Childhood Obesity: Part 1

1. Provided Courtesy of Nutrition411.com Childhood Obesity: Part 1 Adapted with permission of Lucille Beseler, MS, RD, LD Updated by Nutrition411.com staff Review Date 6/13 K-0527

3. 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

4. Obesity in the US: A Major Public Health Problem The greatest health concern affecting our children is the epidemic of obesity and overweight 12.5 million children are obese In one generation, the childhood obesity rate has tripled Obese children are more likely to become obese adults The Centers for Disease Control and Prevention speculates children suffering from obesity may have a lower life expectancy than ever before Source: http://www.CDC.gov. Centers for Disease Control and Prevention Web site. Accessed June 13, 2013.

5. Obesity in the US: A Major Public Health Problem (cont’d) No one has escaped the epidemic of obesity: All genders All ages All racial/ethnic groups Dramatic increase is seen in the prevalence of obesity over very short periods of time

6. Weight Concern in the 1950s

7. Obesity Trends* Among US AdultsBRFSS,1991, 1996, 2003 (*BMI ≥30, or about 30 lb overweight for 5’4” person) No Data <10% 10%-14% 15%-19% 20%-24% ≥ 25% BMI=body mass index, BRFSS=Behavioral Risk Factor Surveillance System, lb=pounds

8. Health Professionalsto the Rescue How did this happen? Obesity is a chronic condition that has taken a significant number of years to develop When did we become concerned? Not soon enough! Cost $147 billion to treat obesity-related disease

9. Is It Only America? This is a global problem—other countries are experiencing similar problems The World Health Organization estimates that 42 million children under 5 years of age are overweight worldwide Source: Childhood overweight and obesity. World Health Organization Web site. http://www.who.int/dietphysicalactivity/childhood/en/. Accessed June 13, 2013.

10. Medical Complications of Obesity Idiopathicintracranialhypertension Pulmonary disease Abnormal function Obstructive sleep apnea Hypoventilation syndrome Stroke Cataracts Nonalcoholic fatty liver disease Steatosis Steatohepatitis Cirrhosis Coronaryheart disease Diabetes Dyslipidemia Hypertension Gallbladder disease Severe pancreatitis Gynecologic abnormalities Abnormal menses Infertility Polycystic ovarian syndrome Cancer Breast, uterus, cervix colon, esophagus, pancreas, kidney, prostate Osteoarthritis Skin Gout Phlebitis Venous stasis

11. Health Problems Associated With Obesity in Children High blood pressure and high cholesterol, which are risk factors for cardiovascular disease Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes Breathing problems, such as sleep apnea and asthma Joint problems and musculoskeletal discomfort Fatty liver disease, gallstones, and gastroesophageal reflux (ie, heartburn) Greater risk of social and psychological problems, such as discrimination and poor self-esteem Source: Basics about childhood obesity. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/obesity/childhood/basics.html. Updated April 27, 2012. Accessed June 13, 2013.

12. 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 Overweight children as young as 5 years of age develop negative self-image Obese adolescents: Have low self-esteem Are more often sad and lonely Engage in high-risk behaviors 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(s):340-347.

13. Contributing Factors

14. Obesity: The Great Debate 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 Television, computer, games The food industry Agriculture policy Cheap food School lunches Vending machines The environment Individual responsibility Fast food

15. Diet-Related Causes Increased calorie consumption Sugar and fat intakes have increased significantly, mostly from: Snacks Juice/soda Foods eaten away from home

16. Contributing Factors Fast-food chains in schools, including preschools (delivery) Over-snacking children, especially during toddlerhood, which may affect satiety Aggressive advertising by food companies and fast-food restaurants is targeted at children (Saturday morning television), resulting in poor food choices vs fruit, vegetables, and whole grains At-home physical activity is replaced by PlayStation, Wii, computer, or television

17. Contributing Factors (cont’d) 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(1):226-231.

18. Contributing Factors (cont’d) Offering food to children in the absence of hunger is associated with an increased risk of overweight Girls 5 to 7 years of age 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.

19. Contributing Factors (cont’d) 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(4);e429-e436.