child healthy weight

Question 1

what is the WHO definition of obesity/overweight?

Answer 1

Abnormal or excessive fat accumulation that may impair health

Question 2

what are the clinical thresholds for child obesity and being overweight?

Answer 2

≥ 91st centile - overweight
≥ 98th centile - clinical obesity

Question 3

what are some of the risk factors for being overweight at 3 years old?

Answer 3

Parental overweight
Black ethnicity
Greater birthweight
Smoking during pregnancy
Lone motherhood
Prepregnancy overweight
Maternal employment ≥21 hrs/week
Solid foods before 4 months
-Breastfeeding ≥ 4 months protective

Question 4

how is a clinical assessment carried put?

Answer 4

BMI – plot on centile chart
Eating habits, physical activity patterns, screen time
Social circumstances
School history
Emotional/ psychological issues
Family support
Stature of close family relatives
Family history e.g. obesity/diabetes

Question 5

what is the maximum recommended sugar intake?

Answer 5

age 4-6: 19g
age 7-10: 24g
age >11: 30g

Question 6

what are the physical activity recommendations for U5s who cant walk?

Answer 6

Encourage through floor-based play and water-based activities in safe environments

Question 7

what are the physical activity recommendations for U5s who can walk?

Answer 7

Should be physically active daily for at least 180 mins, spread throughout the day
On average extra 30-60 mins per day

Question 8

what are the physical activity guidelines for 5-18 year olds?

Answer 8

Required for substantial health benefits (physical and psychological)
Doing more → additional health gains
If currently inactive, doing some activity → some health benefits
Can gain health benefits even if no change in weight
Muscle and bone strengthening activities

Aim for >60 mins of exercise every day

Question 9

why is >2 hours a day of sedentary behaviour bad?

Answer 9

associated with significantly increased risk of overweight and obesity in a dose response manner

Question 10

what are the features of orlistat?

Answer 10

Inhibits gastric and pancreatic lipase to reduce absorption of dietary fat ~30%

GI side effects – oily stools, faecal urgency, nausea, abdo pain

Question 11

when should orlistat be used in children?

Answer 11

not recommended for U12s
only used in 0ver 12s with very severe/extreme obesity (BMI>99.6 centile)