2. Childhood Obesity
Overview
Definition, Facts
The WHO Organization
Factors & Consequences
Affecting Obesity
Measuring Obesity (BMI)
Prevalence of Obesity
in Europe (EYHS)
Prevention Guidelines
3. • Established in 1948, The World Health Organization (WHO) is
the United Nations specialized agency for health.
• WHO's defines Health as a state of complete physical, mental
and social well-being and not merely the absence of disease or
infirmity.
• World Health Assembly is composed of 193 Member States
WHO:
Overweight & Obesity are defined as
abnormal or excessive fat accumulation
that may impair health.
4. • Obesity is a Global Concern
WHO Facts 2005-06 data:
World: 1.6 billion adults (age 15+) overweight
400 million rated obese
20 million (age < 5) are overweight
European obesity estimates:
20% (150 million adults)
10%(15 million child)
By 2010, WHO expects 1 in 10 European children
will be obese and currently obesity is the most common
childhood disorder in Europe.
5. International Obesity TaskForce (IOTF) is part of an International
Association for the Study of Obesity (IASO), a global federation for
researching and understanding the science behind obesity.
Global social trends affecting obesity:
• Increased use of motorized transport e.g. to school
• Fall in opportunities for recreational physical activity
• Increased sedentary recreation
• Multiple TV channels around the clock.
• Greater quantities and variety of energy dense foods available (fat is energy dense).
• Rising levels of promotion and marketing of energy dense foods
• More frequent and widespread food purchasing opportunities
• More use of restaurants and fast food stores.
• Larger portions of food offering better “value” for money.
• Increased frequency of eating occasions
• Rising use of soft drinks to replace water e.g. in schools
6. Health Consequences of Obesity:
• Cardiovascular disease (mainly heart disease & stroke)
world’s #1 cause of death, killing 17 million people worldwide each year
• Diabetes - a world epidemic. WHO projects 50% increase in the next decade worldwide.
• Musculoskeletal disorders, especially osteoarthritis
• Some cancers ( endometrial, breast, colon)
• Childhood Obesity is associated with a higher chance of premature adult death/disability.
• “Double Burden” factor in low and middle-income countries. Caused by inadequate
pre-natal, infant, and child nutrition followed by an exposure to high-fat,
energy dense, micronutrient-poor foods and a lack of physical activity.
• WHO has found under-nutrition and obesity existing side-by-side within the same
country, same community, and even in the same household.
7. Measuring Obesity Using the Body Mass Index (BMI)
BODY MASS INDEX (BMI)
Formula,
Weight ( Kg)/Height (M2)
A simple index of weight-for-height that is
Commonly used to classify underweight,
Overweight, and obesity in adults. Absolute in
Scale and applies to everyone
Example,
BMI CLASSICATION TABLE
CLASSIFICATION
Height
Wt.
Range
BMI
Considered
5” 9”
124 lbs. or
less
Below 18.5
Underweight
125 lbs to
168 lbs
18.5 to 24.9
Healthy
Weight
169 lbs to
202 lbs
25 to 29.9
Overweight
203 lbs or
more
30 or higher
BMI KG/M2
PRINCIPLE
CUT-OFF
POINTS
NORMAL RANGE
OVERWEIGHT
PRE-OBESE
OBESE
Obese
OBESE CLASS 1
18.50-24.99
≥ 25.00
25.00-29.00
≥ 30.00
30.00 - 34.99
OBESE CLASS 2
35.00
OBESE CLASS 3
≥ 40.00
8. BMI for age is adjusted for
children with the same age and
same gender
• RED = OVERWEIGHT
• YELLOW = AT-RISK FOR BEING
OVERWEIGHT
• GREEN = HEALTHY WEIGHT
CATEGORY
• ORANGE = UNDERWEIGHT
CATEGORY
Age
BMI Healthy
Range
10
14.2 - 19.4
13
15.5 - 21.7
15
16.5 - 23.5
Adult
18.5 - 24.99
9. Using the Body Mass Index (BMI)
Advantages:
• Inexpensive to use making it practical
• Can be used on everyone making it universal
• Easy to interpret with a standard measurement in a table
Disadvantages:
• Results are not precise in measurement of Fat content.
For example, a larger individual muscular bound athlete might be rated obese
because their weight although lean, weighs more and this increase
the BMI. BMI correlates with an amount of body
fat but does not directly measure body fat.
Other methods exist to calculate body fat content
Which include, underwater weighing, skin fold calipers, bioelectric
Impedance. This measures electrical impulses traveling through body
tissues such as fat. This method is considered most accurate because
it can measure fat and not just estimate.
10. European Youth Heart Study
• Incorporates 10 EU partners and 1 Non-EU (Australia)
• Each of the 18 locations a study consists of at least 1000
Boys & Girls ages 9 to 15
Primary Goal: Ultimate aim is to reflect the full spectrum of
Adult CardioVascular Disease (CVD) throughout Europe
• Principal assessment are Cardio Vascular Disease (CVD) factors
• physical activity levels • Blood pressure
• Blood lipid levels
• Smoking habits.
• Other CVD factor assessments
• Body mass indexing • insulin levels
• Nutritional status • Food intake,
• Demographic, socio-economic, and environmental issues
• Family support • Parental lifestyle • Intention to change behavior
• Barriers to healthy behavior
• Self-confidence & Stress levels
• Alcohol intake
• Use of leisure time.
11. 30
Prevalence of BMI for 13 years-old
≥ 85th percentile
(At-Risk)
25
20
15
10
% ≥ 85 Centile
5
0
Boys
Denmark
Ireland
Girls
Sweden
Lithuania
Finland
USA
12. Prevalence of BMI for 13 years-old
≥ 95th percentile
(Overweight)
14
12
10
8
6
% ≥ 95 Centile
4
2
0
Boys
Denmark
Ireland
Girls
Sweden
Lithuania
Finland
USA
13. Multiple Factors in Cardio Vascular Disease (CVD)
Body Fat & Fitness Level Changes in 9 year-old Danish Boys and Girls
Using multiple 2-year periods
50
45
40
35
30
25
20
15
10
5
0
fat percent
fitness levels
Boys
1985 -87
Boys
1997 -98
Girls
1985 -87
Girls
1997 -98
14.6
49
15.9
47
23.2
43
22.8
42
14. Prevention Guidelines
WHO recommends,
• Provide clear and consistent consumer information e.g. food labels
• Encourage food companies to provide lower energy food, more nutritious foods
marketed for children
• Develop criteria for advertising that promotes healthier eating
• Design secure play facilities and safe local neighborhoods
• Encourage schools to enact coherent food, nutrition, and physical activity policies
• Encourage medical and health professionals to participate in the development of
public health programs