CHILDHOOD OBESITY

Chilhood Obesity

Childhood obesity has become in the last decades a serious health problem, which has reached epidemic proportions. Our sedentary lifestyles, hectic schedules , poor nutrition habits, and diets high in fats and sugars have contributed to a significant increase in children´s and teen´s body weight and BMI.

Diseases which used to be considered “Adults” such as Type 2 Diabetes, High Blood Pressure, Fatty liver, Hypercholesterolemia, etc. are arising at early ages and are affecting children and teens all over the world, which in many cases is a consequence of years of poor eating habits. The predictions in this matter are less than encouraging since the CDC warns that one in three children born in 2000 will become diabetic unless they change their way of eating and become more active. This is also going to be reflected as a Health crisis since Diabetes alone cost the nation $105 billon dollars annually; and this figure is expected to rise as the incidence of the disease rises (Wang & Dietz 2002, Macera and Wang 2000, Diabetes Research Working Group 1999).

Conditions related to Obesity are:

Type 2 Diabetes, Asthma, High Blood Pressure, Cardiovascular Disease, High Cholesterol, Joint Problems, Sleep Disorders, Early Death, Psychosocial problems, Low Self Esteem, Poor body image, Eating Disorders, Mobility, Activity, Isolation, Weight issues into adulthood.

Recently it has become more socially accepted to be overweight or obese since most of the population waistlines are above the recommendations. (Florida State University, Federal Reserve Bank of Boston. Economic Inquiry)

President Barak Obama implemented a Task Force dedicated to help reduce Childhood Obesity to a rate of less than 5 % by 2030. The recommendations were structured around the same four pillars that support the First Lady’s Let’s Move! Initiative which are:

1.- Empowering parents and caregivers to make healthy choices for their families.

2.- Serving healthier food in schools.

3.- Ensuring access to healthy, affordable food.

4.- Increasing physical activity.

Causes:

The causes of Overweight and Obesity are complex including:

1.- Genetic. Obesity tends to run in families; Genetics alone does not cause obesity, this will occur only when a child eats more calories than he or she uses.

2.- Metabolic. Some diseases or disorders may contribute to obesity such a low thyroid function, cushing syndrome, polycystic ovaric syndrome etc.

3.- Behavioral. More and more families are relying in fast foods, processed snacks and high calorie drinks due to their hectic schedules. This foods are high in fat, sugar and/or calories and low in many other nutrients, and also reduces the consumption of healthy foods such as fruits, vegetables and whole grains. Patterns associated with obesity are eating when not hungry and eating while watching TV or doing homework. Only 2 % of school-aged children consume the recommended number of servings from all food groups, and more than 80 % of children and adolescents eat too much total fat and 90% eat too much saturated fat.

4.- Environmental. There is a natural inclination to be influenced by the appearance and behaviors of people around us; Obese people tend to cluster together. Overweight adolescents have a 70% chance of being an overweight or obese adult, If one parent is obese the child has 50% chance of becoming an obese adult, and if both parents are obese the child has an 80% chance. On the other hand if both parents are normal weight the child has a 5-8% chance of becoming an obese adult.

5.- Cultural. Some Countries rely on high calorie, high sugar and high fat foods; as well as the excessive use of starches and white flours in lots of their dishes. In some countries the use of fresh fruits and vegetables is very little due to low availability or excessive cost.

6.- Socioeconomic Status. Low family incomes and having nonworking parents are associated with greater calorie intake for activity level.

7.- Physical Inactivity. Fewer than one in four American children get 30 minutes or more of physical activity per day, and more than three on four get no more than 20 min of vigorous physical activity per week . The popularity of television, computers and video games translate into a more sedentary (inactive) lifestyle; increasing the prevalence of Obesity in children and adolescents .

9 million school-aged children and adolescents are overweight to a degree that directly affects their health (16% national average). (kids health.com)

Diagnosis

A child’s weight is evaluated by his or her primary care pediatrician during regular check-ups and office visits. Weight issues rarely sprout rapidly but rather develop over time.

There are two main tools Health Providers use to assess a child’s weight:

Growth Charts: These charts are used throughout a child’s development to assess growth, both height and weight, as compared to other children the same age and to watch how a child’s body changes over time. The CDC (Centers of Disease Control and Prevention) Charts are based on the measurement of thousands of children the same age, and are the ones used almost by any Doctor or Dietitian. This tables however do not take into account the individual characteristics of each child, this is the consideration of the child’s age and growth pattern. For example, some children gain weight before the growth spurt, and this doesn’t mean they are becoming obese.

Many health care providers define Obesity in a child weighing 20 % or more over the healthy range.

Body Fat Percentage: The percentage of body weight that is fat is a good marker of obesity. Boys over 25% and girls over 32% fat are considered obese. However this is difficult to measure due to the need of special equipment and trained technicians.

Body Mass Index (BMI): This measure is used to assess weight relative to height. It’s the same as the body mass index used to identify adult obesity. BMI is defined in weight in kilograms divided by height in meters squared (kg/m2). BMI is closely related to body fat percentage, but it’s easier to measure; this is the standard for defining obesity in adults but it’s use in children is not universally accepted.

BMI is interpreted differently for adults and for kids There are separate charts for men and woman and adult ones don’t use percentiles at all. The kids charts take growth into account because it’s common for kids to gain weight during certain times in childhood such as puberty.

BMI charts for kids use percentiles to help kids and teens look at their BMI compared with a very large group of people the same age and gender. A healthy weight would be greater than or equal to 5th but less than 85th percentile .

The CDC suggests two levels of concern for children based on the BMI-for-age charts:

1.- “Overweight” greater than or equal to 85th but less than 95th percentiles

2.- “Obese” greater than or equal to the 95th percentile

But the BMI is not the whole story when it comes to someone’s weight. A more muscular kid may have a higher weight and BMI but not have too much fat. A smaller kid could have an ideal BMI, but might have less muscle and too much body fat.

Waist Circumference (WC): This measurement in a child or adolescent correlates closely with the future risk of developing type 2 diabetes and related complications of the metabolic syndrome (high blood pressure, abnormal circulating cholesterol, and other fat levels, heart attacks, stroke and damage to the eyes, heart and kidneys. The assessment is made with a tape measure stretched across the widest abdominal girth (usually at or just below the level of the belly button, called the umbilicus). Any value over the 90th percentile for age and gender carries the highest risk