1. Weighing In On Childhood Obesity

2. Prevalence of Overweight Among Children and Adolescents Ages 6-19 Years

3. TREND 1 of every 4-5 children is overweight 1 in 3 adults are overweight Doubling of number of severely obese Ethnic differences AA (1/3) > Hispanic > White (1/5). Little information about Asians and Native Americans

4. DEFINITION OVERWEIGHT VS OBESE Overweight = weight greater than set standards (may be muscle, bone or fat) Obese = high proportion of body fat Overweight=BMI >85 percentile Obese=BMI>95 percentile

5. WHAT IS THE BMI? Better measurement of obesity than weight for height Calculation: Weight in kg / height squared in meters Use in children age 6 and over

6. CALCULATING YOUR CHILD’S BMI

7. ITS JUST BABY FAT. SHE’LL OUTGROW IT After the first year of life children become thinner until 5-6 years of age when they become fatter again (Adiposity Rebound) Toddlers are picky eaters Early adiposity rebound is associated with later obesity

8. PREDICTING ADULT OBESITY Obese 6 year old has a 25% chance of becoming obese adult Obese 12 year old has a 75% chance of becoming a obese adult

9. WHY IS MY CHILD OVERWEIGHT? Diet Exercise Genetics Endocrine Cultural/behavioral factors Profound environmental effects on a susceptible population

10. DIET Changing diet with increased fat and calories Changing size of portions- SUPERSIZE MEAL (1800 vs. 600 CAL) BUT no evidence of increased caloric intake in studies

11. EXERCISE Television and videogames What happened to PE? Decline in physical activity in adolescents

12. GENETIC If parents are obese child is more likely to be obese Genetic vs. environmental Melanocortin 4 receptor gene mutation 5% of subjects with severe obesity commencing in childhood more likely in extremely obese

13. ENDOCRINE Thyroid Not usually a cause Endocrine problems=SHORT and fat Lower resting energy expenditure in some AA girls

14. CULTURAL/BEHAVIORAL White girls more dissatisfied with their weight than AA girls AA girls more likely to engage in practices associated with overeating

15. WHY SHOULD I WORRY? TYPE 2 DIABETES Now most frequent cause of diabetes in children HYPERLIPIDEMIA HYPERTENSION Hispanic and African American children at highest risk PSYCHOLOGICAL EFFECTS

16. WHAT CAN I DO?

17. TALK TO YOUR CHILD’S DOCTOR Children are growing and have special needs Aim for gradual weight loss or no weight gain

18. MAKE IT A FAMILY THING Be a role model for your children Plan family activities that provide exercise Reduce the amount of time spent in sedentary activities Help your family choose a healthy diet.

19. The parent’s job is to decide what foods to offer and when. The child’s job is to decide how much to eat.

20. DIET Avoid fad diets Don't eat or snack in front of the TV Eat slowly. Make mealtime enjoyable. Use fruits an vegetables for snacks Don't use food as a reward

21. STOPLIGHT DIET RED: Cakes, cookies, chips, soda YELLOW: Starchy vegetables, pasta, white bread GREEN: Green vegetables, fresh fruits, water

22. EXERCISE Increase exercise Decrease sedentary activity Involve everyone in family

23. DISORDERED EATING Anorexia/Bulimia Be careful what message you send: Focus on health rather than weight

24. WHAT IF IT DOESN’T WORK? Pharmacological and surgical treatments No safe drugs at this time Surgery carries risks Long term consequences for bone mineralization unknown

25. AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE SCHOOL LUNCH P.E.

26. WEB INFORMATION kidnetics.com (ACTIVATE) 9-12 yr. olds niddk.nih.gov/health nhlbi.nih.gov

28. QUESTIONS?