Obese and Overweight Children Less is More

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Information about Obese and Overweight Children Less is More

Published on February 14, 2008

Author: Abbott

Source: authorstream.com

Obese and Overweight Children - Less is More!:  Obese and Overweight Children - Less is More! Shana R. Weber, DO, FAAP August 3, 2005 How Big are we Talking?:  How Big are we Talking? Measured in BMI or body mass index BMI = weight kg/ height m2 Plotted based on age/sex like any other growth curve Great estimate of adiposity but be careful when using it for adolescents that lift weights BMI between 85th and 95th percentile for age and sex is considered at risk of overweight, and BMI at or above the 95th percentile is considered overweight or obese. What are we Dealing with?:  What are we Dealing with? Overweight and obesity is increasing at an alarming rate in the developed/developing countries Proportion of obese youth has doubled in 25 years 1 in 4 students are overweight Poor diets/fast food, genetics, inactivity Who’s at Risk?:  Who’s at Risk? Children with overweight parents Lower socio-economic status Minorities especially African American, Hispanic, Native American and Alaska Natives Less physical activity Children with certain syndromes/endocrine abnormalities Simple Math:  Simple Math If a person takes in more calories than they burn, they will gain weight. “It Runs in our Family”:  “It Runs in our Family” Genetics do predispose some to obesity however it alone DOES NOT explain the dramatic increase in obesity in our youth. Children learn from example – eating patterns/choices and physical activity are learned. Home vs. school vs. combination Childhood obesity results from interaction of nutritional, psychological, familial, and physiological factors. Nutrition:  Nutrition Intake of dairy products has decreased 40% in the last 20 years. Schools and parents use high fat milk. 300% increase in consumption of carbonated beverages Males 12-19 avg 2 cans/day or 9% of their total daily caloric intake 20% of middle & high schools offer brand name fast food vendors Fruits/veggies more expensive. Nutrition:  Nutrition Bigger portions In a survey of adolescents in 1999 . . . < half ate a cooked vegetable the day before the survey < one third ate salad the day before > two thirds ate french fries or potato chips the day before the survey Inactivity at Home:  Inactivity at Home 20% of US children 8 to 16 years of age reported 2 or fewer bouts of vigorous physical activity per week > 25% watched at least 4 hours of television per day. Children who watched 4 or more hours of television per day had significantly greater BMI, compared with those watching fewer than 2 hours per day. A television in the bedroom has been reported to be a strong predictor of being overweight, even in preschool-aged children Inactivity at School:  Inactivity at School Daily participation in PE decreased from 42% in 1991 to 27% in 1997. 50% of districts require PE in elementary grades. 25% require PE through grade 8. Only 5% require PE through grade 12. Their Future:  Their Future cardiovascular health (hypercholesterolemia and dyslipidemia, hypertension) endocrine system (hyperinsulinism, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, menstrual irregularity) mental health (depression, low self-esteem). pulmonary (obstructive sleep apnea) orthopedic (genu varum, slipped capital femoral epiphysis) gastrointestinal/hepatic (nonalcoholic steatohepatitis). Premature death Our Future:  Our Future Extensive burden on the health care system Obesity-associated annual hospital costs for children and youth more than tripled over two decades, rising from $35 million in 1979-1981 to $127 million in 1997-1999. After adjusting for inflation and converting to 2004 dollars, the national healthcare expenditures related to obesity and overweight in adults alone range from $98 billion to $129 billion annually. If people continue to grow at this rate, who will be paying to remodel the airplanes, the movie theaters, other public arenas? We Must Start Early:  We Must Start Early Clinicians should intervene when children > or = 3 years of age become overweight. The risk of persistent obesity increases with the age of the child. change in adolescents was much more difficult to facilitate and sustain The family must be ready for change – permanent, small, gradual changes Positive reinforcement Interesting Facts:  Interesting Facts Almost ½ of American students in grades 1-3 indicate they wish to be thinner Of children older than 10 years, 80% are afraid of becoming fat. Reinforce it is a lifestyle change – no fad diets or quick fixes. Working on a Solution:  Working on a Solution In 2001, the U.S. Surgeon General issued the Call to Action to Prevent and Decrease Overweight and Obesity In 2002, Congress charged the Institute of Medicine (IOM) with developing a prevention-focused action plan to decrease the number of obese children and youth in the United States. Examine the behavioral, social, cultural, and other broad environmental factors involved in childhood obesity and to identify promising approaches for prevention efforts. Working on a Solution:  Working on a Solution The IOM appointed a committee of 19 experts in child health, obesity, nutrition, physical activity, and public health. Action plan is described in the report, titled Preventing Childhood Obesity: Health in the Balance. What they Recommend:  What they Recommend Joint efforts by. . . Federal government State and local governments Health care professionals Industry and media Community organizations State and local education authorities and schools Parents and families Solutions:  Solutions Health care providers Routinely track body mass index (BMI) Serve as role models! appropriate counseling and guidance to children and their families Promote breastfeeding Encourage healthy eating behaviors Exercise prescriptions Limit total screen time to less than 2 hours per day Solutions – Schools’ role:  Solutions – Schools’ role Nutrition Health education – make it fun, emphasize the appealing aspects of healthy eating rather than negative consequences Healthier selections in vending machines and/or limiting availability Eliminate fast food vendors Physical Education AAP recommends daily PE programs from K-12 Goal of 30-60 min of activity daily Coordinate PE with health education Offer a variety of activities Safe/supportive environment Community:  Community Offer activities that promote healthy lifestyles as a family such as family fun runs, cooking classes that focus on healthy but kid friendly foods, etc. Make families want to be out in the community Indutstry/Media:  Indutstry/Media Why is it you have a chance to win great prizes with a Big Mac or large fries but not with the salad or fruit cup? More than half of TV advertisements directed at children are promoting, candy, fast food, sugar cereals, snack foods, and soft drinks. Parents’ role:  Parents’ role The best educator for their children. The best role model for their children. Decrease screen time Healthier choices Eating/cooking as a family at home Increasing physical activity References:  References AAP Committee on School Health, School Health Policy and Practice 6th ed. 2004. Institute of Medicine. Preventing Childhood Obesity: Health in the Balance. 2004. Sarah E. Barlow and William Dietz. Obesity Evaluation and Treatment: Expert Committee Recommendations, Pediatrics September 1998, 102 (3):29. Prevention of Pediatric Overweight and Obesity PEDIATRICS Vol. 112 No. 2 August 2003, pp. 424-430   Physical Fitness and Activity in Schools PEDIATRICS Vol. 105 No. 5 May 2000, pp. 1156-1157

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