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Transcript of Obesity and Type 2 Diabetes in Children A presentation to initiate awareness and advocacy for an...
Obesity and Type 2 Diabetes
in Children
A presentation to initiate awareness and advocacy for an
international health epidemic
The purpose of this presentation is to:• Explain the obesity and type 2
diabetes crisis• Discuss methods of curbing
this epidemic• Encourage participation within
your family, school, and/or community in developing a healthier lifestyle
What is Obesity?• A condition resulting from
excessive storage of fat in the body. (Best measured by BMI)
What is BMI?
• BMI (Body Mass Index) is the ratio of weight in kilograms to square of height in meters. BMI correlates with more accurate measures of body fatness.
• Pediatrics:– At risk: BMI between 85th – 95th percentile for age
and sex – Overweight/Obese: BMI at or above the 95th
percentile for age and sex
American Academy of Pediatrics; Prevention of Pediatric Overweight and Obesity, 2003
Example Calculation
• Weight (lb) ÷ Height (in) ÷ Height (in) x 703 = BMI
• Ex:13 year old boy, wt;146 pounds, ht; 64 in
• 146 ÷ 64 ÷ 64 x 703 = 25• BMI of 25 per growth chart = 95%• This young man is overweight/obese
http://www.cdc.gov/growth charts
Examples of Children At Risk
By Mayo Clinic Staff
The prevalence of childhood overweight and obesity has
doubled in the past 20 years.
American children are less physically active as a group than
were previous generations.
American Academy of Pediatrics Policy Statement: Prevention of Pediatric Overweight
and Obesity, 2003
What are common medical problems in obese children?
• Type 2 diabetes• Heart disease• Mental health; depression, low
self-esteem• Pulmonary or Respiratory
problems
How Does Arizona Fare?
• The number of overweight/obese adults has increased from 44.7% (1994) to 56% (2001)
• Currently it is estimated that 58% of Arizonans are overweight/obese
• 34% of children enrolled in Headstart programs are overweight.
Trends in Prevalence of Overweight* in US Boys 12-17 Years Old
02468
10121416
1966-1970 1971-1974 1976-1980 1988-1994
Caucasian African-AmericanCaucasian, non-Hispanic African-American, non-HispanicMexican
*BMI at or above sex- and age-specific 95th percentile CDC, National Center for Health Statistics. 1998.
Prevalence (%)
Trends in Prevalence of Overweight* in US Girls 12-17 Years Old
0
5
10
15
20
1966-1970 1971-1974 1976-1980 1988-1994
Caucasian African-AmericanCaucasian, non-Hispanic African-American, non-HispanicMexican
Prevalence (%)
*BMI at or above sex- and age-specific 95th percentile CDC, National Center for Health Statistics. 1998.
U. S. Obesity Rates: Past 20 Years
• Today’s obese children could be the 1st generation of Americans with a life expectancy less than their parents!
Richard Carmona MD, US Surgeon General
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1985
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1986
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1987
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1988
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1989
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1990
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1991
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1992
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1993
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1994
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1995
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1996
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1997
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Prevalence of Obesity* Among U.S. AdultsBRFSS, 1998
(*Approximately 30 pounds overweight)
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
<10% 10% to 15% >15%
Obesity Trends* Among U.S. AdultsBRFSS, 1999
No Data <10% 10%–14% 15%–19% ≥20
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Obesity Trends* Among U.S. AdultsBRFSS, 2000
No Data <10% 10%–14% 15%–19% ≥20
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Obesity Trends* Among U.S. AdultsBRFSS, 2001
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Source: Behavioral Risk Factor Surveillance System, CDC
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
1991 1995
2002
Obesity Trends* Among U.S. AdultsBRFSS, 1991-2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
Children Then….
Children Now…….
From Childhood & Adolescent Obesity and Type 2 Diabetes by Francine Kaufman MD
Factors Related to the Onset of Obesity
• Altered dietary intake
• Decreased physical activity
• Increased inactivity
Altered dietary intake
• Nutritional content • Portion size
Decreased physical activity
• Not as much participation in physical activities; walking, active play, recess
Increased inactivity
Look at time spent watching TV, playing electronic games
Enrollment in daily physical education classes
0
10
20
30
40
50
1991 1995perc
ent
of h
igh
scho
ol s
tude
nts
From the Surgeon General's Report on Physical Activity and Health, 1996
Percentage of High School Students Who Reported Not Being Enrolled in Physical Education Class,
1999
CDC, Youth Risk Behavior Surveillance System
The Burden of Obesity(Adapted from American Obesity Association source, 2002)
Prevention is the Key!
• Tommy Thompson, Secretary of Health & Human Services
• Dr. Richard Carmona, U.S. Surgeon General
• Center for Disease Control (CDC)
• American Academy of Pediatrics (AAP)
• American Diabetes Association (ADA)
Why Target Children?
• Prevention is more cost effective than cure
• Children can be reached through schools
• Effects of chronic disease accumulate over time; so need long-term changes– We need to begin awareness at an early age
E. Sanchez, MD, MPH
Why Should Schools Care About Health?
• As a society, we value good health.• Good health is necessary for effective
learning• Healthy students become healthy,
productive citizens• Schools are the one place where the
majority of our nations youth can be foundE. Sanchez, MD, MPH
How Do You Initiate Change?
• Environmental/Policy– Obtain baseline assessments– Make physical activity and
nutrition a priority in schools– Fund preventative programs
and services in community– Develop a comprehensive
approach
How Do You Initiate Change?
• Community Action:– Utilize local data/community input to
assess your needs– Increase awareness of obesity problem in
culturally appropriate ways– Develop partnerships for community-wide
healthy lifestyle actions
How Do You Initiate Change?
• Schools can provide:– Quality daily P.E. classes– Nutrition awareness campaign– Parent education/awareness campaign– Psychosocial education/intervention– School nutrition policy
What Can We Do In Our School?
• Ask for support from the school board and superintendent
• Incorporate students, parents, teachers in providing strategies and ideas
• Look at your school practices• Focus on health and activity,
not weight• HAVE FUN!!!
Governor Napolitano’s Call to Action Reports January 30, 2004
• SELECTED REQUESTS:• Keep recess sacred, not used as a punishment• Daily P. E. classes• Provide healthy vending machine choices• Educate students about marketing ploys for
unhealthy snacks• Age appropriate nutrition education• Omit unhealthy fundraisers/limit candy rewards
for good behavior
Behavior Change Strategies
• Increase physical activity:– Provide exercise choices to children– Encourage age appropriate and creative
exercises– Start with 30 minutes of moderate activity
per day
– Make it fun!
Behavior Change Strategies
• Increase awareness of food choices:– Moderate food portions– “5 a day” Vegetables and Fruits
• Limit inactivity– American Academy of Pediatrics
recommends limiting TV viewing to 1-2 hrs/day
CDC’s Guidelines for Promoting Lifelong Physical Activity
• Physical activity of moderate intensity for 5 days of the week– Walking 2 mi X30’– Running 11/2 mi X 15’– Bicycling 5 mi X30’ / 4 mi X 15’– Basketball X 15-20’
A Pound of Prevention….…
• Life-long healthful eating
• Daily physical activity throughout life
• All things in moderation
TIP: Everyone needs to do these things, whether they
are obese, overweight, or normal weight.
What are
your views?