Paeds: OB

Question 1

BMI is the most appropriate ? measure for body fat to diagnose and define childhood obesity

Answer 1

BMI is the most appropriate proxy measure for body fat to diagnose and define childhood obesity

Question 2

For paediatrics, where should BMI be plotted?

Answer 2

For paediatrics,
BMI should be plotted on the WHO 2-20years BMI growth centile chart with the appropriate sex and age.

Question 3

What is the prevalence of childhood obesity/overwight among children?

Answer 3

Prevalence of childhood obesity/overwight among children:
* 1 in 5 children in reception is overweight or obese
* 1 in 3 children in Year 6 is overweight or obese
* Boys are more likely to be overweight or obese than girls
(National Child Measurement Programme 2019/2020)

Question 4

Obesity in children classification

Answer 4

Obesity in children classification
Overweight: > 91st centile
Obese: >98th centile
Severely obese: >99.6 centile
Very severely obese: >/= +3.5sd
Extremely obese: >/= +4sd

Question 5

Can waist circumference be used for the diagnosis of obesity/overweight in children?

Answer 5

It is not clear if waist circumference can be used for the diagnosis of obesity/overweight in children.
WC can detect small changes in the child and adolescent population over time.
A high waist circumference centile added to a high BMI centile can support conclusive diagnosis.

Question 6

Health consequences in childhood related to childhood obesity

Answer 6

Health consequences in childhood related to childhood obesity
* Type II DM (Lee et al 2015)
* Hyperinsulinaemia
* High BP
* Dyslipidaemia
* Psychological disorders
(Gatineau and Dent 2011 )
* Asthma exacerbation

Question 7

Health consequences in adulthood related to childhood obesity

Answer 7

Health consequences in adulthood related to childhood obesity
* Type II DM
* High BP
* CHD (MIs & angina)
* Gall bladder disease
* Ovarian cancer
* Osteoarthritis
* CVA

Question 8

Core components of a nutritional programme for childhood obesity

Answer 8

Core components of a nutritional programme for childhood obesity
* Behaviour change techniques
* Positive parenting skills
* Family involvement
* Tailored plan
* Nutritional labelling
* Building in physical activity into daily life

Question 9

Tailored plan for childhood obesity

Answer 9

Tailored plan for childhood obesity:
* Assessment including co-morbidities
* Mental wellbeing, self-esteem
* Family recognition of level of obesity
* Weight, BMI
* Older children can self-monitor (over 12)
* Dietary changes - Eatwell plate, consider growth
* Manage expectations

Question 10

Questions to ask (Childhood obesity)

Answer 10

• Work with what the child or family will tell you
• Other sources of food
  – Are they given food when they are away from home (nursery/childminders/grandparents)?
  – School meals?
  – Get food themselves?
• What is the family set up?

Question 11

Important to note about classification system of overweight/obesity in children UK

Answer 11

More than 1 classification system is used in the UK to define whether children are overweight or obese.