Epidemiology: Children and Obesity

Epidemiology: Children and Obesity

Introduction

The prevalence of obesity in children and adolescents has increased significantly in recent decades to be a major public health problem. Obesity is considered to excess body weight, due mainly to fat mass, a situation that affects the health of individuals and puts you at risk of developing a chronic disease. Clinically, a child is considered obese when their weight exceeds 20% over ideal weight for their age, height and sex. For diagnostic accuracy, this should be supplemented with an index to estimate body fat, such as triceps skinfold measurement.

The weight for age, in isolation, is not a good indicator because it can be classified as obese children with height above the mean or children with increased muscle development and normal amount of fat tissue, or conversely, be considered normal children short stature with low body mass and excess body fat. According to the criteria currently used for assessment of nutritional status in infants and in children under age 6 are considered obese one whose weight for height is located above 2 SD in the NCHS reference charts for the appropriate sex, and overweight or at risk of obesity when this indicator is between +1 and +2 SD.

For children aged 10 years or who have initiated pubertal development, WHO recommends the use of body mass index (BMI), calculated by dividing actual weight by height squared. Suggested criteria to define obesity are: BMI 95th percentile or, BMI greater than 85th percentile, associated with measurement of triceps and subscapular folds above the 90th percentile of NCHS reference values. There have been various suggestions with regard to the reference tables recommended BMI (Must, local tables, curves developed by an international group of obesity), but there is still controversy, since some of them favor a misdiagnosis.

Discussion

In assessing the child you should make a detailed history including personal history such as age of onset of overweight, and progression of this magnitude, possible triggering factors or situations, food surveys, description of habits of patient and family in relation to food and physical activity presence of other associated symptoms or clinical manifestations. It is important to proper dietary assessment, detailing the child's eating habits to identify those behaviors that can lead to excessive calorie intake and possible to target action. This can be supplemented with a 24-hour recall or evaluating consumer trends. It is also necessary to evaluate the physical activity performed by the patient, in order to identify opportunities to increase energy expenditure.

The family history is important to find out presence of obesity in other family members, presence of chronic non communicable diseases (diabetes mellitus, hypertension, dyslipidemia, and cardiovascular disease), family situation, people with whom the child lives, person responsible perception of their care and family about the child's nutritional status. The review is critical physical anthropometry; you should consider weight and height to calculate BMI as IPT or the child's age. It is important to estimate adipose tissue and its distribution, if possible with measurement of skinfolds and the ...