ISL WEEK 13 TITLE

: FORUM SCRIPT :CHILDHOOD OBESITY

Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low - and middle-income countries, particularly in urban settings. The prevalence has increased at an alarming ra te. Globally, in 2010 the number of overweight

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children under the age of five, is estimated to be over 42 million. Close to 35 million of these are living in developing countries. Due to the rising prevalence of obesity in children and its many adverse hea lth effects it is being recognized as a serious public health concern. (asking question to panel 1) What are the causes or factors that lead to this problem?

Firstly, allow me to explain about our topic, further. Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Body mass index (BMI) is acceptable for determining obesity for childre n two years of age and older. The normal range for BMI in children vary with age and sex. The Center for Disease Control defines obesity as a BMI greater than the 95th percentile. It has published tables for determining this in children. Enough about the explanation, we will move on to the point. As with many conditions, childhood obesity can be brought on by a range of factors which often act in combination. Dietary, sedentary lifestyle,

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genetics, home environment, developmental factors, medical illness and psychological factors. In diatery, calorie -rich drinks and foods are readily available to children. Consumption of sugar -laden soft drinks may contribute to childhood obesity. In a study of 548 children over a 19 month period the likelihood of obesity increased 1.6 times for every additional soft drink consumed per day. Calorie-dense, prepared snacks are available in many locations frequented by children. Eating at fast food restaurants is very common among young people with 75% of 7th to 12th grade students consuming fast food in a given week. The fast food industry is a lso at fault for the rise in childhood obesity. This industry spends about $42 billion on advertisements

aimed at young children. Some literature has found a relationship between fast food consumption and obesity. Including a study which found that fast food restaurants near schools increases the risk of obesity among the student population. Whole milk consumption verses 2% milk consumption in children of one to two years of age had no effect on weight, height, or body fat percentage. Therefore, whole mi lk continues to be recommended for this age group. However the trend of substituting sweetened drink for milk has been found to lead to excess weight gain. While, focusing on the point of sedentary lifestyle, physical inactivity of children has also shown to be a serious cause, and children who fail to engage in regular physical activity are at greater risk of obesity. Staying physically inactive leaves unused energy in the body, most of which is stored as fat. Many children fail to exercise be cause they are spending time doing stationary activities such as computer usage, playing video games or watching television. TV and other technology may be large factors of physically inactive children. Researchers provided a technology questionnaire to 4, 561 children, ages 14, 16, and 18. They discovered children were 21.5% more likely to be overweight when watching 4+ hours of TV per day, 4.5% more likely to be overweight when using a computer one or more hours per day, and unaffected by potential weight gain from playing video games For genetics, childhood obesity is often the result of an interplay between many genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose individuals to obesit y when sufficient calories are present. As such obesity is a major feature of a number of rare genetic conditions that often present in childhood. Children's food choices are also influenced by family meals. The results of a survey in the UK pub lished in 2010 imply that children raised by their grandparents are more likely to be obese as adults than th ose raised by their parents. An American study released in 2011 found the more mothers

work the more children are more likely to be overweight or o bese. Various developmental factors may affects rates of obesity. Breast feeding for example may protect against obesity in later life with the duration of breast-feeding inversely associated with the risk o f being overweight later on. A child's body growth pattern may influence the tendency to gain weight. A child's weight may be influenced when he/she is only an infant. Researchers did a cohort study on 19,397 babies, from their birth until age seven and discovered that fat babies at four mon ths were 1.38 times more likely to be overweight at seven years old compared to normal weight babies. Fat babies at the age of one were 1.17 times more likely to be overweight at age seven compared to normal weight babies. Focusing on medical illness, C ushing's syndrome (a condition in which the body contains excess amounts of cortisol) may also influence childhood obesity. Hypothyroidism is a hormonal cause of obesity, but it does not significantly affect obese people who have it more than obese people wh o do not have it. Lastly, due to the factor of psychological factors. Stress can influence a child's eating habits. Researchers tested the stress inventory of 28 college females and discovered that those who were binge eating had a mean of 29.65 points on the perceived stress scale, compared to the control group who had a mean of 15.19 points. Feelings obesity. of depression can cause a child to overeat.

Antidepressants, however, seem to have very little influence on childhood

Now that we know the causes that lead to this issue, how about the effect of

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this disease towards health. If Panel 2 wouldnt mind, can you answer this question? The first problems to occur in obese children are usuall y emotional or psychological. Childhood obesity however can also lead to life threatening conditions including diabetes, high blood pressure, heart

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disease, sleep problems, cancer, and other disorders. Some of the other disorders would include liver disease, early puberty or menarche, eating disorders such as anorexia and bulimia, skin infections, and asthma and other respiratory problems. Studies have shown that overweight children are more likely to grow up to be overweight adults. Obesity during adolescenc e has been found to increase mort ality rates during adulthood. Obese children often suffer from teasing by their peers. Some are harassed or discriminated a gainst by their own family. Stereotypes abound and may lead to low self-esteem and depression. A 2008 study has found that children who are obese have carotid arteries which have prematurely aged by as much as thirty years as well as abnormal levels of cholesterol. (responds towards explanation panel 2). Pane l 1,can we gain the information

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about the updates about this case? Sure. This update we called epidemiology, that is the study of patterns of health and illness and associated factors at the population level. It is the cornerstone method of public health research, and helps inform evidence-based medicine for identifying risk factors for disease and determining optimal treatment approaches to clinical practice and for preventive medicine. In the study of communicable and non -communicable diseases, epidemiologists are involved in outbreak investigation to study design, data collection, statistical analysis, documentation of results and submission for publication. Rates of childhood obesity have increased greatly between 1980 and 2010. Currently 10% of children worldwide are either overweight or obese. In Canada, the rate of overweight and obesity among Canadian children h as increased dramatically in recent years. In boys, the rate increased from 11% in 1980s to 30% in 1990s. While in Brazil, the rate of overweight and obesity in Brazilian children increased from 4% in the 1980s to 14% in the 1990s. In United States, the rate of obesity among children and

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adolescents in the United States has nearly tripled between the early 1980s and 2000. It has however not changed significantly between 2000 and 2006 with the most recent statistics showing a level just over 17 percent.[53] In 2008, the rate of overweight and obese children in the United States was 32%, and had stopped climbing. Since the onset of the 21st Century, Australia has found that childhood obesit y has followed trend with the United States. Information garnered has concluded that the increase has occurred in the lower socioeconomic areas where poor nutritional education has been blamed. How about ways to cure it? Is there any methods to treat nor to prevent this

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obesity disease? Actually, the main point is depending on management that one should take. This management system can be divided into two that is, lifestyle and medications First is about ones lifestyle. Exclusive breast -feeding is

recommended in all newborn infants for its nutritional and other beneficial effects. It may also protect against obesity in later life.

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Second is, medications. There are no medications currentl y approved for the treatment of obesity in children. Orlistat and sibutramine may however be helpful in managing moderate obesity in adolescence. Sibutramine is approved for adolescents older than 16. It works by altering the brain's chemistry and decreasi ng appetite. Orlistat is approved for adolescents older than 12. It works by preventing the absorption of fat in the intestines. That was a very brilliant methods to take to overcome this problem. Well,

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seems that our show had come to its point. See you in next show. Till then, bye!

Prepared by: NUR FARHANA BT. MUHAMMAD FUAD TG.INTAN MASTURA BT. TG. RAMLI NURSAKINAH BT. MOHD. HAMSANI RAFIDAH BT. SHAHADAD