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Episode 144: Risk Factors for Pediatric Overweight and Obesity
Rio Bravo qWeek
English - July 07, 2023 12:00 - 23 minutes - 21.9 MBMedicine Health & Fitness Mental Health kern medical rio bravo medical discussion rio bravo qweek medical residency weekly medical info qweek residency podcast Homepage Download Google Podcasts Overcast Castro Pocket Casts RSS feed
Episode 144: Risk Factors for Pediatric Overweight and Obesity
Future Dr. Lal describes multiple risk factors associated with childhood overweight and obesity. Dr. Arreaza adds comments about caring for pediatric patients with obesity. Practice guidelines are mentioned throughout this episode.
Written by Krustina Lal, MSIII, Western University College of Osteopathic of the Pacific. Comments by Hector Arreaza, MD.
You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.
Introduction:
Obesity is one of the most common pediatric chronic diseases affecting 14.4 million children and adolescents (about twice the population of New Jersey).A recent simulation study from the US found that by 2030, a staggering 55–60% of today’s children will be obese.1 in 4 children in California have obesity.Research shows that the ages between 0 and 5 years is a critical period in the development of overweight and obesity. Obesity has complex genetic, physiologic, socioeconomic, and environmental contributors. Pediatricians and other primary care physicians need to be aware of the risk factors for pediatric obesity to provide early anticipatory guidance for prevention, close monitoring, and early intervention when the weight trajectory increases.We will discuss the risk factors for children and adolescents to develop overweight and obesity, we will be diving deep into general, environmental, and familial factors. This is based off the AAP (American Academy of Pediatrics) “Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity.” This guideline was published in February 2023, it is available online for free, and this is the first edition.
A. General Factors
- Socioeconomic Status
-Children in Families That Have Immigrated to the US
Recently arrived immigrants tend to be healthier than their US-born counterparts. However, as immigrants try to adjust to a new culture, they may adopt Americanized foodways, which are high in fat, sugar, and salt.Second-generation Hispanic immigrants are 55% more likely to have obesity than nonimmigrant white children, whereas first-generation Asian immigrants had a 63% lower risk of having obesity.Larger body sizes may be an indication of health and wealth in some cultures. This cultural factor may make it more difficult for parents to understand the gravity of their children’s obesity.Comment: This is a common concern among Hispanic families that bring their children to the clinic to get “vitamins” to gain weight because they look “sick,” but their BMIs are normal. PCPs should be prepared to address that concern in the clinic.
B. Neighborhood and Community Environments
-School Environment
The presence of fast foods, vending machines, and/or sweetened beverages in schools may negatively influence children’s food choices, this effect is larger in younger grades.One day I went to have lunch with Devin, I liked that they had to go through the salad bar before they went to get other foods. They had the choice between vegetables or fruits.
-Lack of Fresh Food Access
-Fast food proximity
-Access to safe physical activity
-Environmental Health
C. Family and home environment factors
-Parenting feeding style
-Sugar-sweetened beverages within the home
-Portion sizes and snacking behavior
-Dining out and family meals
-Screen time – This is one of the major struggles we have as parents. It’s a daily fight.
-Sedentary behavior
-Sleep duration
-Environmental smoke exposure
-Psychosocial stress
-Adverse childhood experiences
ACEs include a history of physical, emotional, or sexual abuse; exposure to domestic violence; household dysfunction from parental divorce or substance abuse; economic insecurity; mental illness; and/or loss of a parent because of death or incarceration.A study found that having many ACEs increased two times the risk of children having overweight or obese compared with children with no history of ACEs. Stress may result in abnormal coping strategies—such as binge eating, eating in the absence of hunger, impulsive eating, and poor sleep hygiene—which may result in further weight gain.Summary: The consequences of childhood obesity are far-reaching and extend beyond physical health issues. Children with obesity are more likely to experience a range of health complications, including type 2 diabetes, high blood pressure, sleep apnea, joint problems, and psychological issues such as low self-esteem and depression. Moreover, children with obesity are at a higher risk of carrying their weight-related problems into adulthood, increasing their susceptibility to chronic conditions such as cardiovascular disease, certain types of cancer, and premature mortality.
As medical providers, we all need to keep general, environmental, and familial factors in mind when discussing weight changes among our pediatric patients. Having knowledge of such influences will help us intervene and prevent further progression.
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Conclusion: Now we conclude episode number 144, “Risk Factors for Pediatric Overweight and Obesity.” Future Dr. LaL reminded us that childhood obesity is a disease linked to multiple risk factors, including but not limited to: low socioeconomic status, lack of access to safe spaces for exercise, parenting feeding styles, sleep disturbances, and adverse childhood events. Dr. Arreaza emphasized the importance of providing obesity care with kindness and empathy, especially when caring for pediatric patients.
This week we thank Hector Arreaza and Krustina Lal. Audio editing by Adrianne Silva.
Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at [email protected], or visit our website riobravofmrp.org/qweek. See you next week!
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References:
Sarah E. Hampl, Sandra G. Hassink, Asheley C. Skinner, Sarah C. Armstrong, Sarah E. Barlow, Christopher F. Bolling, Kimberly C. Avila Edwards, Ihuoma Eneli, Robin Hamre, Madeline M. Joseph, Doug Lunsford, Eneida Mendonca, Marc P. Michalsky, Nazrat Mirza, Eduardo R. Ochoa, Mona Sharifi, Amanda E. Staiano, Ashley E. Weedn, Susan K. Flinn, Jeanne Lindros, Kymika Okechukwu; Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics February 2023; 151 (2): e2022060640. 10.1542/peds.2022-060640. https://publications.aap.org/pediatrics/article/151/2/e2022060640/190443/Clinical-Practice-Guideline-for-the-Evaluation-and?autologincheck=redirected.Weihrauch-Blüher, S., Wiegand, S. Risk Factors and Implications of Childhood Obesity. Curr Obes Rep 7, 254–259 (2018).Hemmingsson, E. Early Childhood Obesity Risk Factors: Socioeconomic Adversity, Family Dysfunction, Offspring Distress, and Junk Food Self-Medication. Curr Obes Rep 7, 204–209 (2018).Royalty-free music used for this episode: "Latina Havana Boulevard." Downloaded on October 13, 2022, from https://www.videvo.net/