Obesity in Young Children

Bariatric News from Barb MacTaggart

Summary of article by Deborah Krepcio, RN, MSN, CPNP, Kathleen Foell, RD, MS, Sara C. Folta, PhD and Jeanne P. Goldberg, RD, PhD

Childhood obesity is a rapidly growing health problem which extends across populations, races, ethnicity, income, or education.  Children in the U.S., ages 2 to 5, approximately 26% are overweight (greater than the 85th percentile on BMI charts).  Weight problems lead to other health problems.  Obesity is the most common cause of abnormal acceleration of growth in childhood.  It leads to early puberty in girls and abnormalities in sexual development in boys. Diabetes mellitus is becoming more prevalent also.  Obese children are more likely to become obese adults, and obese adults have a greater risk of developing health problems such as hypertension, dyslipidemia, coronary heart disease, diabetes mellitus, gallbladder disease, respiratory disease, certain cancers, gout, and arthritis.  Childhood obesity has psychosocial consequences also.  Studies have shown that even young children are sensitized to obesity, and older children rank overweight children as low potential friends.

Causes of childhood obesity:  Hormonal imbalances are rare, and account for less than 1% of children.  Inactivity contributes to obesity and has been documented even in babies less than a year old.  The percentage of body fat is inversely related to their activity level.  Dietary trends also contribute to obesity.  Compared to 25 years ago, children have doubled their intake of soda (almost all is regular, not diet).  Children are also consuming foods higher in calories, such as pizza and snack foods.  Consumption of vegetables has decreased, except for fried potatoes, which has increased.  Families eat more meals away from home, and these meals typically have more fat and saturated fat, less dietary fiber, and less nutrients, and large portions.  Television viewing also contributes to obesity, not only because it displaces physical activity, but also food intake increases.  Children view advertising which affects food preferences.  Typically, these foods are nutrition poor.

Interventions:  Limit children’s television and video game time.  Keep a food diary and review with a health professional.  Avoid using food as a reward for good behavior or to keep the child occupied.  Schedule meal and snack times.  Caloric restriction is ineffective for managing children’s weight.  Encourage children to eat slowly.  Eating should not be in front of the TV.  Decrease the amount of calorie dense foods offered to the child.  Encourage physical activity the entire family can participate together.  Make realistic goals with one or two changes at a time with positive reinforcement  

Dr. Rosen Note:  This is the same calories in – calories out equation we all talk about.  We are learning that our bodies and minds can influence this equation to a great extent and there are multiple influences including genetics that can make calories in worse and our society can make the calories out less.  Let’s all work on these for all of our families to become healthier.

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