
Name:
RC #1
Date: September 30, 2009
10. Leptin (N): A hormone that is produced by fat cells and plays a role in body weight
regulation by acting on the hypothalamus to suppress appetite and burn fat stored
in adipose tissue Ex: Many people over weight suffer from leptin resistance.
11. Ubiquitous (A): being present everywhere Ex: Coffee shops are ubiquitous these
days.
12. Enzyme (N): A protein molecule that helps other organic molecules enters into
chemical reactions with one another but is itself unaffected by these reactions. In
other words, enzymes act as catalysts for organic biochemical reactions. Ex: An
enzyme in the saliva of the mouth starts the process of breaking down the food.
Comprehension Questions
1. Why is childhood obesity with the early onset characteristic tricky to be treated?
2. What are two major organs and their important consequences the author emphasis
in relation to obesity in this article?
3. How do visceral fat and subcutaneous fat differ from each other on location and
function? Fill in the following table.
visceral fat
subcutaneous fat
Location
Function
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ELI 82 (3): Advanced ESL Reading
Name:
RC #1
Date: September 30, 2009
4. Explain Type 1 diabetes and Type 2 diabetes, respectively. Which one is more
common among school children?
Type 1:
Type 2:
5. How many percent of school-age kids with Type 2 diabetes have increased since
1994?
6. If someone lives with an overloaded calories diet and he doesn’t get insulin
resistance or diabetes now, does that guarantee he will still be safe in another ten
years?
Discussion Questions
1. Do you know any school kid, who is extremely overweight? How does that excess fat
affect his/her daily life? Think about it in terms of health and social life.
2. When it comes to food, if there are many of your favorite foods available to you, do you
continue eating even after you feel full?
3. What advice or tips you want to give to people around you to prevent obesity?
4. Do you think the environment where people live does affect the way they live and eat?
How?
5. In your opinion, who should be responsible for child obesity?
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