obesity in children, risk factors, causes, consequences, symptoms, prevention, diet advice, management

1. CHILDHOOD OBESITY
BY: Pooja Tumma
SVT college of home
science

5. DEFINiTION
• Obesity is defined as abnormal or excessive fat
accumulation that may impair health.
• Childhood obesity is a medical condition that
affects children and teenagers.

6. WHAT IS BMI?
• Body Mass Index (BMI) is a measure of body fat
based on weight in relation to height.
• BMI= weight/ (height)m²
• Cut –offs for measuring BMI
Nutritional status WHO criteria Asian criteria
Underweight < 18.5 < 18.5
Normal 18.5-24.9 18.5-22.9
Overweight 25-29.9 23-24.9
Obese ≥ 30 ≥ 30

7. PREVALENCE RATE IN INDIA AND GLOBALLY
• If current trends continue the number of overweight or obese
infants and young children globally will increase to 70 million
by 2025.
Ref: facts & figures of childhood obesity by WHO

8. PREVALENCE of Childhood obesity

10. CAUSES OF CHILDHOOD
OBESITY

11. CAUSES OF CHILDHOOD
OBESITY
• The most common causes of childhood obesity
are:
1. Genetic factors
2. Lack of physical activity
3. Unhealthy eating pattern or combination of these
factors
4. Sedentary lifestyle
• In rare cases, overweight caused by medical
condition such as hormonal problems.

12. RISK FACTORS OF CHILDHOOD OBESITY
• Diet. Regularly eating high-calorie foods, such as fast foods, baked goods
and vending machine snacks, can easily cause your child to gain weight.
Candy and desserts also can cause weight gain, and more and more
evidence points to sugary drinks, including fruit juices, as culprits in
obesity in some people.
• Lack of exercise. Children who don't exercise much are more likely to gain
weight because they don't burn as many calories. Too much time spent in
sedentary activities, such as watching television or playing video games,
also contributes to the problem.
• Family factors. If your child comes from a family of overweight people,
he or she may be more likely to put on weight. This is especially true in an
environment where high-calorie foods are always available and physical
activity isn't encouraged.

13. RISK FACTORS CONTD…..
• Psychological factors. Personal, parental and family stress can
increase a child's risk of obesity. Some children overeat to cope with
problems or to deal with emotions, such as stress, or to fight
boredom. Their parents may have similar tendencies.
• Socioeconomic factors. People in some communities have limited
resources and limited access to supermarkets. As a result, they may
opt for convenience foods that don't spoil quickly, such as frozen
meals, crackers and cookies. In addition, people who live in lower
income neighborhoods might not have access to a safe place to
exercise.

14. HEALTH CONSEQUENCES AND SYMPTOMS OF OF
CHILDHOOD OBESITY
1. Metabolic/ Endocrine
• Type 2 diabetes mellitus
• Insulin resistance/ Impaired glucose tolerance
• Metabolic syndrome
• Menstrual abnormalities in girls
• PCOD
2. Cardiovascular
• Atherosclerosis
• High BP
• Dyslipidemia
• Raised TG
3. Pulmonary
• Obstructive Sleep Apnea
• Asthma

15. SYMPTOMS
4. Gastroenterology
• Non- Alcoholic Fatty Liver disease
• GERD
5. Renal
• Proteinuria
6. Psychological
• Low self esteem
• Depression

16. PREVENTION OF CHILDHOOD OBESITY
• According to WHO, there are 3 modes of preventive measures:
 Universal Prevention
 Selective Prevention
 Targeted Prevention
• Some preventive strategies recommended by WHO 2003 in infants, children
and adolescents:
 Infants and young children:
o The promotion of exclusive breast- feeding during the first 6 months.
o Avoiding the use of added sugars and starches when feeding for formula.
o Instructing mothers to accept their child’s ability to regulate energy intake rather
than force- feed them.
o Assuring the appropriate micro-nutrient intake needed to promote linear growth.
 Children and Adolescents:
o Promote and active lifestyle.
o Limit television viewing.
o Promote intake of fruits and vegetables.
o Restrict intake of energy dense and micro- nutrient poor foods .
o Restrict intake of sugar- sweetened soft drinks.

17. Physical Activity
 More people are driven by technology based, comfort
oriented lifestyles, resulting in changes in the activity
patterns of children towards more sedentary living.
 Children who regularly participate in atleast 3 hours per
weeks for sports activities are protected against total and
regional fat accumulation.
 With increase in physical fitness compared to children
who do not participate sports activities.
 Television viewing, video games and computer games
have been associated with childhood obesity. Time spent
viewing television is considered to be major contributor to
obesity.

