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Childhood Obesity

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10 calories extra per day results in 1 lb of weight gain per year ... Don't focus on one child; involve the entire family in a get healthy together adventure ... – PowerPoint PPT presentation

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Title: Childhood Obesity


1
Childhood Obesity
  • Cindy Devore, M.D., F.A.A.P.

2
OBESITY IS A PROBLEM OF EPIDEMIC PROPORTIONS IN
OUR YOUTH.
3
United States
  • Obesity related deaths in US are about
    400,000/year.
  • This is about the same number of deaths due to
    tobacco use in the US.

4
Statistics on obesity
  • One out of four (24) of African- American
    children is obese,
  • One out of five (22) of Hispanic-American
    children is obese,
  • One out of six (16) of Caucasian-American
    children is obese, and there is another one out
    of ten (10-15) at risk of obesity based on their
    current weight.

5
Definitions of Obesity
  • Medical definition Obesity is a Body Mass Index
    (BMI) of greater than the 95 percentile for age
    and gender at risk for obesity is a BMI of
    greater than the 85 percentile for age and
    gender.
  • Lay definition overweight above normal weight
    clothes fit too tightly

6
What Is Body Mass Index (BMI)?
  • Body mass index is a formula measuring height
    against weight (as kilograms divided by meters
    squared).
  • It is expressed as a number from about 17 through
    60.
  • BMI differs for men and women, adults and
    children, and may not be as accurate in athletic
    or muscular children, but it is a very useful
    measure.

7
BMI INTERPRETATION
  • Underweight lt19.0
  • Normal range 19.1- 26.9
  • Overweight (85th) 27.0 29.9
  • Obese (95th) gt30

8
The Serious Nature of the Obesity in American
Youth
  • American children are becoming more obese faster
    today than at any other time in our history!

9
Anticipated Outcome of this Trend
  • American children are expected to have a shorter
    life span than their parents. This is a first in
    the history of human life!

10
  • Yet, everyone is afraid to talk about it, as if
    to offend someone when what we are talking about
    is medical risk for our most precious resource
    our children!

11
Purpose of This Talk
  • To provide an understanding of the scope and
    causes of this leading nutritional disease in
    America
  • To discuss the risks of childhood obesity
  • To discuss the role of the parent and the
    possible things you can do as a parent to attack
    the problem

12
Causes of Childhood Obesity
  • THERE ARE TWO MAJOR AND BASIC CAUSES OF OBESITY
  • Too many calories in
  • Too few calories out

13
  • However, that is a simplistic statement.
  • In reality, the problem is MULTIFACTORIAL,
    meaning there are many factors surrounding the
    causes of childhood obesity
  • Some causes are preventable. Some are not

14
Multifactorial Causes of Obesity
  • Increased eating
  • Decreased activity
  • Family history
  • Stress
  • Drugs
  • Genetics

15
Causes Increased Eating or Intake
  • Modest increases in intake not compensated by
    activity can result in large weight gain over
    time.
  • 10 calories extra per day results in 1 lb of
    weight gain per year
  • 150 calories extra per day 15lbs/year
  • Cut out one cookie a day lose 15 lbs in a year

16
Common causes of increased eating
  • Excessive snacking
  • Sweet beverages
  • Increased portions
  • Limited variety
  • Fast food
  • Multiple caretakers
  • Holiday excesses
  • Less supervision.

17
Common causes of decreased activity
  • Increased TV viewing, computer use, video game
    playing
  • Increased concerns of safety issues outdoors
  • Reduced physical education and recess in school
  • Over-scheduling so family life is disrupted
  • Decreased family activity time together

18
Decreased Activity
  • Todays children are 4 times less active in their
    daily lives as were their grandparents
  • Homework burden greater at younger ages
  • Decreased intensity of daily living
  • Inactive families serve as role models

19
Exercise recommendations
  • Children 60 minutes a day five days a week of
    vigorous physical activity that makes them sweat
  • Adults 30 minutes of the same five days a week
  • Key point find something you and your child
    enjoy and schedule it right into your day

20
Causes Genetic Factors or Family History
  • Adoption studies found a high correlation between
    obesity in adopted children and their biologic
    parents
  • Twins reared together or apart have similar rates
    of obesity

21
Genetic Factors
  • Having two obese parents increases a childs risk
    of obesity up to 80 compared to a risk of 9 for
    having lean parents
  • More than 200 genes or gene markers are
    associated in some way with obesity and research
    is working on this

22
Key Points
  • GENETICS ARE A RARE CAUSE OF OBESITY THAT WE
    CANNOT CONTROL.
  • WE CAN CONTROL OUR ENVIRONMENT
  • THEREFORE, OBESITY IN MOST CASES IS PREVENTABLE
    AND TREATABLE

23
Causes Stress
  • Stress factors in the environment may trigger the
    onset of obesity. In children, these factors can
    include
  • Death of a parent
  • Parental divorce or separation
  • Learning or school problems
  • Emotional problems
  • Medical illnesses
  • Family discord

24
Why is stress a factor in overeating?
  • Eating is associated with feeling good and during
    times of stress, we want to feel better
  • Parents use food to soothe or reward children
    during times of stress
  • During stressful times we tend to eat out, eat
    fast food, or eat at different times rather than
    as a family unit

25
Causes Drugs
  • Glucocorticoids prednisone
  • Antidepressants Amitriptyline, desipramine,
    fluoxetine
  • Anticonvulsants Valproic acid
  • Antihypertensives Clonidine, Prazosin,
    Propranolol
  • Major antipsycholitic drugs Rispridol, Haldol
  • Recreational drugs marijuana

