Childhood Obesity

Saurabh Patel, DPT, Total Health Systems of Macomb County

Happy children having funDefinition: Body mass index is the most widely accepted method used to screen for obesity in children and adolescents.1Based on the 2000 CDC Growth Charts for the United States an expert committee1. Being Overweight is defined as a BMI at or above the 85th percentile but lower than the 95th percentile.1Obesityon the other hand is defined as a BMI at or above the 95th percentile for children of the same age and sex.1CDC Recommendations are to use the CDC growth charts to monitor growth for children age 2 years and older and to use the WHO growth standards to monitor growth for infants and children ages 0 to 2 years of age.Prevalence of obesity among children aged 6 to 11 years has increased from 6.5% in 1980 to 19.6% in 2008.4More than TRIPLED in the last 30 years!An increase in prevalence from 10% to 20% inadolescents5where the highest frequency is found among lower socioeconomic groups5Obesity,is regarded as most prevalent nutritional disorder among US children and adolescents.6It is the most common problem seen by pediatricians.6“Children today have a shorter life expectancy than their parents for the first time in a 100 years.” Childhood BMI has been shown as a good predictor to adult BMI.7A Healthy lifestyle (or unhealthy one) that develop in childhood often continue into adulthood8, which makes promoting a healthy lifestyle particularly important in children! 8Complications of obesity include:Musculoskeletal, Medical, and Psychosocial. Some medical complications include Insulin resistance, Type II Diabetes, Asthma, Hypertension, High total and LDL cholesterol, High triglyceride levels, Sleep apnea, early puberty, Non-alcoholic steatohepatitis (Fatty infiltration and inflammation of the liver). Psychosocial complications include, depressive symptoms, poor body image, low self-concept, at risk for eating disorders, behavior and learning problems. This might lead to teasing and bullying, social isolation. Some musculoskeletal complications include Slipped capital femoral epiphysis, Tibia torsion, bowed legs, Blount’s disease, Spinal complications, and an increased risk of fractures.

The Role of a physical therapist (PT), in our current healthcare system is moving away from the primitive diagnostic and treatment model, to a more preventative approach.1 To improve the communal well being of a society as a whole, a physical therapist need to take up a more pro-active approach to assessment and treatment.1 A parent can become the first line of defense in establishing lifelong patterns of physical activity.1For those who are already obese, a PT can help by creating a personalized and safe exercise routine which can help:Reduce pain,  Restore flexibility, Increase strength, Increase cardiovascular endurance.1The American Physical Therapy Association(APTA) clearly states, PT’s should, “identify and assess the health needs of individuals, groups and communities, including screening, prevention, and wellness program appropriate to PT.1

As a PT, the primary focus would be geared towards Neuro-musculoskeletal problems.These diagnoses can lead to Poor quality of life, Problems with joint pain, Decreased mobility, Functional limitations, and generalized de-conditioning.Parents should promote better eating habits and address particular nutritional needs, exercise, and physical activity.Working on: Flexibility, Strength, Endurance, and Balance.Example: low-impact aerobics, exercise ball, resistive bands.Main focus on safe and efficient movement. Early PT intervention can promote habits which will foster, wellness, promote a sense of an improved well-being, education on optimal health patterns, improve one’s own participation into preferred play, and to reduce risk from secondary injuries.  A multidisciplinary approach when addressing preventative and preexisting conditions, parents need to incorporate a broad support system, one which should include Physicians, Physical Therapist, Chiropractors, Psychologist, Nutritionist, and Peers (buddy system).

Guidelines approved by the Health & Human Services suggest: Children should get one hour or more physical activity per day. Adults should do two and half hours of moderate to intense activities or one hour and fifteen minute of vigorous intensity per week.Education is the KEY in the promotion and maintenance of a better health self. Awareness is needed to foster better habits and develop healthy habits.

Our three conveniently located Total Health Systems of Macomb County offices are here to serve you in all your healthcare needs so call and make an appointment today.

References:

  1. http://www.cdc.gov/obesity/childhood/defining.html
  2. http://www.cdc.gov/growthcharts/who_charts.htm
  3. http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm
  4. http://www.cdc.gov/healthyyouth/obesity/
  5. Obesity. http://rdas-proxy.mercy.edu:2372/sp-3.3.1a/ovidweb.cgi
  6. www.obesity.org/who.html
  7. N Engl J Med. 1997 Sep 25;337(13):869-73. Predicting obesity in young adulthood from childhood and parental obesity.
  8. PediatrPhysTher. 2005 Summer;17(2):148-57. Wellness promotion beliefs and practices of pediatric physical therapists.