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OBESITY: AN EMERGING THREAT

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  1. OBESITY: AN EMERGING THREAT Dr. Nikhil Tandon Additional Professor Department of Endocrinology All India Institute of Medical Sciences New Delhi

  2. 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

  3. Obesity in Children and Young Adults Obesity Abdominal Obesity Misra and colleagues, International Journal of Obesity, 2004

  4. 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

  5. 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

  6. CAYA-2DM Trial • 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

  7. CAYA-2DM Trial • Comparative Clinical Profile *:p<0.05; **: p<0.01; ***: p<0.001

  8. CAYA-2DM TrialComparison of Cases and Controls

  9. CAYA-2DM TrialComparison of Cases and Controls *:p<0.05; **: p<0.01; ***: p<0.001

  10. CAYA-2DM Trial • 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.

  11. How to Predict Diabetes in Children

  12. 100 90 80 70 60 Percentiles 50 40 30 20 10 0 Birthweight Present weight CAYA-2DM TrialWeight Percentiles of Cases: Birth and Current

  13. ISSUES • 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

  14. INTERVENTIONS • 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