15-16. Childhood Obesity & Obesity

Question 1

How does the diagnosis of obesity in children differ from adults?

Answer 1

• Children: BMI greater than or equal to 95th percentile for their age and gender
• Adults: BMI of 25, 30, 35, 40

Question 2

While a large fraction of the U.S. population seems to have the genetic predisposition for obesity, what has changed since the 1960s that has revealed this predisposition in children?

Answer 2

Obesigenic society

Question 3

In what ways is childhood obesity a “prejudiced” disease? What segments of the population are disproportionately affected?

Answer 3

Tends to affect lower income populations more

Question 4

What steps would you institute in K-12 schools to attempt to stop the rising tide of childhood obesity?

Answer 4

• Reduce access to unhealthy foods
• Increase physical activity
• Health education

Question 5

Name 3 diff diseases that become much more likely when a child becomes more sedentary and unhealthy?

Answer 5

• Diabetes
• Atherosclerosis
• Obesity

Question 6

What is the equation for BMI?

Answer 6

BMI = Kg/m^2

Question 7

What is the BMI criteria for childhood obesity? Overweight?

Answer 7

• Obese: BMI greater than or equal to 95th percentile for age and gender
• Overweight: 85-95th percentile

Question 8

In what % of children is extreme obesity found?

Answer 8

6.4%

Question 9

What is the effect of obesity on life expectancy?

Answer 9

Decline in life expectancy

Question 10

What is the prevalence of type 2 diabetes in youth?

Answer 10

1.54 / 1000

Question 11

What is acanthosis nigrans?

Answer 11

A sign of hyperinsulinemia characterized by tough, darkened skin particularly in skin creases

Question 12

How is birth weight a predictor of childhood metabolic syndrome?

Answer 12

• Over or underweight infants develop obesity and insulin resistance in higher prevalence
• Average weight is best

Question 13

What are some target organ consequences of ectopic fat?

Answer 13

• Nonalcoholic fatty liver disease

- Lipid cardiomyopathy

Question 14

How does physical activity affect insulin sensitivity

Answer 14

Increase

Question 15

What are the ranges of normal blood glucose? Pre-diabetic? Diabetic?

Answer 15

• Normal = 70-109
• Pre-diabetic = 110-125
• Diabetic: greater than 126

Question 16

Type I vs. Type II diabetes?

Answer 16

TYPE I:
-uncommon (10% of cases)
-low/no insulin
-auto-immune destruction of pancreatic beta cells
-childhood onset
-not hypokinetic
TYPE II:
-common (90% of cases)
-normal/high insulin
-insulin resistant insulin receptors
-mid-life onset
-hypokinetic disease

Question 17

What is HbA1c?

Answer 17

Gives a 2-3 month estimate of avg blood glucose based on glycosylation of Hb

Question 18

What level HbA1c is normal? Elevated?

Answer 18

• Normal: less than 6.5

- Elevated: greater than 6.5

Question 19

What is the treatment target HbA1c for diabetics?

Answer 19

Less than 7.0

Question 20

What HbA1c constitutes “inadequate control” of diabetes?

Answer 20

7.5-9.0

Question 21

What are the short term complications of diabetes?

Answer 21

• Dehydration (polyuria, polydipsia)
• Weight loss, muscle wasting (polyphagia)
• Hypoglycemia (due to drugs)

Question 22

What are the long term complications of diabetes?

Answer 22

• Accelerated atherosclerosis

- Microvascular occlusion (retina, kidneys, nerves, extremities)