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OBESITY: AN EMERGING THREAT Dr. Nikhil Tandon Additional Professor Department of Endocrinology All India Institute of Medical Sciences New Delhi PREVALENCE OF OBESITY IN DELHI SCHOOL CHILDREN FROM DIFFERENT SOCIO -ECONOMIC GROUPS 1400 1200 1000 800 Total Non-obese 600 24.4

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OBESITY: AN EMERGING THREAT

Dr. Nikhil Tandon

Additional Professor

Department of Endocrinology

All India Institute of Medical Sciences

New Delhi


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PREVALENCE OF OBESITY IN DELHI SCHOOL CHILDREN

FROM DIFFERENT SOCIO -ECONOMIC GROUPS

1400

1200

1000

800

Total

Non-obese

600

24.4

Obese /Overwt.

400

23.9

28.7

200

1.5

0

Private

Boys

Girls

Govt.

Tandon and colleagues, 2004


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Obesity in Children and Young Adults

Obesity

Abdominal Obesity

Misra and colleagues, International Journal of Obesity, 2004


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Childhood Obesity is the Important Determinant for Diabetes in Children

Snapshot

  • Youth-onset Type 2 diabetes is a real concern in many countries

  • Our data show that increase fat over chest and abdomen is a extremely important determinant of youth-onset diabetes


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To study the anthropometric, biochemical and immunological profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

Type 2 Diabetes Mellitus in Children, Adolescents and Young Adult Asian Indians (CAYA-2DM Trial):

A Multicenter Collaborative study

Objective


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  • CAYA-2DM Trial profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

  • Methods

Subjects:

  • 31 patients; 59 age-matched healthy controls

    Anthropometric Profile:

  • Body mass index, waist circumference, waist-hip ratio, skinfold thickness at 8 sites

  • Percentage body fat by two-point bioelectrical impedance


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  • CAYA-2DM Trial profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

  • Comparative Clinical Profile

*:p<0.05; **: p<0.01; ***: p<0.001


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CAYA-2DM Trial profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controlsComparison of Cases and Controls


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CAYA-2DM Trial profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controlsComparison of Cases and Controls

*:p<0.05; **: p<0.01; ***: p<0.001


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  • CAYA-2DM Trial profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

  • Conclusions

Generalized (high BMI) as well as abdominal obesity (high W-HR) are the most important predictors for early onset of IGT and T2DM in Asian Indians.


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How to Predict Diabetes in Children profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls


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100 profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

90

80

70

60

Percentiles

50

40

30

20

10

0

Birthweight

Present weight

CAYA-2DM TrialWeight Percentiles of Cases: Birth and Current


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ISSUES profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

  • Increasing obesity

  • Contributory factors: - calorie dense food - consumption of processed foods - limited physical activity - sedentary interests: computers, TV, video games

  • THE SEED FOR ADULT OBESITY IS SOWN EARLY - CHILDHOOD


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INTERVENTIONS profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

  • Catch them young - school age children must be targeted

  • Increase awareness: media; school teachers; governmental and NGO effort

  • Minimise advertising pressure for “junk foods”

  • School play grounds; “Games periods”

  • Health food in school canteens