Obesity in Children - Essay Example

Running Head Obesity in Children Obesity in Children Effective long-term treatment options for obese children are currently limited, but critics suggest that the primary goal of managing uncomplicated childhood obesity should be healthy eating and physical activity, not achievement of ideal body weight. Data are sparse for trends in overweight/obesity in children, but in the USA there has been a significant increase from 4% in 6-11-year-old boys and girls in 1990s to 11% in boys and 10% in girls in 2000. Similar increases are evident for the 12-17-year-old group (Caprio 2006). Childhood obesity is also associated with hyperlipidemia, high blood pressure and early symptoms of type 2 diabetes. Thesis Child obesity is one of the main problems today caused by unhealthy dietary patterns, lack of physical activities and sedentary lifestyle. An increase in body mass index (BMI) and percentage ideal body weight are good predictors of morbidity, some researchers suggest that visceral obesity represents a variant that is more closely related to excess morbidity. Daniels states that obesity-problems and diseases "once thought applicable only to adults are now being seen in children and with increasing frequency. Examples include high blood pressure, early symptoms of hardening of the arteries, type 2 diabetes, nonalcoholic fatty liver disease, polycystic ovary disorder, and disordered breathing during sleep" (Daniels 2006, 47). Following Wadden and Stunkard (9) blood volume is increased in obesity in proportion to the increased body mass. Because blood volume increases with obesity proportionally more than does cardiac output, even simple obesity is a volume expanded state. Even in simple obesity, cardiac stroke volume and pulse rate are increased in line with the hypervolaemic conditions mentioned above. Obese patients with co-morbidities have cardiac dilation and hypertrophy demonstrable by echocardiography (Hills 82). ECG diagnosis of hypertrophy is more problematic because of the effect of thickening of the chest wall. Some studies suggest left ventricular mass index is proportional to BMI, others that it is more closely related to percentage of body weight over ideal weight. However, as the strain on the heart persists both impaired systolic function and diastolic function typically develop (Glanz and Sallis 2006). Obesity can impact on lung function, with excess central fat deposition producing a restrictive pulmonary abnormality and increased work of breathing. As a result, respiratory complaints are common in subjects with obesity and conditions such as asthma are often overdiagnosed in obese patients. Obesity is also linked to breathing disorders during sleep, such as sleep apnoea and nocturnal hypoventilation (Wadden and Stunkard 92). Fast food, unhealthy behavior patterns and lack of physical activity lead to increased obesity in children. As the most important, "the industry markets heavily to children with the goal of fostering a fast-food habit that will persist into adulthood" (Murphy, 2000). As with adults, it is critical that children who are overweight or obese at minimum achieve the recommendations of physical activity for health for their age. Two consensus conferences held during the last decade have addressed the activity needs of young people. Achieving standard recommendations has been even more difficult with children than with adults (Hulls 43). The main problem is that children can show deterioration in their health due to low activity levels, because there has been insufficient time, and therefore there are no strong epidemiological endpoints on which to establish relationships (Daniels 2006). As well as reinforcing physical activity behaviors, reducing access to sedentary life style can increase activity levels in obese children. There is a close link between sedentary living (such as the amount of time spent watching television) and obesity, than physically active pursuits and obesity (Karen et al 2005). Helping children make permanent, healthy changes to their eating habits is a duty of parents and school authorities responsible to prevent of overweight and treat obesity in children Although many health professionals recognize the importance of dietary management, research suggests that there is a difficulty in the specific food changes, which are practical and realistic for patients to implement over the longer term (Daniels 2006). Such difficulty may be related to inadequate training in nutrition or physical activity. For instance, it is well known that the body's fat and energy stores are determined by the balance between energy intake and energy expenditure (Glanz and Sallis 2006). Negative energy balance can be induced by a reduction in energy consumed, an increase in energy expended, or a combination of both. In theory, reducing fat should be simple; eat less and exercise more. However, as understanding of obesity has increased so it has become evident that the condition is not simply the result of eating too much and exercising too little. The regulation of body weight is controlled by a complex, and as yet incompletely understood, number of physiological processes which interact with various environmental and societal factors (Glanz and Sallis 2006). "The protein stores increase in size in response to such growth stimuli as growth hormone, androgens, physical training, and weight gain, but do not increase simply from increased dietary protein" (Wadden and Stunkard 51). Some children, particularly those who have attempted to diet many times previously, often have disordered eating patterns with erratic eating times and missed meals. The role and task of parents and school administration is to control dietary patterns and skip meals as a means of controlling weight, turning to 'grazing' patterns of eating. To many it may seem logical that one less meal a day would result in quicker weight loss. However, evidence suggests the reverse; meal skipping leads to increased eating and overcompensation later in the day and commonly to increase snacking on high fat, energy dense foods (Glanz and Sallis 2006). Fat appears to exert its influence on energy balance through its effects on appetite. In studies where people have been allowed to eat as much as they like, the same quantity of food is generally eaten with high fat as with high carbohydrate meals. Fruits and vegetables are naturally low in fat, high in fibre and are rich sources of vitamins and minerals, particularly antioxidant nutrients such as vitamin C, beta-carotene, selenium and others such as lycopene (Wadden and Stunkard 232). Many people believe starchy foods are fattening and often avoid, or limit, their consumption. Increasing starchy foods is the mainstay of healthy eating for the reasons previously outlined. To help patients overcome the myth of starch being fattening it is important to explain that the extra fat