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Childhood and Adolescent Obesity

Childhood and Adolescent Obesity. Laura Stewart BSc BA RD Independent Consultant Dietitian the children’s weight clinic. www.childrensweightclinic.com. What is obesity?. How big is the problem ?. There are approximately one million obese children and adolescents in the UK. BMA 2005.

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Childhood and Adolescent Obesity

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  1. Childhood and Adolescent Obesity Laura Stewart BSc BA RD Independent Consultant Dietitian the children’s weight clinic www.childrensweightclinic.com Promoting a healthy family lifestyle

  2. What is obesity? Promoting a healthy family lifestyle

  3. How big is the problem ? There are approximately one million obese children and adolescents in the UK BMA 2005 Promoting a healthy family lifestyle

  4. What about Scotland ? Pre-school 20.7% P1 21.8% P7 34.1% S3 31.3% ISD Scotland 2006 Promoting a healthy family lifestyle

  5. Does it matter ? • Dyslipideamia – raised triglycerides, LDL, lowered HDL • Insulin resistance • Raised blood glucose • Hypertension • Metabolic syndrome • Obesity tracking into adulthood Promoting a healthy family lifestyle

  6. And that means ? • Heart disease • Type II diabetes • Polycystic ovary disease • Liver disease • Respiratory problems – asthma, sleep apnoea • Orthopaedic problems • Psychosocial / self-esteem Promoting a healthy family lifestyle

  7. Physical activity - 1 hour /day Sedentary time - < 2 hours /day Food and drink -  foods particularly high in fat and sugar - discourage multiple snacks - portion sizes Energy Balance Promoting a healthy family lifestyle

  8. More physical activity Less sedentary time Promoting a healthy family lifestyle

  9. SPARKLE:what children do all day Reilly et al Lancet 2004 Promoting a healthy family lifestyle

  10. ‘I can resist anything but temptation’Oscar Wilde (playwright, poet & wit) Promoting a healthy family lifestyle

  11. Best bets - prevention • School based intervention – integrated into interdisciplinary curriculum • Uses trained enthusiastic teachers • Targeted increasing fruit and vegetables • Decreasing television viewing • Increasing moderate to vigorous physical activity Planet Health Gortmaker 1999 Promoting a healthy family lifestyle

  12. Best bets - treatment • treatment should be directed at motivated families only • treatment is directed at the entire family • weight maintenance is a desirable treatment outcome • treatment should be more intensive than the norm (more frequent and longer appointments) • treatment should target diet plus changes in physical activity and/or reduction in sedentary behaviour Promoting a healthy family lifestyle

  13. Promoting a healthy family lifestyle

  14. Useful Resources • SIGN 69 guideline 2003 (www.sign.ac.uk) • RCPCH : Gibson et al 2002 (www.rcpch.ac.uk) • US expert committee report; Barlow & Dietz 1998 (www.pediatrics.org/cgicontent/full/102/3/e29) Promoting a healthy family lifestyle

  15. Useful Resources • Interventions for treating obesity in childhood. (Cochrane review). Summerbell et al 2003 • HEBS website (www.hebs.scot.nhs.uk/learningcentre/weightmanagement/childhood) • Reilly et al 2002 Arch Dis Child 86:392-395 Promoting a healthy family lifestyle

  16. Useful Resources • NICE Guidelines on Adult and Childhood Obesity and Overweight 43. 2006 • Cochrane Review, Prevention of Childhood Obesity. 2005 • Gortmaker,S. Planet Health, Archives of Pediatric and Adolescent medicine; 1999:151:409-418. Promoting a healthy family lifestyle

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