Childhood Obesity Childhood Obesity EuropeEurope

Childhood Obesity Childhood Obesity OverviewOverview

Definition, FactsDefinition, Facts The WHO Organization The WHO Organization

Factors & Consequences Factors & Consequences Affecting ObesityAffecting Obesity

Measuring Obesity (BMI)Measuring Obesity (BMI)

Prevalence of Obesity Prevalence of Obesity in Europe (EYHS) in Europe (EYHS)

Prevention GuidelinesPrevention Guidelines

WHO:WHO:

Overweight & Obesity are defined as Overweight & Obesity are defined as abnormal or excessive fat accumulation abnormal or excessive fat accumulation that may impair health. that may impair health.

• Established in 1948, The World Health Organization (WHO) is the United Nations specialized agency for health.

• WHO's defines Health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

• World Health Assembly is composed of 193 Member States

• Obesity is a Global Concern

WHO Facts 2005-06 data: World: 1.6 billion adults (age 15+) overweight

400 million rated obese 20 million (age < 5) are overweight

European obesity estimates: 20% (150 million adults) 10%(15 million child)

By 2010, WHO expects 1 in 10 European childrenwill be obese and currently obesity is the most common childhood disorder in Europe.

International Obesity TaskForce (IOTF) is part of an International Association for the Study of Obesity (IASO), a global federation for researching and understanding the science behind obesity.

Global social trends affecting obesity:

• Increased use of motorized transport e.g. to school

• Fall in opportunities for recreational physical activity

• Increased sedentary recreation

• Multiple TV channels around the clock.

• Greater quantities and variety of energy dense foods available (fat is energy dense).

• Rising levels of promotion and marketing of energy dense foods

• More frequent and widespread food purchasing opportunities

• More use of restaurants and fast food stores.

• Larger portions of food offering better “value” for money.

• Increased frequency of eating occasions

• Rising use of soft drinks to replace water e.g. in schools

Health Consequences of Obesity:

• Cardiovascular disease (mainly heart disease & stroke)

world’s #1 cause of death, killing 17 million people worldwide each year

• Diabetes - a world epidemic. WHO projects 50% increase in the next decade worldwide.

• Musculoskeletal disorders, especially osteoarthritis

• Some cancers ( endometrial, breast, colon)

• Childhood Obesity is associated with a higher chance of premature adult death/disability.

• “Double Burden” factor in low and middle-income countries. Caused by inadequate

pre-natal, infant, and child nutrition followed by an exposure to high-fat,

energy dense, micronutrient-poor foods and a lack of physical activity.

• WHO has found under-nutrition and obesity existing side-by-side within the same

country, same community, and even in the same household.

CLASSIFICATION BMI KG/M2

PRINCIPLE CUT-OFF POINTS

NORMAL RANGE 18.50-24.99

OVERWEIGHT ≥ 25.00

PRE-OBESE 25.00-29.00

OBESE ≥ 30.00

OBESE CLASS 1 30.00 - 34.99

OBESE CLASS 2

35.00

OBESE CLASS 3 ≥ 40.00

BMI CLASSICATION TABLE

Measuring Obesity Using the Body Mass Index (BMI)

BODY MASS INDEX (BMI) Formula, Weight ( Kg)/Height (M2)

A simple index of weight-for-height that is Commonly used to classify underweight,Overweight, and obesity in adults. Absolute inScale and applies to everyone

Example,

Height Wt.Range

BMI Considered

5” 9” 124 lbs. or less

Below 18.5 Underweight

125 lbs to 168 lbs

18.5 to 24.9 HealthyWeight

169 lbs to 202 lbs

25 to 29.9 Overweight

203 lbs or more

30 or higher Obese

BMI for age is adjusted for children with the same age and same gender

• RED = OVERWEIGHT

• YELLOW = AT-RISK FOR BEING OVERWEIGHT

• GREEN = HEALTHY WEIGHTCATEGORY

• ORANGE = UNDERWEIGHTCATEGORY

AgeAge BMI HealthyBMI Healthy

RangeRange

1010 14.2 - 19.414.2 - 19.4

1313 15.5 - 21.715.5 - 21.7

1515 16.5 - 23.516.5 - 23.5

AdultAdult 18.5 - 24.9918.5 - 24.99

Using the Body Mass Index (BMI)

Advantages: • Inexpensive to use making it practical• Can be used on everyone making it universal• Easy to interpret with a standard measurement in a table

Disadvantages:• Results are not precise in measurement of Fat content.For example, a larger individual muscular bound athlete might be rated obese because their weight although lean, weighs more and this increasethe BMI. BMI correlates with an amount of body fat but does not directly measure body fat.

Other methods exist to calculate body fat content Which include, underwater weighing, skin fold calipers, bioelectricImpedance. This measures electrical impulses traveling through bodytissues such as fat. This method is considered most accurate becauseit can measure fat and not just estimate.

European Youth Heart Study• Incorporates 10 EU partners and 1 Non-EU (Australia)• Each of the 18 locations a study consists of at least 1000 Boys & Girls ages 9 to 15

Primary Goal: Ultimate aim is to reflect the full spectrum of Adult CardioVascular Disease (CVD) throughout Europe

• Principal assessment are Cardio Vascular Disease (CVD) factors • physical activity levels • Blood pressure • Blood lipid levels • Smoking habits.• Other CVD factor assessments • Body mass indexing • insulin levels • Nutritional status • Food intake,• Demographic, socio-economic, and environmental issues • Family support • Parental lifestyle • Intention to change behavior • Barriers to healthy behavior • Self-confidence & Stress levels • Alcohol intake • Use of leisure time.

0

5

10

15

20

25

30

Boys Girls

% ≥85 Centile

Denmark Sweden FinlandIreland Lithuania USA

Prevalence of BMI for 13 years-old ≥ 85th percentile

(At-Risk)

0

2

4

6

8

10

12

14

Boys Girls

% ≥ 95 Centile

Denmark Sweden FinlandIreland Lithuania USA

Prevalence of BMI for 13 years-old ≥ 95th percentile

(Overweight)

0

5

10

15

20

25

30

35

40

45

50

fat percent 14.6 15.9 23.2 22.8

fitness levels 49 47 43 42

Boys 1985 -87

Boys 1997 -98

Girls 1985 -87

Girls 1997 -98

Multiple Factors in Cardio Vascular Disease (CVD)Body Fat & Fitness Level Changes in 9 year-old Danish Boys and Girls

Using multiple 2-year periods

Prevention GuidelinesPrevention Guidelines

WHO recommends, WHO recommends,

• • Provide clear and consistent consumer information e.g. food labelsProvide clear and consistent consumer information e.g. food labels

• • Encourage food companies to provide lower energy food, more nutritious foods Encourage food companies to provide lower energy food, more nutritious foods marketed for childrenmarketed for children

• • Develop criteria for advertising that promotes healthier eatingDevelop criteria for advertising that promotes healthier eating

• • Design secure play facilities and safe local neighborhoodsDesign secure play facilities and safe local neighborhoods

• • Encourage schools to enact coherent food, nutrition, and physical activity policiesEncourage schools to enact coherent food, nutrition, and physical activity policies

• • Encourage medical and health professionals to participate in the development of Encourage medical and health professionals to participate in the development of public health programspublic health programs