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Obesity in Childrem (cont)

Obesity in Children Causes

Children who regularly consume more calories than they use will gain weight. If this is not reversed, the child will become obese over time. Consumption of just 100 calories (the equivalent of 8 ounces of a soft drink) above daily requirements will typically result in a 10-pound weight gain over one year. Many different factors contribute to this imbalance between calorie intake and consumption.

• Genetic factors
  
  • Obesity tends to run in families.
  • A child with an obese parent, brother, or sister is more likely to become obese.
  • Genetics alone does not cause obesity. Obesity will occur only when a child eats more calories than he or she uses.
• Dietary habits
  
  • Children's dietary habits have shifted away from healthy foods (such as fruits, vegetables, and whole grains) to a much greater reliance on fast food, processed snack foods, and sugary drinks.
  • These foods tend to be high in fat and/or calories and low in many other nutrients.
  • Patterns associated with obesity are eating when not hungry and eating while watching TV or doing homework.
    
• Socioeconomic status
  
  • Low family incomes and having nonworking parents are associated with greater calorie intake for activity level.
    
• Physical inactivity
  
  • The popularity of television, computers, and video games translates into an increasingly sedentary (inactive) lifestyle for many children in the United States.
    
  • Children in the United States spend an average of over three hours per day watching television. Not only does this use little energy (calories), it also encourages snacking.
  • Fewer than half of children in the United States have a parent who engages in regular physical exercise.
  • Only one third of children in the United States have daily physical education at school.
  • Parents' busy schedules and fears about safety prevent many children from taking part in after-school sports programs.
    
• Certain medical conditions can cause obesity, but these are very rare. They include hormone or other chemical imbalances and inherited disorders of metabolism.
  
  
• Certain medications can cause weight gain by altering how the body processes food or stores fat.

Obesity in Children Overview

Obesity means an excess amount of body fat. No general agreement exists on the definition of obesity in children as it does adults. Most professionals use published guidelines based on the body mass index(BMI), or a modified BMI for age, to measure obesity in children. Others define obesity in children as body weight at least 20% higher than a healthy weight for a child of that height, or a body fat percentage above 25% in boys or above 32% in girls.
Although rare in the past, obesity is now among the most widespread medical problems affecting children and adolescents living in the United States and other developed countries. About 15% of adolescents (aged 12-19 years) and children (aged 6-11 years) are obese in the United States according to the American Obesity Association. The numbers are expected to continue increasing. Childhood obesity represents one of our greatest health challenges.
Obesity has a profound effect on a child's life. Obesity increases the child's risk of numerous health problems, and it also can create emotional and social problems. Obese children are also more likely to be obese as adults, increasing their risk of serious health problems such as heart disease and stroke.
If your child is overweight, further weight gain can be prevented. Parents can help their children keep their weight in the healthy range.

• In infancy, breastfeeding and delaying introduction of solid foods may help prevent obesity.
  
• In early childhood, children should be given healthful, low-fat snacks and take part in vigorous physical activity every day. Their television viewing should be limited to no more than seven hours per week (which includes video games and the Internet).
  
• Older children can be taught to select healthy, nutritious foods and to develop good exercise habits. Their time spent watching television and playing with computer or video games should be limited to no more than seven hours each week. Avoid snacking or eating meals while watching TV, movies, and videos.

Lifestyle Counseling in Primary Care Setting Reduces Treatment Goals for Diabetics

Lifestyle counseling, practiced as part of routine care for people with diabetes, helps people more quickly lower blood glucose, blood pressure and cholesterol levels and keep them under control, according to a large, long-term study published in the February issue of Diabetes Care (not affiliated with DiabetesCare.net).

Researchers at Brigham and Women's Hospital (BWH) conducted a retrospective cohort study of more than 30,000 people with diabetes who received diet, exercise and weight-loss counseling in a primary care setting over the course of at least two years (with an average follow-up time of almost seven years) and who had elevated blood glucose, blood pressure or cholesterol.
They found that the use of counseling reduced the time it took for patients to lower blood glucose, blood pressure and cholesterol levels. Previous studies have documented the success of counseling in a clinical trial setting, but until now many have questioned whether it would be as effective when conducted as part of ongoing treatment in a primary care setting, where fewer resources are available and patients may be less motivated.
"This study shows that persistent lifestyle counseling can and should be a critical piece of any routine diabetes treatment plan," said senior author Alexander Turchin, MD, MS, director of informatics research at the BWH Division of Endocrinology. "Clearly it gets people to goals faster than when they are not given continued encouragement and information on how to increase physical activity levels, eat properly and reduce lipids. Primary care providers should take these findings to heart."
The study found that the more frequently patients received counseling, the faster they reached their treatment goals, with those who received counseling at least once a month achieving the best results. Those who received face-to-face counseling once a month or more took an average of 3.9 weeks to reach their target goals for A1C, blood pressure and cholesterol, as compared to 13.5 months for those who received counseling only once every one to six months.
Because counseling can be time intensive, researchers recommend that working with providers such as nurse practitioners, physician assistants or dietitians, as well as providing support in group settings, may be more cost-effective ways of providing this necessary support.
This research was supported by the Agency for Healthcare Research and Quality, National Library of Medicine, and Diabetes Action Research and Education Foundation.

Source: American Diabetes Association Press Release