26
Obesity Related Health Problems
  • Heart problems (hardening of arteries, high blood
    pressure)
  • Metabolic (Hyperinsulinemia, non-insulin
    dependent type II diabetes)
  • Orthopedic (joint problems, arthritis)
  • Respiratory (Daytime sleepiness Sleep
    disturbance Snoring and sleep apnea Inadequate
    ventilation Asthma)
  • GI and Liver disease (fatty liver, cirrhosis)

27
Metabolic Syndrome Obesity, Type II Diabetes,
High Blood Pressure
  • In 1988 only 2 of all children diagnosed with
    diabetes had adult onset diabetes caused by
    obesity
  • In 2007 up to 40 of all new onset diabetics have
    Type II diabetes, a condition that can be
    eliminated by weight loss

28
Reality of the danger of Type II diabetes
  • It takes about 15 years from onset of diabetes to
    start seeing the severe complications.
  • If an adult is diagnosed at age 55, by the time
    they are 70, they may have kidney disease,
    damaged eyesight, etc.
  • If a 15 year old child is diagnosed, by the age
    of 30 their bodies can start to fail.

29
Small steps to healthier living
  • A journey of a thousand miles begins with a
    single first step.
  • Chinese
    proverb

30
Families need education and support to experience
success and then must
  • Prioritize need for change in family
    functioning.
  • Build skills in order to effect change.
  • Set realistic step-wise goals.

31
Families need to understand
  • Best success is in the pediatric age group.
  • Changes in behavior can overcome genetic
    influences.
  • As little as ten percent weight loss can lessen
    metabolic risk factors.
  • Parents are a role model

32
Where do parents begin?
  • Remember it took time for our children to gain
    weight, and it will take time for them to lose
    weight
  • Aim for small steps to begin the process

33
SMALL STEPS TO A HEALTHIER LIFESTYLE
  • PHYSICAL ACTIVITY

34
Small Steps Toward a Healthier Lifestyle Get
moving
  • Exercise regularly
  • Get active together
  • Decrease screen time
  • Increase exercise
  • Decrease barriers to exercise
  • Take the Presidents Challenge

35
Exercise regularly
  • Walking is the key to good health
  • Take the stairs instead of an elevator or
    escalator when you can
  • Get off a bus stop a little early and walk
  • Park in a spot farther away and walk
  • Step up the intensity of chores at home
  • Feel good about working up a sweat

36
Get active together as a family
  • Look at family over-scheduling and change
  • Plan on family hikes, biking, swimming, skating,
    skiing, dancing, anything active together
  • Get more physical on the weekends
  • Do a charity fun run or walk or car wash
  • Practice sports at home
  • Be a good role model
  • Start in small steps, 10 minutes and build to 60
    minutes

37
Decrease screen time
  • Limit TV, video games, or non-educational
    computer time to no more than 1 to 2 hours per
    day
  • Plan that for every hour or computer or TV or
    video games a child must have ½ hour of physical
    activity intense enough to make him/her sweat.

38
Decrease barriers to physical activity
  • Work with community leaders to ensure safe places
    for physical activity indoors and outdoors
  • Work with your legislators to insist that obesity
    is covered under health insurance policies
  • If your child is home alone, stock the house with
    healthy snacks and encourage kids to find
    something to do everyday that is physical like
    jumping jacks.

39
Take the Presidents Challenge
  • Every child needs 60 minutes of vigorous physical
    activity five days a week
  • Every adult needs 30 minutes of vigorous physical
    activity five days a week
  • Log onto www.presidentschallenge.org and enter
    the challenge to do moderate physical activity.
    Chart your progress over six weeks and win an
    award.

40
Take the Body for Life Challenge
  • Register for Bill Phillips Body for Life
    Challenge at www.EAS.com
  • Take before photos
  • Engage in 3 months of healthy living
  • Take after pictures
  • Submit the photos and short required essays and
    win 1,000,000 if you are selected

41
SMALL STEPS TO A HEALTHY LIFESTYLE
  • EATING

42
Small Steps Toward a Healthier Lifestyle Eating
  • Think portions
  • Switch it up
  • Offer healthy meals and snacks
  • Everything in moderation
  • Involve the entire family

43
Think portions remember serving size
  • Meat 2-3 oz. (a deck of cards)
  • Pasta ½ cup (tennis ball)
  • Bread 1 slice (1 post card)
  • Peanut butter 2 T (ping pong ball)
  • Cheese 1 oz. (four dice)
  • Vegetables ½ cup (light bulb)

44
Portions when dining out
  • Share or split a meal
  • Bring home half for another meal
  • Tell kids to listen to their bodies to know if
    their stomachs are empty or full and to stop
    eating when they feel full before they feel sick
    or stuffed
  • Never supersize it alone. EVER. Only if sharing
    half

45
Switch it up
  • Switch whole grains for white flour
  • Whole wheat for regular pasta
  • Whole wheat tortillas for white tortillas
  • Brown or wild rice for white rice

46
Offer Healthy Meals and Snacks
  • Decrease red meat and increase fish and poultry
  • Go from whole milk to 2 to skim milk
  • Go from frying to steaming, baking, grilling
  • Use low fat yogurt as a snack
  • Use low fat crackers, pretzels, fruits
  • Encourage drinking water or diet beverages

47
Everything in moderation
  • Dont try to eliminate junk just reduce it
  • Reduce it in stages
  • Look for small 100 calorie snacks, but stick to
    that size

48
Involve the entire family
  • Dont focus on one child involve the entire
    family in a get healthy together adventure
  • Have children help prepare meals and eat together
    as a family. Strengthen family life
  • Be a good role model

49
Parting words
  • Do not become discouraged. Become involved, and
    be a good role model.
  • Remember small steps have enormous benefits
    decrease 100 calories a day increase physical
    activity to burn 100 calories a day to lose
    weight healthfully
  • Children can and do succeed at changing
    lifestyles
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