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OBESITY: AN EMERGING THREAT Dr. Nikhil Tandon Additional Professor Department of Endocrinology All India Institute of Medical Sciences New Delhi.

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Presentation on theme: "OBESITY: AN EMERGING THREAT Dr. Nikhil Tandon Additional Professor Department of Endocrinology All India Institute of Medical Sciences New Delhi."— Presentation transcript:

1 OBESITY: AN EMERGING THREAT Dr. Nikhil Tandon Additional Professor Department of Endocrinology All India Institute of Medical Sciences New Delhi

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6 PREVALENCE OF OBESITY IN DELHI SCHOOL CHILDREN FROM DIFFERENT SOCIO -ECONOMIC GROUPS PrivateBoysGirlsGovt. Total Non-obese Obese /Overwt Tandon and colleagues, 2004

7 Obesity in Children and Young Adults Obesity Abdominal Obesity Misra and colleagues, International Journal of Obesity, 2004

8 Childhood Obesity is the Important Determinant for Diabetes in Children Snapshot Youth-onset Type 2 diabetes is a real concern in many countries Our data show that increase fat over chest and abdomen is a extremely important determinant of youth-onset diabetes

9 Type 2 Diabetes Mellitus in Children, Adolescents and Young Adult Asian Indians (CAYA-2DM Trial): A Multicenter Collaborative study Objective To study the anthropometric, biochemical and immunological profiles of children, adolescents and young adults with type 2 diabetes mellitus and compare them with age-matched healthy controls

10 Subjects: 31 patients; 59 age-matched healthy controls Anthropometric Profile: Body mass index, waist circumference, waist-hip ratio, skinfold thickness at 8 sites Percentage body fat by two-point bioelectrical impedance CAYA-2DM Trial Methods

11 Variable(s)Cases (n=31)Controls (n=59) Pulse rate81.6± ±10.2 Systolic BP (mmHg) 121.5± ±12.2*** Diastolic BP (mmHg) 76.6± ±11.0 BMI (kg/m 2 )24.7± ±5.3** Waist Circumference (cm) 83.0± ±15.2*** Waist Hip Ratio0.89± ±0.07*** *:p<0.05; **: p<0.01; ***: p<0.001 CAYA-2DM Trial Comparative Clinical Profile

12 CAYA-2DM Trial Comparison of Cases and Controls Variable(s)Cases (n=31)Controls (n=59) Skinfold thickness (mm) Biceps13.8±6.38.7±6.3** Triceps21.2± ±8.7* Subscapular29.0± ±10.7*** Suprailiac29.7± ±12.3** Thigh31.7± ±13.0 Calf19.5± ±7.2 Percent body fat33.1± ±9.6*** *:p<0.05; **: p<0.01; ***: p<0.001

13 CAYA-2DM Trial Comparison of Cases and Controls Variable(s)Cases (n=31)Controls (n=59) Overweight (BMI>25 kg/m 2 ) ** High %BF (>25% M, >30% F) ** High WC (>102 cm M, > 88 F) * High W-HR (>0.95 M,> 0.80 F) ** Hypercholesterolemia (>200 mg/dL) * Hypertriglyceridemia (>150 mg/dL) ** Low HDL-C (< 40 M, < 50 F) * High LDL-C (>130 mg/dL) *:p<0.05; **: p<0.01; ***: p<0.001

14 Generalized (high BMI) as well as abdominal obesity (high W-HR) are the most important predictors for early onset of IGT and T2DM in Asian Indians. CAYA-2DM Trial Conclusions

15 How to Predict Diabetes in Children ParameterRisk Abdominal obesity & family history of diabetes 68 times

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17 CAYA-2DM Trial Weight Percentiles of Cases: Birth and Current

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20 ISSUES Increasing obesity Contributory factors: - calorie dense food - consumption of processed foods - limited physical activity - sedentary interests: computers, TV, video games THE SEED FOR ADULT OBESITY IS SOWN EARLY - CHILDHOOD

21 INTERVENTIONS Catch them young - school age children must be targeted Increase awareness: media; school teachers; governmental and NGO effort Minimise advertising pressure for “junk foods” School play grounds; “Games periods” Health food in school canteens


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