Obesity and Overweight in Children | What We Need to Know

Obesity and overweight are not only common pathologies in adults, but also in children, which represent a serious problem for the child population.

The number of people with overweight and obesity has increased dramatically over the past 40-50 years. By 2020, 39 million children under the age of 5 were overweight or obese. Obesity or overweight is more common in boys.

Childhood obesity is now reaching pandemic levels in both developed and developing countries. It is well known that overweight and obesity in childhood have a significant impact on both physical and psychological health. Children who are obese in childhood are more likely to be obese in adulthood, which increases the risk of metabolic disorders and diabetes.

What is obesity and overweight?

Overweight and obesity are defined as inappropriate or excessive accumulation of fat.

Body mass index (BMI) is a simple measure of height and weight, indicating whether a person (adult) is overweight or obese. Body mass index (BMI) is calculated by dividing a person's weight (in kilograms) by the square of their height (in meters). BMI=kg/m2

Weight assessment in children is done using special growth charts or graphs that take into account not only the child's weight and height, but also gender, age, and possibly other indicators. Using these charts and graphs, pediatricians and pediatric endocrinologists identify a child's body mass index.

Causes of childhood obesity

As is known, the development of overweight and obesity is associated with excess calorie and fat intake.

In addition, sugary drinks, increased food portions, and regular lack of physical activity have a significant impact on the development of obesity.

Childhood obesity has a profound impact on a child's physical health, social and emotional well-being, and self-esteem, sometimes resulting in poor academic performance in school.

Obesity is associated with conditions such as: metabolic and cardiovascular disorders, orthopedic, neurological, liver, lung, kidney diseases, and others.

Genetic predisposition significantly increases the risk of developing obesity.

Problems related to childhood obesity

• asthma
• Sleep apnea (“snoring”)
• Type 2 diabetes
• arterial hypertension
• Elevated blood cholesterol levels (metabolic syndrome)
• Risk of heart disease
• stroke
• Osteoarthritis and other bone and joint pathologies
• Increased risk of breast and colon cancer
• Fatty liver

In addition to physical pathologies, children with obesity and overweight often suffer from:

• Bullying
• Social isolation
• Decreased self-esteem
• depression

Obesity diagnostics

As part of pediatric care, the doctor regularly checks the child's body mass index and, using growth charts, determines whether his or her indicators correspond to age norms.

When filling out weight and height charts, in addition to body mass index, other data is also evaluated:

• Family history of weight-related problems and diabetes
• Child's eating habits
• Physical activity level
• Psychosocial history: episodes of depression, sleep disorders, etc.

Laboratory diagnostics

Regular laboratory evaluation of obese and overweight children is essential

• Lipidprofile

A standard lipid profile includes a set of blood tests that examine: triglyceride levels, total cholesterol, as well as high-density lipoproteins (HDL), low-density lipoproteins (LDL, VLDL), and the atherogenic index.

When is it recommended to eat:

It is recommended that lipid profiles be determined in overweight children from the age of 9–11 years.

RegularიMonitoring

Regular lipid profile check – at least once a year, is necessary if:

• High risk of developing diabetes and metabolic disorders (e.g. family history)
• A recent study found elevated lipid levels
• Treatment included antilipid medications

• Liver enzymes ALT, AST

Fatty liver is a condition where fat accumulates in liver cells and in most cases it is associated with obesity or being overweight.

Even with fatty liver, children may not develop symptoms, but the fatty degeneration eventually leads to inflammation of liver cells and connective tissue degeneration.

The functional state of the liver is assessed by evaluating its functional tests, mainly alanine aminotransferase and aspartate aminotransferase. An increase in these values ​​always indicates a pathological process occurring in the liver.

• Thyroid hormones

Obesity significantly affects thyroid function. TSH hormone levels are directly proportional to body mass index. As a result, in obese children, TSH levels above the upper limit of normal often indicate compensated hypothyroidism (thyroid hormones FT3 and FT4 are often normal).

• Blood Determination of glucose and glycated hemoglobin

Obesity is usually associated with insulin resistance, which is characterized by elevated fasting insulin and C-peptide levels in the blood. However, it is common for insulin levels to be normal.

All obese patients should be screened for diabetes. It is necessary to assess both the level of glycemia (fasting and after eating), as well as the glycated hemoglobin level (glycated hemoglobin gives the average blood glucose level over the past 3 months).

PrediabetesTime is marked Elevated fasting glucose or impaired glucose tolerance 2 hours after a glucose load. A glucose tolerance test involves measuring blood glucose levels 2 hours after a 50-70g glucose load. Such patients are at a much higher risk of developing diabetes.

Obesity and metabolic syndrome

Increasing rates of metabolic syndrome are being observed in overweight and obese children and adults, further increasing the risk of developing diabetes and cardiovascular disease in these individuals.

Metabolic syndrome includes the following criteria:

• Abdominal fat(abdominal circumference more than 80 cm in women and more than 94 cm in European men);
• Systolic blood pressure130 mmHg and above; diastolic blood pressure 85 mmHg and above Despite treatment
• Fasting glycemia Levels of 100 mg/dL or higher, despite hypoglycemic treatment.
• TriglyceridesIncreased blood concentration ≥ 150 mg/dL (1.7 mmol/L)
• Low HDL cholesterol levels:

< 40 mg/dL (1 mmol/L) in men

< 50 mg/dL (1.3 mmol/L) in women

90% of obese children and adults have at least 1 of the following criteria.

Ways to prevent childhood obesity

The World Health Organization has established a special commission that has been providing recommendations for almost a decade to prevent and combat childhood obesity and overweight:

1. HealthyfoodEncouragement
   • In children and adolescents Healthy foodConsumption promotion
   • არაჯანსაღიProducts (for example, fast food) and SugaryDrinks Reducing consumption
2. PhysicalActivityStimulation
   • AdultsPhysicalActivity promotion
   • SedentaryBehavior, for example, reducing the amount of time you spend watching TV or sitting at the computer for long periods of time
3. PreventionჯერagainPregnancyPeriod
   • Management of laboratory parameters, nutrition, and physical activity of the pregnant woman for further management of fetal weight
4. Of a childLifefirstYearsManagement
   • Healthyfood, Enoughsleep და PhysicalActivitySupport in the early years of childhood.
   • Harmoniousgrowth და HealthyHabitsFormation.
5. SchoolRole
   • HealthyEnvironment in schools, which provides:
     • Correct information about a healthy lifestyle and nutrition
     • To introduce the benefits of physical activity
6. FamilyEngagement
   • HealthyLifeStyleProvision in the family

Laboratory "Synevo" offers a wide range of laboratory tests:

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