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Weighing In On. Childhood Obesity. Prevalence of Overweight Among Children and Adolescents Ages 6-19 Years. TREND. 1 of every 4-5 children is overweight 1 in 3 adults are overweight Doubling of number of severely obese Ethnic differences
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Weighing In On Childhood Obesity
Prevalence of Overweight Among Children and Adolescents Ages 6-19 Years
TREND • 1 of every 4-5 children is overweight • 1 in 3 adults are overweight • Doubling of number of severely obese • Ethnic differences • AA (1/3) > Hispanic > White (1/5). Little information about Asians and Native Americans
DEFINITION • OVERWEIGHT VS OBESE • Overweight = weight greater than set standards (may be muscle, bone or fat) • Obese = high proportion of body fat • Overweight=BMI >85 percentile • Obese=BMI>95 percentile
WHAT IS THE BMI? • Better measurement of obesity than weight for height • Calculation: • Weight in kg / height squared in meters • Use in children age 6 and over
ITS JUST BABY FAT. SHE’LL OUTGROW IT • After the first year of life children become thinner until 5-6 years of age when they become fatter again (Adiposity Rebound) • Toddlers are picky eaters • Early adiposity rebound is associated with later obesity
PREDICTING ADULT OBESITY Obese 6 year old has a 25% chance of becoming obese adult Obese 12 year old has a 75% chance of becoming a obese adult
WHY IS MY CHILD OVERWEIGHT? • Diet • Exercise • Genetics • Endocrine • Cultural/behavioral factors • Profound environmental effects on a susceptible population
DIET • Changing diet with increased fat and calories • Changing size of portions-SUPERSIZE MEAL (1800 vs. 600 CAL) • BUT no evidence of increased caloric intake in studies
EXERCISE • Television and videogames • What happened to PE? • Decline in physical activity in adolescents
GENETIC • If parents are obese child is more likely to be obese • Genetic vs. environmental • Melanocortin 4 receptor gene mutation • 5% of subjects with severe obesity commencing in childhood • more likely in extremely obese
ENDOCRINE • Thyroid • Not usually a cause • Endocrine problems=SHORT and fat • Lower resting energy expenditure in some AA girls
CULTURAL/BEHAVIORAL • White girls more dissatisfied with their weight than AA girls • AA girls more likely to engage in practices associated with overeating
WHY SHOULD I WORRY? • TYPE 2 DIABETES • Now most frequent cause of diabetes in children • HYPERLIPIDEMIA • HYPERTENSION • Hispanic and African American children at highest risk • PSYCHOLOGICAL EFFECTS
TALK TO YOUR CHILD’S DOCTOR • Children are growing and have special needs • Aim for gradual weight loss or no weight gain
MAKE IT A FAMILY THING • Be a role model for your children • Plan family activities that provide exercise • Reduce the amount of time spent in sedentary activities • Help your family choose a healthy diet.
The parent’s job is to decide what foods to offer and when. The child’s job is to decide how much to eat.
DIET • Avoid fad diets • Don't eat or snack in front of the TV • Eat slowly. Make mealtime enjoyable. • Use fruits an vegetables for snacks • Don't use food as a reward
STOPLIGHT DIET • RED: Cakes, cookies, chips, soda • YELLOW: Starchy vegetables, pasta, white bread • GREEN: Green vegetables, fresh fruits, water
EXERCISE • Increase exercise • Decrease sedentary activity • Involve everyone in family
DISORDERED EATING • Anorexia/Bulimia • Be careful what message you send: • Focus on health rather than weight
WHAT IF IT DOESN’T WORK? • Pharmacological and surgical treatments • No safe drugs at this time • Surgery carries risks • Long term consequences for bone mineralization unknown
AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE SCHOOL LUNCH P.E.
WEB INFORMATION • kidnetics.com (ACTIVATE) 9-12 yr. olds • niddk.nih.gov/health • nhlbi.nih.gov