added to these foods is the source of excess calories, rather than starch per se, for example the creamy rich sauce with pasta, the knob of butter on a jacket potato or the oil used to potatoes (Wadden and Stunkard 259). The food items in this group include meat, poultry, fish, beans, eggs and nuts. These foods are valuable sources of protein, iron, B vitamins, zinc and magnesium. Critics admit that care must be taken to ensure they are not high in fat. Red meat has received a great deal of bad press over recent years, resulting in many people believing it to be an unhealthy food which should be avoided (Wadden and Stunkard 239). For instance, red meat can be part of a healthy diet so long as lean cuts are chosen and it is cooked in a low-fat way. When discussing this food group with patients, emphasize the importance of making low-fat choices (Wadden and Stunkard 236). Epidemiological studies suggest the antioxidant and fibre content of fruit and vegetables provides protection against disease, particularly cardiovascular disease and cancer. When the growing problem of overweight and obesity is mentioned, the issues that immediately spring to mind for most people will be food intake and overeating (Wadden and Stunkard 87). Until the last 5 years, lack of physical activity has received at best secondary attention. General practitioners and practice nurses are much more likely to refer overweight and obese patients to dietitians rather than exercise specialists. Even today, almost all commercially-driven weight loss programs focus primarily on dieting, with only cursory interest in exercise as a means of weight control (Cawley 2006). Typically, the benefits of physical activity are presented in terms of its effectiveness in weight loss. However, in recent years there has been a general shift in emphasis in obesity treatment from large weight losses to moderate weight loss and improved health or metabolic status as the key outcome (Cawley 2006). Particular emphasis has been placed on working towards healthier levels of blood pressure, blood lipids, glucose tolerance and insulin sensitivity and the role of weight loss in achieving these changes. Throughout the last decade, evidence has accumulated to show that physical activity has a key role to play in both normal weight and obese individuals in terms of reduced risk of mortality and several diseases. Physical activity has additional health benefits which include reduced risk of colon cancer and improved physical fitness and psychological well-being. Furthermore, those individuals who are successful in improving from low to high fitness appear to reduce their risks considerably (Caprio 2006). Exercise has several potential effects in weight management (Wadden and Stunkard 47). It may result in weight and body fat losses and help individuals sustain their weight loss over the longer term. It may also help prevent weight gain across the lifespan or attenuate the degree of weight gain that is typically experienced through early and late middle age. A typical three of four session a week aerobic exercise/walking program would produce between 600 and 1000 kcal extra energy expenditure (depending on body weight) and this would roughly explain this degree of weight loss (Wadden and Stunkard 214). Exercise is effective, particularly over the long term; however, the rate of loss is often disappointing to the patient who wishes to lose large amounts of weight rapidly (Cawley 2006). Weight loss due to exercise also seems to be less in females than in males. Furthermore, exercise for obese children is usually too difficult for them to accumulate sufficient energy expenditure for significant amounts of weight loss. For this reason, exercise becomes more important as the degree of obesity diminishes, and where prevention of further weight gain rather than substantial weight loss is targeted. This is substantiated by evidence that exercise has a differential effect on the source of weight lost. When exercise is added to a hypocaloric diet, there is a greater loss of fat mass and conservation of lean tissue (mainly muscle mass) when compared to diet alone (Daniels 2006). For some children, the amount of weight loss due to exercise may seem disappointing, especially as it cannot compete with dieting for rapid weight loss. However, when viewed over the longer term its effect on energy balance, both through the extra energy expended during the activity itself and through higher resting metabolic rate, is likely to be very important for weight control. It is also very important through its contribution to health and fitness gain for any person undergoing weight loss (Wadden and Stunkard 237). Weight loss in itself is difficult, keeping weight off in the long term seems to be achieved by only a small percentage and as such has to be regarded as exceptional. In sum, the problem of obesity is caused by inappropriate living habits, poor dietary patterns and lack of physical activity. Obesity in children leads to sleep-disorders and cardiovascular disorders, diabetes II and high blood pressure. Social support from family and school administration is crucial for children and their future. Similar to dieting, exercise is a health behavior with sufficiently crucial implications that it requires professional support to facilitate change in children' lifestyle. Fruits and vegetables are very good sources of vitamins, particularly antioxidant vitamins, minerals and nonstarch polysaccharide, are naturally low in fat and should form an important part of any healthy diet. References 1. Caprio, S. (2006). Treating Child Obesity and Associated Medical Conditions. The Future of Children, 16 (1), p. 209. 2. Cawley, J. (2006). Markets and Childhood Obesity Policy. Future of Children, 16 (1), p. 69. 3. Childhood Obesity in the USA: Facts and Figures (2004). Retrieved 06 February 2008, from www.iom.edu/File.aspxID=22606 4. Childhood Overweight (2005) The Center for Health and Health Care in Schools. Retrieved from www.healthinschools.org/sh/obesity.asp 5. Daniels. S.R. (2006). The Consequences of Childhood Overweight and Obesity. The Future of Children, 16 (1), p. 47. 6. Glanz, K., Sallis, J.F. he Role of Built Environments in Physical Activity, Eating and Obesity in Childhood. The Future of Children, 16 (1), p. 89. 7. Hills, E. (2007). Children, Obesity and Exercise: Prevention, treatment and management of childhood and adolescent obesity. Routledge. 8. Karen B. Dorsey et al (2005). Evaluation and Treatment of Childhood Obesity in Pediatric Practice, Archives of Pediatric and Adolescent Medicine 159 (4), pp. 632-38. 9. Murphy, J. (2000). The Super-sizing of America: Are Fast Food Chains to Blame for the Nation's Obesity Retrieved 06 February 2008 from, http://speakout.com/activism/issue_briefs/1333b-1.html 10. Wadden, Th, A., Stunkard, A. J. (2004). Handbook of Obesity Treatment. The Guilford Press; Updated edition. Read More