Tuesday, 20 June 2017

Obese Kids, Cute or Acute?

Assumption that chubby and chunky children are healthy and well-treated is, in fact, not completely true. Instead, this is one thing the parents should beware of. Obesity will bring various health problems to children, such as asthma, non-alcoholic steatohepatitis, heart and blood vessel disorders, diabetes, and sleeping problems signed by snoring.

A research also reveals that obese children have lower confidence than those with normal weight. The lack of confidence has been associated with declining academic achievements and social rejection so that the children tend to be reticent. In addition, some researches found that:

  • 8 out of 10 children having obesity at the age of 10-15 will keep experiencing so at the age of 25.
  • Obesity occurring to the children aged < 8 might increase the risk of severe obesity in the adulthood.
  • It is found that 1 out of 4 obese adults experienced obesity during their childhood.

Overweight or obesity has become a serious health problem in many countries, particularly in developing countries such as Indonesia. Obesity is a condition caused by imbalanced amount of calories, namely that the intake of the dietary calories is greater than the amount of calories used for growth and development, metabolism, or physical activities. The imbalance is associated with many factors, among which are heredity, behavior, and environment.

Is my child obese?

It is difficult for parents to objectively assess whether their children are sturdy or obese. However, the fact that your children are bigger and fatter than their fellows or they have to wear larger or even adult clothes might be a warning about obesity.

According to IDAI (Indonesian Pediatric Society), obesity is a condition in which the children BMI (Body Mass Index) is above the 95th percentile in the children growth chart based on the gender. Below are the simple ways to recognize.

  • Pay attention to the physical characteristics such as round face, sharp fingers, pot belly, abrasion between the tights caused by frictions when walking, snoring, penis sunk by the fat around it for boys, and the cellulites around the shoulders.
  • The children weight (aged < 5 years) is above the green line in the KMS (Growth Chart).
  • Count the BMI and draw in the BMI chart of CDC (Center of Disease Control) based on the age (> 2 years old) and the sex.
  • The children weight status category based on the BMI method is related to the percentile value of CDC seen in the following table.

How to determine the weight status category for children?

Example:

A boy named Dani, aged 10, with 34 kg weights (W) and 121 cm or 1.21 m heights (H).

Step 1 - measuring BMI

BMI = W (kg) / (H) (m))2 = 34 kg/ (1.21 m)2 = 23.22 kg/m2

Step 2 - plotting the BMI measurement result in the BMI percentile chart based on the age and gender of CDC.

The area is determined by plotting the children age in the age line using the BMI percentile chart for boys (Dani aged 10) and then draw the line up based on his BMI (Dani' s BMI is 23.22 kg/m2). By applying this method, we know that Dani' s weight status is above the 95th percentile or in the red area. Conclusively, Dani belongs to the obese category.

Weight and BMI are not enough for diagnosis

BMI is recommended by CDC and AAP (American Academy of Pediatrics) as the screening test to figure out the weight status of children aged 2-19. However, BMI alone is not enough to determine whether a child is obese or not. Basic examinations aside, some additional examinations are required to further evaluate the children' s health condition.

Other than to support diagnosis, laboratory test is also necessary to evaluate the health risks that might arise from obesity and to obtain a clear description of the children health status. Some advisable tests along with the benefits are as follows:

  1. Routine Hematology and Peripheral Blood Description to detect the possibility of anemia. The obese children and teenagers are at risk of anemia.
  2. Total Cholesterol, HDL Cholesterol, Direct LDL Cholesterol, Triglyceride, and ApoB to assess the lipid profile. Commonly, obese people also have lipid profile disorder, such as high triglycerides with low HDL.
  3. hs-CRP to assess the risk of inflammation.
  4. Uric Acid to assess the risk of metabolic disorder in the form of hyperuricemia.
  5. Fasting Glucose to assess the risks of hyperglycemia.
  6. SGOT and SGPT to assess liver functions and the possibility of non-alcoholic steatohepatitis.
  7. Urea and Creatinine to assess kidney function.
  8. Abdominal Circumference
  9. Blood Pressure

The early detection of the health risks occurring from childhood obesity is expected to suppress the disability and mortality rate during the adulthood.

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