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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
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
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.
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
Weight Concern
in the 1950s
Obesity Trends* Among US Adults
BRFSS, 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
Health Professionals
to 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
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.
Medical Complications of Obesity
Pulmonary disease
Abnormal function
Obstructive sleep apnea
Hypoventilation syndrome
Nonalcoholic fatty liver
disease
Steatosis
Steatohepatitis
Cirrhosis
Gallbladder disease
Gynecologic abnormalities
Abnormal menses
Infertility
Polycystic ovarian syndrome
Osteoarthritis
Skin
Gout
Idiopathic intracranial hypertension
Stroke
Cataracts
Coronary heart disease
Diabetes
Dyslipidemia
Hypertension
Severe pancreatitis
Cancer
Breast, uterus, cervix
colon, esophagus, pancreas,
kidney, prostate
Phlebitis
Venous stasis
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.
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.
Contributing Factors
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
Diet-Related Causes
• Increased calorie consumption
• Sugar and fat intakes have increased significantly,
mostly from:
– Snacks
– Juice/soda
– Foods eaten away from home
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 fastfood 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
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.
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.
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.