obesitas
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Transcript of obesitas
Obesity is a health problems in Developed & Developing countries
Approximately 310 millions people faced with chronic excessive energy & obesity
WHO (2000) : big threatening to health in western countries
Background
Obesity : Accumulation of excessive fat tissue in
the body
Overweight : Excess body weight due to
increase muscle mass
Definition
Idiopathic
- > 90% cases- tall stature
- Family history of obesity
- Normal mental status
- Normal/advanced bone age
- Normal physical appearance
Endogenous
- < 10% cases
- Short stature
- Family history of obesity (-)
- Often MR
- Delayed bone age
- Stigmata on PE
Idiopathic & Endogenous Obesity
Jakarta : 21 % Semarang : 12.1% Jogyakarta : 10% Manado : 5.3% Sumbar : 2,5-25,6%
Indonesian’s childhood obesity multi center study(school children aged 6-12 years)
( Sjarif DR et al, 2005 )
Prevalens
Energy Balance
Energy Production and Energy Balance
Carbohydrate
Fat
Basal metabolism
Thermic effectof food
Protein
Physicalactivity
Adaptivethermogenesis
1. Dietary management
2. Physical activity/Exercise
3. Behavior Therapy & Family involvement
4. Medical treatment : drugs & surgery
5. Prevention
Management
1. Diet is the mainstay for the treatment of pediatric obesity
2. Approx 20 % weight loss can be achieve by a decrease in sodas, juices & excess milk in the diet
3. Two main types diet programs- Balance hypocaloric diet- Protein sparing modified fast
Dietary Management
1. Consist of 1200 – 2000 calories
2. Deficit 30 – 40 % usual intake
3. Lose weight 0.5 kg/week & grow normal
4. Recommended diet:- fat : 25-30%- CHO : 50-55%- Protein : 20-25%
Balance hypocaloric diet
Traffic light diet/stop light
Green light- free consumption- low density foods
Yellow light- Moderate consumption- Moderate density protein containing foods
Red light- very limited consumption
High caloric density &/ high sugar & fat content
Calory content of the diet 900 - 1300 kcal/day
(Epstein LH et al. JAMA 1990)
1. Should only be used for more severe cases of obesity
2. 600-800 kcal/day
3. 1.5-2 g/ideal bw protein/day; 2 liters water, 2-4 cups low starch vegetables & multivitamin
4. Lose weight 1.0 kg/week
5. Reported associated with nitrogen loss, orthostatic hypotension, cardiac arrhythmias, impaired growth, hair lost & gallstones
6. Not suitable for children
Protein sparing modified diet
The goal of dietary intervention : to reach healthy
weight without affecting linear growth
Balance Diet : 10% over ideal weight
Food pyramid, food exchange, portion size is
important
Summary