The Epidemic Of Childhood Obesity In The United States:: Old Before Their Time

The Epidemic of Childhood Obesity in the United States: Michelle D. Kelly

Old Before Their Time

References • • • • • • •

•

Discrimination and Health pp.36-75. Kreiger, N., in Social Epidemiology, 2008. Berkman, L., and Kawachi, I., Eds. Gene-Diet Interactions in Childhood Obesity. Papoutsakis, C. and Dedoussis, D. World Health Organization, Geneva, Switzerland, 2006. The integrative role of the CNS fuel sensing mechanisms in energy balance and glucose regulation. Sandoval, D., Cota, D., and Seely RJ. Annu Rev Physiol. 2008; 70:513-35. Management approaches for pediatric obesity. Miller, J. & Silverstein, J. Nature Clinical Practice Endocrinology & Metabolism 2007. 3, 810-81 Mechanisms linking obesity to insulin resistance and type 2 diabetes. Kahn, S., Hull, R., and Utzschneider, K. Nature. 2006, vol 444, 840-845 The Association of Television and Video Viewing with Fast Food Intake by Preschool-Age Children. Taveras, E., Sandora, T., Shih, M., Ross-Degnan, D., Goldman, D., and Gillman, M. Obesity (2006) 14, 2034–2041. Childhood and Adolesecent Obesity: Prevalence and Significance. Styne, D. The Pediatric Clinics of North America, 2001. Available online 15 July 2005. Treatment of impaired glucose tolerance in childhood. Caprio, S. Nature Clinical Practice Endocrinology & Metabolism (2008) 4, 320-321.

Emerging literature • epidemic of childhood obesity relatively new phenomena • # childhood onset cases of DM type 2 increase • environment & genetics blamed • US: 9 million overweight children of which 4.5 million are obese all are likely to become overweight adults

Cause and effect in Childhood Obesity: Solution for a National Epidemic. Wieting, J. 2008. Journal American Osteopath Association; 108(10) 544-552. Increased risk of preventable and chronic health issues

Obesity is diabetes in the making Born in the USA- year 2000

1 in 3 30% of boys 40% of girls

(Styne, 2005)

Children predicted to have shorter life spans than their parents

Race & societal factors Risk of overweight Native American African American Hispanic 24%

Urban access to grocery store safe play space

(Kreiger, 2008)

39% 24%

stigma Isolation Depression Poor self esteem

Lower quality of life

(Taveras, Sandora, Shih, Ross-Degnan, Goldman, & Gillman, 2006)

physical inactivity Nintendo…..

PE Walking Playing Sports

mass media

5 minutes of TV = One food commercial 5 h /day = 40,000/yr

Advocacy Regulate Helmets Car seats

Assessment 2007 • • • •

Annual BMI Dietary patterns Level of (in)activity FH • obesity, DM, CVD, • early mortality heart disease or stroke • Physical exam Expert Committee on the Assessment, Prevention & Treatment of Child & Adolescent Overweight and Obesity, 2009

Practice Recommendation:

Screen for Pediatric Obesity

• Pulse • Blood pressure • Fasting lipid profile • overwt w/o risk factors

• Overwt with risk factors • AST-ALT • Fasting glucose • Obese - BUN, creatinine

(Miller & Silverstein, 2008)