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Childhood Obesity
Childhood Obesity
is a condition where excess body fat negatively affects a child's health or well being.
Epidemiology• The prevalence has increased at
an alarming rate.• Globally, in 2013 the number of
overweight children under the age of five, is estimated to be over 42 million.
• In 1996, Egypt had the highest average BMI in the world at 26.3.
• In 1998, 1.6% of 2- to 6-year-olds, 4.9% of 6- to 10-year-olds, 14.7% of 10- to 14-year-olds, and 13.4% of 14- to 18-year-olds were obese.
Diagnosis of childhood obesity
• Body mass index (BMI) is acceptable for determining obesity for children two years of age and older.Formula: weight (kg) / [height
(m)]2
• The normal range for BMI in children
vary with age and gender.
• While a BMI above the 85th percentile is defined as overweight, a BMI greater than or equal to the 95th percentile is defined as obesity by CDC.
• References:- Haemer MA, Daniels SR. Special issues in treatment of pediatric obesity. In: Gray GA,
Bouchard C, editors. Handbook of obesity, volume 2: clinical applications. 4th ed. Boca Raton: CRC Press; 2014.
Public Health Agency of Canada (2012). Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights. http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/framework-cadre/index-eng.php
http://www.ncbi.nlm.nih.gov/pmc/articles/ http://www.who.int/countries/egy/en/ http://www.cdc.gov/healthyschools/obesity/facts.htm
• Name :- Mostafa Mohamed Mostafa Abdelkader
• ID :- • 897
Thank you
Causes of childhood obesity
• By: Mustapha Mansour Ahmed • No.: 898
• Genetics and early life factors.– Leptin encoding gene mutation.– Syndromes with certain genetic
mutations. (Prader-Willi).• Neuroendocrinal causes.
– Hypothyroidism.– Cushing’s $.– 1ry hyperinsulinism.
Diet and Energy input.
Physical activity and
Life style.
Thank you
METABOLIC SYNDROME
ابراهيم حلمي معتز يونس
900
Metabolic syndrome
High blood glucose level
Visceral obesity
Reduced HDL
Raised triglycerides
High arterial blood
pressure
High arterial blood pressurepathophysiology
obesity insulin resistance
hyperinsulinemia
increases the
sympathetic activity
Increases the activity in the renin-angiotensin
system
hypertension
Classification Systolic or diastolic blood pressure*Normal < 90th percentile
Prehypertension 90th to < 95th percentile or ≥ 120/80 mm Hg†
Stage 1 hypertension 95th to < 99th percentile plus 5 mm Hg
Stage 2 hypertension > 99th percentile plus 5 mm Hg
Diagnosis
NHBPEP Classification of Prehypertension and Hypertension in Children and Adolescents
Management :
If blood pressure < normal
Lifestyle modification for several weeks
BP not on goal : add ACEI or ARB
BP not on goal : add CCB
BP not on goal : add carvedilol or nebivolol
mechanismHyperglycemia
• Impaired fasting glucose (IFG): IFG is 100-125 mg/dL
• Impaired glucose tolerance (IGT): A plasma glucose level (obtained 2 hours after a 75-g oral glucose challenge) > 140 mg/dL but < 200 mg/dL
• Hemoglobin A1c (A1c): A1c level of 5.7%-6.4% as an indicator of prediabetes. The advantage of A1c measurement is that it reflects plasma glucose levels over time and does not require fasting
Prediabetes
Criteria for diagnosing diabetes in childhood are based on glucose levels and the presence of symptoms :
1. Fasting glycemia > 126 mg/dl 2. Post-overload glucose levels with 1.75 g/kg of anhydrous glucose up to 75 g dissolved in water, ≥ 200 mg/dl3. Classic symptoms of diabetes and casual glycemia ≥ 200 mg/dl, where ‘casual’ is defined as any time of day, not related to the last meal, and ‘classic symptoms’ include polyuria, polydipsia and unexplainable weight loss.
Plasma C peptide levels over 1 ng/mL one year after diagnosis are highly suggestive of T2D
Diet
Exercise
pharmacotherapy
Management
By: Manar SabryNo.: 902
Prevention and treatment of child obesity
• OFFICE-BASED MANAGEMENT.
• MULTIDISCIPLINARY AND COMMUNITY-BASED MANAGEMENT.
OFFICE-BASED MANAGEMENT. Anticipatory Guidance: Establishing Healthy Eating Habits in Children
•Do not punish a child during mealtimes with regard to eating. The emotional atmosphere of a meal is very important. Interactions during meals should be pleasant and happy
• Do not use foods as rewards.
•Parents, siblings, and peers should model healthy eating, tasting new foods, and eating a well-balanced meal.
• Children should be exposed to a wide range of foods, tastes, and textures.
• Foods should be offered multiple times. Repeated exposure to initially disliked foods will break down resistance.
• Offering a range of foods with low energy density helps children balance energy intake.
• Restricting access to foods will increase rather than decrease a child's preference for that food.
• Forcing a child to eat a certain food will decrease his or her preference for that food. Children's wariness of new foods is normal and should be expected.
• Children tend to be more aware of satiety than adults, so allow children to respond to satiety, and let that dictate servings. Do not force children to “clean their plate”.
MULTIDISCIPLINARY AND COMMUNITY-BASED MANAGEMENT.
• Community-based programs to inform families regarding age-appropriate healthy eating choices, meal and portion size planning, decreasing “screen time,” and approaches to increasing physical activity provide an important service for families with children at risk for becoming overweight or mildly to moderately overweight without comorbidities.
• Teams may include a physician, a psychologist, a dietitian, an exercise specialist (physical therapist, exercise physiologist, educator), a nurse, and counselors.
Proposed Suggestions for the Prevention of obesityPREGNAN
CY
POSTPARTUM
AND INFANC
Y
FAMILIES SCHOOLS
COMMUNITIE
S
HEALTH CARE
PROVIDERSINDUSTR
Y
GOVERNMENT AND
REGULATORY AGENCIES
MEDICATIONS.
Pharmacologic treatment is sometimes
indicated as an adjunct to diet
and physical activity in
overweight adults with
obesity -related complications.
sibutramine
Orlistat
Topiramate
Metformin
octreotide
Rimonabant