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Pediatrics > Child and Adolescent Obesity > Flashcards

Child and Adolescent Obesity Flashcards

1
Q

How is obesity measured?

A

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

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2
Q

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

A

85th-96th percentile

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3
Q

Which percentile is a child with obesity in?

A

97th+

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4
Q

What is the trend in prevalence of obesity in Canada?

A

It has been increasing over the years

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5
Q

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

A

26%

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6
Q

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

A

Alberta (22%)
Quebec (23%)

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7
Q

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

A

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

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8
Q

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

A

31.5%

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9
Q

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

A

80%

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10
Q

What are the spheres of influence of overweight/obesity?

A

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

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11
Q

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

A

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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12
Q

What are some causes of childhood obesity?

A

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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13
Q

At what age does the adiposity rebound happen?

A

6years old

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14
Q

What are critical periods in obesity?

A

developmental stages where physiological alterations increase risk of obesity

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15
Q

What are the three critical periods?

A

Prenatal
Adiposity rebound
Adolescence

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16
Q

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

A

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

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17
Q

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

A

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

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18
Q

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

A

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

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19
Q

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

A

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

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20
Q

What increases the likelihood of having a large baby?

A

Being overweight and even more so if you’re obese

21
Q

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

A

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

22
Q

What are some Familial obesity causes?

A

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

23
Q

What are some obesity causes at school?

A

PE
Food environments
School lunch programs
Weight-based teasing

24
Q

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

A

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

25
Q

Between 1995-2008 weight bias increased by how much?

A

by 66%

26
Q

Weight-based teasing starts at what age?

A

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

27
Q

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

A

weight bias

28
Q

What are some effects of weight stigma?

A

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

29
Q

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

A

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

30
Q

What are excess sugar sweetened beverages associated with?

A

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

31
Q

What is the link between food marketing and children?

A

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

32
Q

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

A

physical
Communication
Economic
Social
Political

33
Q

What does the food environment look like around schools?

A

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

34
Q

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

A

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

35
Q

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

A

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

36
Q

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

A

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

37
Q

What is the gut microbiota involved in?

A

Involved in the control of BW, energy homeostasis and inflammation

38
Q

What variables influence the gut microbiota ecology?

A

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

39
Q

What are some long term complications of Obesity

A

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

40
Q

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

A

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

41
Q

What is the hypothetical pathway from Obesity to T2D?

A

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

42
Q

What is the hypothetical pathway from obesity to hypertension?

A

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

43
Q

What is the hypothetical pathway from obesity to stroke?

A

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

44
Q

What is the hypothetical pathway from obesity to cancer?

A

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

45
Q

What causes systemic inflammation in children with obesity?

A

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

46
Q

Atherosclerosis develops over how long?

A

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

47
Q

What is the link between childhood obesity and insulin resistance?

A

52.1% of obese children have insulin resistance

48
Q

When is it safe to carry excess weight?

A

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

49
Q

What do we do to help obesity?

A

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)

Pediatrics (17 decks)

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