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    Childhood Obesity: Causes and Consequences, Prevention and Management.
    Childhood Obesity: Causes and Consequences, Prevention and Management.
    Childhood Obesity: Causes and Consequences, Prevention and Management.
    Ebook98 pages55 minutes

    Childhood Obesity: Causes and Consequences, Prevention and Management.

    By Wendy Hicks

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    About this ebook

    A comprehensive book describing the causes of childhood obesity including genetics, nutrition and physical activity; the consequences such as diabetes, gall bladder disease and other associated conditions; prevention both by individuals and families as well as government departments and industries and the management of those children already overweight or obese. The book is based on recent research, is fully referenced, has a useful glossary of terminology and also has links for further reading.

    LanguageEnglish
    PublisherWendy Hicks
    Release dateApr 10, 2014
    ISBN9781311594525
    Childhood Obesity: Causes and Consequences, Prevention and Management.
    Author

    Wendy Hicks

    I trained as a State Registered Nurse qualifying in 1977. I then went on to study midwifery before returning to general nursing working in A&E and fracture and orthopaedics. In 1991 I qualified as a health visitor and worked in Cumbria and North-East England. The following year I was asked to work with the Dept of Health developing services within primary care for patients with drug and alcohol problems. at the end of this 1 year project I returned to health visiting and also completed an MA in Counselling at Durham University. In 2002 I was appointed as a Nurse Consultant in Obesity management and established the first nurse-led, community-based, NHS service in the country. The service was commended by, amongst others Derek Wanless describing it as an example of best practice. I was the first nurse able to prescribe anti-obesity medication and also developed an 'expertise' which enabled me to assess patient's suitability for consideration of bariatric surgery. I retired from the NHS in 2008 but continued to work with the overweight and obese and have recently put my knowledge and understanding of overweight and obesity into print.

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      Book preview

      Childhood Obesity - Wendy Hicks

      CHILDHOOD OBESITY:

      CAUSES AND CONSEQUENCES; PREVENTION AND MANAGEMENT

      Wendy Hicks

      Smashwords edition, copyright 2014

      Wendy Hicks

      Childhood Obesity: Causes And Consequences; Prevention And Management

      © 2014, Wendy Hicks

      Self publishing

      ALL RIGHTS RESERVED. This book contains material protected under International and Federal Copyright Laws and Treaties. Any unauthorized reprint or use of this material is prohibited. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system without express written permission from the author / publisher.

      CONTENTS

      INTRODUCTION and CONTEXT

      CHAPTER ONE. IDENTIFYING OVERWEIGHT AND OBESE CHILDREN

      CHAPTER TWO. CAUSES OF CHILDHOOD OBESITY

      CHAPTER THREE. HEALTH RISKS ASSOCIATED WITH CHILDHOOD OBESITY

      CHAPTER FOUR. CHILD PROTECTION

      CHAPTER FIVE. PREVENTION AND MANAGEMENT

      CHAPTER 6. CONCLUSION

      GLOSSARY

      REFERENCES

      INTRODUCTION AND CONTEXT

      Obesity is probably the greatest cause of ill-health and premature death in the UK. It presents a greater public health problem than smoking and alcohol consumption. According to Sturm and Wells (2002) the health risks associated with obesity are worse than smoking, drinking or poverty. Furthermore, it affects children and young people and there is an expectation that the next generation of children will pre-decease their parents because of obesity and its associated health problems.

      Kaur et al (2003) have stated that the critical times for the development of obesity are in the prenatal, early childhood and adolescent periods. According to the World Health Organisation (WHO) 65% of the world’s population are now living in countries where overweight and obesity cause more deaths than underweight. So, even in developing countries obesity has overtaken malnutrition in terms of causing ill health (morbidity) and death (mortality). Furthermore, the numbers of children affected has reached epidemic proportions; public health care systems may be unsustainable and, in the developed world approximately 10% of health care funds are spent on treating conditions related to obesity such as diabetes and heart disease. Again, the WHO estimates that at least 155 million children are overweight or obese.

      North America has 6% of the world’s population — 1/3rd of its population are obese!

      According to The Information Centre for Health and Social Care (2012) in England alone three in ten boys and girls aged 2-15 years are either overweight (31%) or obese (29%).

      In 2010 17% of boys and 15% of girls aged 2-15 were obese. The centre also estimated that, in 2010/11 one in ten reception class children, i.e. children aged 4-5 years, were obese representing 9.4% of that age group. Three in ten boys and four in ten girls aged 2 to 15 are not doing the amount of physical activity recommended by the chief medical officer.

      The International Obesity Task Force estimates that 25% of 13 to 17 year olds living in England are overweight or obese, exceeding other northern European countries.

      The European Congress on Obesity (2005)* announced that children in the UK were narrowing the gap between the numbers of UK and USA children who were obese.

      *(see reference for Lobstein and Bauer). Paradoxically not all obese adults are overweight or obese as children and yet overweight children have a high risk of becoming obese adults. This book will discuss childhood obesity; its causes and consequences and, perhaps more importantly its prevention and management.

      CHAPTER ONE. IDENTIFYING OVERWEIGHT AND OBESE CHILDREN

      Background to BMI and Centile Charts

      The somewhat contentious issue of accurately measuring child growth and identifying those at risk of becoming overweight or obese has been the subject of much research for several decades.

      Body Mass Index (BMI) is a measure derived from height and weight. For most adults BMI is an effective means of determining ‘healthy’ and ‘unhealthy’ weight. However, for children BMI percentiles (1) derived from a population have been used since the 1950’s when children were smaller. Improvements in ante-natal care, nutrition, sanitation and the prevention of infectious diseases account for just some of these changes in child growth.

      Between 1978 and 1994 a large sample of 32,222 measurements of children were collected and the following BMI cut-offs used:

      Underweight: 2nd centile for population monitoring and clinical assessment

      Overweight: 85th centile for population monitoring, 91st centile for clinical

      assessment

      Obese: 95th centile for population monitoring, 98th centile for clinical assessment.

      In the 1990’s Cole (1998) wrote about the difficulties of growth chart designs and in the UK a group of experts from the Scientific Advisory Committee on Nutrition (SACN) and the Royal College of Paediatrics and Child Health (RCPCH) joined forces to discuss the WHO growth standards and to suggest a way forward in defining overweight and obesity in children aged 2 -18 years of age. According to the SACN and the RCPCH, The lack of coherence has given rise to confusion and lack of consistency in the reporting of overweight and obesity. In particular, comparisons across countries have been approached inconsistently, and discrepancies are evident between adult and child BMI thresholds.

      Some of the difficulties associated with the use of centile charts were:

      Bottle fed and breast fed babies gain weight differently. On occasion this has resulted in breast-fed babies appearing (by centile chart) to be failing to thrive and given supplementary formula milk feeds.

      Centile charts show the statistical scatter of the ‘normal’ population and this requires a sample size large enough to be statistically rigorous. Given that centile charts are supposed to represent the ‘normal’ population anyone outside of ‘normal’ would need to be excluded from the data required to produce the charts. In other words they are statistically derived from a reference population.

      Centile charts do not show if a particular parameter is normal or abnormal; they merely show a comparison of a measurement in other individuals.

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