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Provided Courtesy of RD411.com Where dietitians go for information. Childhood Obesity Part 1. Adapted with permission of Lucille Beseler, MS, RD, LD. Review Date 1/08 K-0527. Objectives. Review current statistics on the prevalence of obesity Discuss consequences of obesity in children
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Provided Courtesy of RD411.com Where dietitians go for information Childhood Obesity Part 1 Adapted with permission of Lucille Beseler, MS, RD, LD Review Date 1/08 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 Major Public Health Problem • The greatest health concern affecting our children is the epidemic of obesity and overweight • 6 million children are overweight, enough to endanger their health • 5 million children are on the threshold • From 1990 to date children are 30% heavier • 97 million are overweight and obese—55% of the population • The CDC speculates children suffering from obesity may have a lower life expectancy than ever before Source: Centers for Disease Control and Prevention. Available at: http://www.CDC.gov. Accessed December 12, 2007.
Obesity in the US: A Major Public Health Problem • No one has escaped the epidemic of obesity: • All genders • All ages • All racial/ethnic groups • Dramatic increases in the prevalence of obesity over very short periods of time
1991 Obesity Trends* Among US AdultsBRFSS,1991, 1996, 2003 (*BMI 30, or about 30 lb overweight for 5’4” person) 1996 2003 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Overweight Kids: A Growing Problem Source: Prevalence of Overweight and Obesity in the United States, 1999-2004. JAMA. 2006;295:1549-1555.
Health Professionals to the Rescue How did this happen? • Obesity is a chronic condition, which has taken a significant numbers of years to develop When did we become concerned? • Not soon enough! • Cost $100 billion to treat obesity-related disease
Is It Only America? This is a global problem—other countries are experiencing similar problems According to the World Health Organization, 17.6 million children under age 5 are estimated to be overweight worldwide
Obesity Rates Around the Globe • According to recent statistics, the biggest health crisis is in China’s cities • 12% of adults and 8% of children are classified as obese • During the past 10 years, China’s overall obesity rate has increased by an astronomical 97%
Idiopathicintracranialhypertension Pulmonary disease abnormal function obstructive sleep apnea hypoventilation syndrome Stroke Cataracts Nonalcoholic fatty liver disease steatosis steatohepatitis cirrhosis Coronaryheart disease Diabetes Dyslipidemia Hypertension Gall bladder disease Severe pancreatitis Gynecologic abnormalities abnormal menses infertility polycystic ovarian syndrome Cancer breast, uterus, cervix colon, esophagus, pancreas, kidney, prostate Osteoarthritis Skin Gout Medical Complications of Obesity Phlebitis venous stasis Source: Supersizing servings and bigger beverages build bulging bellies. Available at:http://news-info.wustl.edu/tips/page/normal/447.html. Accessed Dec 13, 2007.
Health Problems Associated With Obesity in Children* • Type 2 diabetes • Fatty liver precursor to cirrhosis • Obstructive sleep apnea • Increased blood pressure • Increased cholesterol levels • Early puberty Source: Dietz WH. Health Consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(suppl 3):518-525.
Consequences of Weight Problems in Children • Obese kids suffer physically and emotionally throughout childhood • Quality of life issue is extremely important, not to be overlooked 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;115:340-347.
Consequences of Weight Problems in Children • Overweight children as young as age 5 develop negative self-image • Obese adolescents: • Have low self-esteem • Are more often sad and lonely • Engage in high-risk behaviors
Contributing FactorsGillis LJ, Bar-Or O.Food away from home, sugar-sweetened drink consumption and juvenile obesity. J Am Coll Nutr. 2003;22:539-545.
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 TV/computer/games The food industry Agriculture policy Cheap food School lunch Vending machines The environment Individual responsibility Fast food Obesity: The Great Debate
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 • May affect satiety • Aggressive advertising by food companies and fast-food restaurants is targeted at children (Saturday AMTV), which results in poor food choices vs fruit, vegetables, and whole grains • At-home physical activity replaced by Nintendo, computer, or TV
Contributing Factors • 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;76:226-231.
Contributing Factors • Offering food to children in the absence of hunger is associated with an increased risk of overweight • Girls between ages 5-7 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 • 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: e429-e436.