Child and Adolescent Obesity Flashcards by J Unknown

How is obesity measured?

Age(yrs)
BMI (kg/m^2)

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Which percentile of the growth curve says a child is overweight?

85th-96th percentile

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Which percentile is a child with obesity in?

97th+

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What is the trend in prevalence of obesity in Canada?

It has been increasing over the years

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What is the percentage of overweight/obese children in Canada?

26%

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What two provinces are under the national percentage of obese/overweight children?

Alberta (22%)
Quebec (23%)

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What do the portraits of 12 year olds in 1981 vs 2007-2009 show us?

Our body composition numbers have increased
Our fitness test numbers have decreased
We have gotten worse overall

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What is the percentage of children and adolescents classified as having overweight or obesity?

31.5%

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What is the percentage of adolescents with obesity that have obesity in adulthood?

80%

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What are the spheres of influence of overweight/obesity?

Weight-related issues<==> individual characteristics <==> familial influences <==> peer influences <==> school & other institutional factors <==> community factors <==> societal factors

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What are the problematic social trends that lead to an increased incidence of obesity?

Increased use of motorized transport
Decreased opportunities for recreational PA
Increased sedentary recreation
24/7 TV
Increased quantity and variety of energy-dense foods available
Increased promotion and marketing of energy-dense foods
Increased frequency and opportunities to purchase food
Increased use of restaurants and fast food
Larger portions, better “value”
Increased number of eating occasions
Water being replaced

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What are some causes of childhood obesity?

Sleep debt
Endocrine disruption
Decreased variability of ambient temperature
Smoking
Pharmaceuticals
Age and ethnic groups
Increasing maternal age
Intra-uterine and intergenerational effects
Genetic predisposition
Assortative mating

Weak evidence for:
Calcium insufficiency
Increased maternal age
Breastfeeding
Endocrine disruptors

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At what age does the adiposity rebound happen?

6years old

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What are critical periods in obesity?

developmental stages where physiological alterations increase risk of obesity

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What are the three critical periods?

Prenatal
Adiposity rebound
Adolescence

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What happens if the adiposity rebound happens earlier than 6 y/o?

5.5 y/o or earlier is associated with increased risk of adult obesity

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What happens to the baby when mothers with OW/OB give birth?

give birth to large babies (LGA)
fetal BW tracks into adulthood

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What happens when the mother gains excessive gestational weight? And what is the normal amount of weight gain during pregnancy?

Increased maternal postpartum weight retention
Mothers should gain 25-35 lbs during a normal pregnancy

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What are some consequences of obesity towards maternal and fetal health?

Mom: increased risk for gestational diabetes, T2D, CVD
Baby: increased risk for obesity and CVD as kids

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What increases the likelihood of having a large baby?

Being overweight and even more so if you’re obese

What are the factors associated with greater risk of childhood obesity and intergenerational cycle of obesity throughout the lifespan?

Higher pre-pregnancy weight
Excessive gestational weight gain
Babies born LGA

What are some Familial obesity causes?

significant driver of childhood OW/OB (genetic, social factors)
Parental obesity (1 OW parent= 50% chance of child OW/OB, 2 OW parents=80% chance of child OW/OB)
Family meals (12% less likely to be obese when getting at least 3 family meals per week)
Family PA patterns
Family lifestyle

What are some obesity causes at school?

PE
Food environments
School lunch programs
Weight-based teasing

What happens during adolescence that could increase the risk of obesity?

Change in diet and behavior
Puberty
Change in quantity and distribution of fat
Decrease in physical activity
Decrease fitness
Changes to circadian rhythm which affects eating habits

Between 1995-2008 weight bias increased by how much?

by 66%

Weight-based teasing starts at what age?

According to the article: 4y/o According to the slides: 3-5 y/o

What is the most frequent source of employment discrimination that adults describe?

weight bias

What are some effects of weight stigma?

Stress Binge eating Maladaptive weight control Disordered eating Elevated BP Poorer treatment adherence Less trust of health providers Avoidance of follow-up care Depression/anxiety Low self-esteem Poor body image Poor glycemic control Less effective chronic disease self-management

What is the trend with consumption of sugar-sweetened beverages?

Increased dramatically in recent decades Increased fast food consumption and at home

What are excess sugar sweetened beverages associated with?

Increase energy intake High in fructose corn syrup==> increased lipogenesis==> inhibit satiety signals==> reduce energy expenditure Increase risk of weight gain

What is the link between food marketing and children?

Children view more than 25 million food and beverage ads online (3/4 for unhealthy food) Children view 15-20 ads per hour

What are the different sphere where municipalities can ensure micro-environments provide and encourage healthy food choices?

physical Communication Economic Social Political

What does the food environment look like around schools?

About 70% of schools have 1 or more unhealthy food vendor within 500m of them

What are the WHO and United Nations stances on food marketing?

WHO: Need to manage marketing to children, "settings where children gather should be free from all forms of marketing of foods... United Nations: recommended action on marketing and advertising to children

What is the Quebec government stance on food marketing to children?

Quebec Consumer Protection Act Only province that prohibits all commercial advertising to children (not just food and beverages) Specifically during peak viewing times

What is the federal government's stance on food marketing to children?

Health Canada's Healthy Eating Strategy Senate Bill "the Child Health Protection Act" seeks to prohibit marketing of unhealthy food and beverages to children <17 y/o ==> Never received final approval

What is the gut microbiota involved in?

Involved in the control of BW, energy homeostasis and inflammation

What variables influence the gut microbiota ecology?

Host genetics, delivery method, diet, age, environment, and the use of pre, pro and antibiotics

What are some long term complications of Obesity

Type 2 diabetes Mellitus Metabolic syndrome Dyslipidemia Hypertension Non-alcoholic fatty liver disease Polycystic ovarian syndrome Infertility Malignancies: uterine, colon, breast

What are the effects of obesity on a child's quality of life?

Often experience depression, low self-esteem Health related quality of life scores similar to kids undergoing chemotherapy

What is the hypothetical pathway from Obesity to T2D?

Childhood obesity ==> adulthood obesity==> obesity related event ==> increased insulin resistance ==> increased blood glucose ==> T2D

What is the hypothetical pathway from obesity to hypertension?

Increased demand on the CV system ==> Increased BP ==> Hypertension

What is the hypothetical pathway from obesity to stroke?

Increased blood lipids==> atherosclerosis==> heart attack/stroke

What is the hypothetical pathway from obesity to cancer?

Increased cellular stress ==> increased malignant cell formation ==> cancer

What causes systemic inflammation in children with obesity?

Excessive fat tissue expansion (obesity) ==> stress response ==> inflammation Chronic elevated systematic inflammation is linked to T2D and CVD

Atherosclerosis develops over how long?

Over the course of 50 years beginning in the early teenage years

What is the link between childhood obesity and insulin resistance?

52.1% of obese children have insulin resistance

When is it safe to carry excess weight?

There is no safe time to carry excess weight Effects of obesity on our systems begin in childhood not adulthood Consequences appear later in life

What do we do to help obesity?

Difficulties in pediatric weight management Attrition/dropout/low adherence transition from child to adult care Terminology and words used Parent buy in (clinical interventions that focus on the family are most effective)