Childhood overweight and obesity developing a pct strategy
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Childhood Overweight and Obesity Developing a PCT strategy. John McBride Senior Lecturer Institute of Health and Community Studies Bournemouth University. Why Does it Matter?. Significant and increasing problems.

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Childhood Overweight and ObesityDeveloping a PCT strategy

John McBride

Senior Lecturer

Institute of Health and Community Studies

Bournemouth University


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Why Does it Matter?

Significant and increasing problems.

Likely to have long term adverse influences on the health of individuals and populations unless action is taken.


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Effects

  • Poor health in childhood.

  • Development of obesity and obesity related health problems in adulthood (Balaban and Silva 2004, Caballero 2001)

  • Greater risk of psychological problems (Phillips and Hill 1998, Neumark-Sztainer and Hannan 2000).

  • Habits and behaviours established in childhood are hard to change at a later stage (Caroli and Lagravinese 2002).


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Findings from Literature Review


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Definition

  • Lack of a rigorous scientific definition of terms.

  • Lack of clarity over assessment strategies (Livieri et al 2003).

  • BMI

  • Waist circumference

  • Skinfold thickness


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BMI

  • Cole et al’s (2000) tool: reasonably accurate measure of obesity or overweight in children aged 2-6 (Liveri et al 2003, Abrantes et al 2003, Rolland-Cachera 2003)

  • Ruxton (2004) suggests 4 years as the lowest age for diagnosis.


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BMI Definitions

  • Obese children: BMI above the 98th age and sex specific percentile

  • Overweight children: BMI greater than or equal to the 91st age and sex specific centile (Harrell et al 2003, SIGN 2003)


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Clinical Vs Research Terms

SIGN (2003) : this contrasts with the international consensus used for research purposes which defines obesity as the 95th centile or above, and overweight as the 85th centile or above.


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Additional Considerations

  • BMI may not accurately identify all obese children (Eto et al 2004).

  • There are differences in “normal” BMI between ethnic groups (Karasalihoglu et al 2003, Liveri et al 2003)


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Triceps Skinfold & Waist Circumference

  • Obesity: triceps skinfold higher than the 85th centile for age and gender (Livieri et al 2003).

  • Requires practical training and use of equations to transform measurements into percentage body fat.

  • Waist Circumference less reliable or valid a measure or predictor of obesity as BMI percentiles or subcutaneous skinfold thickness (SIGN 2003).


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Interventions Must

  • Encompass the numerous possible causative or predisposing factors.

  • Include child and family.

  • Maximise the likelihood of compliance.


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Problem Identification

  • Monitor children’s growth and development in order to identify those who are/ are at risk of becoming overweight or obese (Ariza et al 2004).

  • Consider disease or genetic processes.

  • Investigate dietary input, level of activity, and food related behaviour.


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Developing the strategy

  • Partnership working

  • Linking with existing projects

    • NHSI

    • Bournemouth health network

    • Community development projects

    • Collaborative working across health and social care and local authorities


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