Obesity and

Comorbities in
Childhood

Kyle Taylor
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Obesity is a result of calories consumed being

more than energy expended
In United States, main reason is children are
exercising less, particularly on a daily basis
Considered an epidemic in the United States

Prevalence of obesity is 18.2% for males and 16%

for females (Ball, 2012)

Background of Obesity

Socio-demographic factors present

Race/ethnicity: Hispanic boys and African American
girls have higher rates of obesity
Household income: lower socio-economic income
have higher rates of obesity
Prenatal care: Higher maternal weight before
pregnancy and maternal smoking during pregnancy
Familial Environment

High television viewing- obesity risk is a linear

relationship with hours of television watched
Lack of family rules means a lack of consitency (Huang,
Lanza & Anglin, (2013)

Background of Obesity

Complications Include:

Early development of hypertension

Microalbuminuia
Dyslipidemia (Narasimhan and Weinstock, 2014)
Sleep disordered breathing
Low qualtiy of life
Obesity following into adults (Birken &
Hamilton, 2014)
Prediabetes and Type 2 Diabetes

Complications of Obesity

Strong relationship between early onset obesity

and increased risk of diabetes
Type 2 diabetes previously diagnosed only in
adults
Now over 20,000 children in the United States
are affected
Studies indicate that type 2 diabetes can be
more aggressive and progress more rapidly
when started in youth (Narasimhan &
Weinstock, 2014)

Background for Type 2

Diabetes in Children

Obesity is associated with many health problems

Most notably Type 2 Diabetes

Body weight increases and the visceral fat produces a

cytokine hormone
Cellular insulin receptors become desensitized
Pancreatic cells produce more insulin to overcome insulin
resistance
Insulin levels elevate in the blood
The islet of Langerhans beta cells fail in their ability to
hypersecrete insulin
Glucose tolerance is impaired (Ball, 2012)

Pathophysiology of
Diabetes

Serious complications my occur early

Hypertension
Albuminuria
Impaired renal function
Retinopathy (Narasimhan & Weinstock, 2014)

Complications of Type 2
Diabetes

Three levels are performed

Primary intervention: prevent new cases of

overweight
Secondary intervention: identify children who
are overweight
Tertiary Interventions: support youth and
families to establish healthy eating and excersing
habits (Ball, 2012)

Levels of Prevention for

Obesity

Most important
Engagement of parents

Fosters tight family connections, children more

willing to follow healthy food consumption
advice (Huang, Lanza & Anglin, 2013)

Emphasis on physical activity

At least sixty minutes a day of activity

recommended

Primary Preventions for

Obesity

Limit television and computer time to a

maximum of two hours a day
Nutrition- Limit sugar sweetened beverages
and increase fruit and vegetable consumption
(Birken & Hamilton, 2014)
No television or computers in childs bedroom
(Ball, 2012)

Forces the child to play outside and perform

physical activity

Primary Preventions for

Obesity

Primary Preventions:

Similar to preventions for obesity

Lifestyle modification most important
Moderate exercise recommended

Secondary Preventions

Screening is important tool

American Diabetes Association recommends
screening at-risk children every two years starting
at 10 years of age

Most notably a combination of HbA1c and fasting

glucose (Brar, Mengwall, Franklin & Fierman, 2014)

Preventions for Diabetes

Prevention is key!
Encourage exercise
Encourage healthy food choices
If at risk, screening is important for diabetes

Nursing Interventions

Recommendations

Ball, J., Bindler, R., & Cowen, K. (2012). Principles of Pediatric

Nursing: Caring for Children (5th ed). Upper Saddle River, NJ:
Pearson.
Birken, C., Hamilton, J. (2014). Obesity in a Young Child. Canadian
Medical Association Journal, 186(6), 443-444.
Brar, P. C., Mengwall, L., Franklin, B. H. & Fierman, A. H. (2014).
Screening Obese Children and Adolescents for
Prediabetes and/or
Type 2 Diabetes in Pediatric Practices: A Validation Study. Clinical
Pediatrics, 53(8),
771-776.
Huang, D.Y.C., Lanza, H.I., & Anglin, M.D. (2014). Trajectory
of
Adolescent Obesity: Exploring the Imact of Prenatal to Childhood
Experiences. Journal of Child & Family
Studies, 23, 1090-1101.
Narasimhan, S. & Weinstock, R.S. (2014). Youth-Onset Type 2
Diabetes Mellitus: Lessons Learned From the TODAY Study. Mayo
Clinic Proceedings, 89(6), 806-816.

References