Childhood Obesity: Obesity:

Part 1Part 1

Provided Courtesy of Nutrition411.com

Adapted with permission of Lucille Beseler, MS, RD, LDUpdated by Nutrition411.com staff Review Date 6/13 K-0527

Objectives

• Review current statistics on the prevalence of obesity

• Discuss consequences of obesity in children• Outline causes of obesity• Discuss assessment and evaluation of the

obese child• Treatment: What can health professionals do?• Prevention• References

Obesity in the US: A Obesity in the US: A Major Public Health Major Public Health ProblemProblem

• The greatest health concern affecting our children is the epidemic of obesity and overweight

• 12.5 million children are obese• In one generation, the childhood obesity rate has

tripled• Obese children are more likely to become obese

adults• The Centers for Disease Control and Prevention

speculates children suffering from obesity may have a lower life expectancy than ever before

Source: http://www.CDC.gov. Centers for Disease Control and Prevention Web site. Accessed June 13, 2013.

Obesity in the US: A Obesity in the US: A Major Public Health Major Public Health Problem Problem (cont’d)(cont’d)

• No one has escaped the epidemic of obesity:– All genders– All ages– All racial/ethnic groups

• Dramatic increase is seen in the prevalence of obesity over very short periods of time

Weight Concern in the 1950s

Obesity Trends* Among US AdultsBRFSS, 1991, 1996, 2003

(*BMI ≥30, or about 30 lb overweight for 5’4” person)

No Data <10% 10%-14% 15%-19% 20%-24% ≥ 25%

BMI=body mass index, BRFSS=Behavioral Risk Factor Surveillance System, lb=pounds

Health Professionalsto the Rescue

How did this happen?• Obesity is a chronic condition that has

taken a significant number of years to develop

When did we become concerned?• Not soon enough!• Cost $147 billion to treat obesity-related

disease

Is It Only America?

• This is a global problem—other countries are experiencing similar problems

• The World Health Organization estimates that 42 million children under 5 years of age are overweight worldwide

Source: Childhood overweight and obesity. World Health Organization Web site. http://www.who.int/dietphysicalactivity/childhood/en/. Accessed June 13, 2013.

Medical Complications of Medical Complications of Obesity

PhlebitisVenous stasis

Coronary heart disease

Pulmonary diseaseAbnormal functionObstructive sleep apneaHypoventilation syndrome

Gallbladder disease

Gynecologic abnormalitiesAbnormal mensesInfertilityPolycystic ovarian syndrome

Gout

Stroke

Diabetes

Osteoarthritis

CancerBreast, uterus, cervixcolon, esophagus, pancreas,kidney, prostate

Nonalcoholic fatty liver diseaseSteatosisSteatohepatitisCirrhosis

HypertensionDyslipidemia

Cataracts

Skin

Idiopathic intracranial hypertension

Severe pancreatitis

Health Problems Health Problems Associated With Obesity Associated With Obesity in Childrenin Children

• High blood pressure and high cholesterol, which are risk factors for cardiovascular disease

• Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes

• Breathing problems, such as sleep apnea and asthma

• Joint problems and musculoskeletal discomfort• Fatty liver disease, gallstones, and

gastroesophageal reflux (ie, heartburn)• Greater risk of social and psychological problems,

such as discrimination and poor self-esteem

Source: Basics about childhood obesity. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/obesity/childhood/basics.html. Updated April 27, 2012. Accessed June 13, 2013.

Consequences of Weight Consequences of Weight Problems in ChildrenProblems in Children

• Obese kids suffer physically and emotionally throughout childhood

• Quality of life issue is extremely important, not to be overlooked

• Overweight children as young as 5 years of age develop negative self-image

• Obese adolescents:– Have low self-esteem– Are more often sad and lonely– Engage in high-risk behaviors

Source: Swallen KC, Reither EN, Haas SA, Meier AM. Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics. 2005;115(s):340-347.

Contributing Factors

Obesity: The Great Debate

• Energy balance• Physical inactivity• Food choices• Eating behaviors• Meals consumed away from home

• Genetics• Community design• Automobile culture• Parenting practices and behavior

• Individual foods/soft drinks

• Television, computer, games

• The food industry• Agriculture policy• Cheap food• School lunches• Vending machines• The environment• Individual responsibility• Fast food

Diet-Related Causes

• Increased calorie consumption• Sugar and fat intakes have increased

significantly, mostly from: – Snacks– Juice/soda– Foods eaten away from home

Contributing Factors

• Fast-food chains in schools, including preschools (delivery)

• Over-snacking children, especially during toddlerhood, which may affect satiety

• Aggressive advertising by food companies and fast-food restaurants is targeted at children (Saturday morning television), resulting in poor food choices vs fruit, vegetables, and whole grains

• At-home physical activity is replaced by PlayStation, Wii, computer, or television

Contributing Factors (cont’d)

• Restricting young children’s access to foods does not promote moderate intake of restricted foods

• Study does not suggest abandonment of structure in child feeding

• Limit setting is an important part of child feeding

• Families need guidance to prevent overly restrictive approaches

Source: Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5-7 y of age. Am J Clin Nutr. 2002;76(1):226-231.

Contributing Factors (cont’d)

• Offering food to children in the absence of hunger is associated with an increased risk of overweight

• Girls 5 to 7 years of age who ate large amounts of snack foods in the absence of hunger were 4.6 times more likely to be overweight

Source: Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5-7 y of age. Am J Clin Nutr. 2002;76:226-231.

Contributing Factors (cont’d)

• Genetic predisposition in conjunction with parental feeding attitudes and styles

• Children born at a high risk for overweight experience more rapid weight gain by 6 years of age than do children at low risk for obesity

• Latest news: Mother’s diet in pregnancy linked to childhood obesity

Source: Faith MS, Berkowitz RI, Stallings VA, Kerns J, Storey M, Stunkard AJ. Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction. Pediatrics. 2004:114(4);e429-e436.