18. Physical activity contd…
• Further recommendations to promote physical
activity especially in Indian children.
1. At parent-child level
2. At school- student level
3. At government –community level

19. DIETARY GUIDELINES
• Small, frequent meals at regularly scheduled times.
• Regularly scheduled snacks of fruit or vegetables.
• Do not skip meals.
• No foods are off limits however in order to encourage success moderation is
the key.
• Most of us underestimate the amount of food we eat
• Limiting portion sizes is critical for good health
• Check serving sizes listed on packages & learn to judge sizes more
accurately.

20. Cutting Back On Calories But Feeling Full
• Add vegetables to as many things as possible.
• Eat several servings of fruits daily.
• Avoid processed & fried foods, red meat, ghee
butter, cream & chocolates.
• Some fat is needed to provide essential
nutrients to the body; use veg. oils like olive &
sunflower, but avoid saturated fats.
• Watch foods labeled “fat-free” or “low-fat”;
you may consume more calories overall.

21. Cutting Back On Calories But Feeling Full
• Traditionally, dieters cut cereals, pasta and
potatoes to control weight
• These are sources for complex carbohydrates
that help you feel full and maintain a healthy
weight
• Avoid high-fat toppings on carbohydrates and
try plain or low-fat yogurt.
• Foods high in protein are often high in fat, so
limit protein to 10-15% of total daily calorie
intake

22. Food Diaries
• Suggest taking notebook and taking a one
week diary.
• Note in diary all intake of food, snacks, drinks
and activities while eating.

23. Management
• For overweight children small reduction in
calories allows gradual decline in BMI.
• For obese children & adolescents weight loss of
0.5-1 kg/week is the goal.
• Rapid wt loss can lead to electrolyte disturbances
( K+, uric acid)
• Special diets like protein rich diet not
recommended.

24. Dieting and Eating Habits
• Maximum recommended daily calorie intake:
1600 calories: house wives & older adults
2200 calories: most children, teen girls, active
women, and sedentary men
2800 calories: teen boys & active men

26. Examples
Examples of foods with omega 6 oils: peanuts, soy,
vegetables and seeds and their oils, meat.
Examples of foods with Omega 3 oils: seafood such
as salmon & tuna, walnuts, flaxseed, leafy green
vegetables.
Examples of monounsaturated oils: olive oil, soy
products and oils, canola oil.

27. Carbohydrates
• Toddlers are very active and need a lot of energy
from carbohydrates which also provide a quick
source of glucose for the brain
• The RDA for carbohydrates for toddlers is 130 grams
per day
• The intake of carbohydrates should be from 45-65 %
of their total energy intake
• The carbohydrates should mostly be comprised of
complex carbohydrates such as whole grain breads,
cereals, muffins, fruits and vegetables
• Simple or refined carbohydrates such as white flour
products; breads, cakes, muffins, crackers, candy and
syrups should be kept to a minimum

28. Proteins
• The RDA for toddlers for protein is 1.10 grams per
kg of body weight per day.
Good sources of protein are meats such as poultry
and fish, dairy and soy products.

29. FATS:
• Only 20% or less energy.
• Emphasis must be on unsaturated fats so as to reduce the
risk of heart problems.
• Some amounts of fat is important to make food palatable
and acceptable.
• Fried foods should be restricted or avoided.
• INCLUDE EXCLUDE

30. VITAMINS AND MINERALS
• Adequate amounts of essential nutrients like vitamin and
minerals to maintain good nutritional status.
• Fruits and vegetables should be in ample in the diet as
they are low in energy and good source of vitamins and
minerals.

31. ROLE OF PARENTS
Spare time in learning and cooking nutritious food
for the child
Never use food as a reward
Never encourage children to give orders for home
delivery of fast foods

32.  Encourage them to participate in sports activities
 Reduce use of motor vehicles
 Monitor their fluid intake. Teach children to drink water
instead of sweetened carbonated beverages.
 Avoid storing stocks of energy dense food at home
 Give them healthy packed lunch from home while going to
school
 Use whole grains, vegetables and fruits.
 Monitor and restrict the time spent in watching T.V, computer
use and sitting activities.

34. Foods to Limit or have in Small
Quantities
• Pop, fruit flavored drinks such as sports and energy drinks, candy
and chocolate, cakes pastries, doughnuts, granola bars, cookies,
potato chips, nachos and french fries