Weighing In On

Childhood Obesity

Prevalence of Overweight Among Children and Adolescents Ages 6-19 Years

6-11 years of age 12-19 years of age 16% 14% 12% 10% 8% 6% 4% 2% 0% 1963 70 1971 74 1976 80 1988 94 1999 00

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

CALCULATING YOUR CHILD’S BMI

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

WHAT CAN I DO?

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

QUESTIONS?