Windows of Opportunity.ppt

Windows of Opportunity Obesity Prevention in Childhood Alan M. Lake, M.D. Taskforce on Obesity Prevention in Childhood Maryland Chapter, American Academy of Pediatrics Prevention vs. Treatment Why Prevention? Appeal, indeed mantra, in Pediatrics Opportunities begin in-utero or before Greatest and Quickest impact Low risk Poor ability to recognize increased risk in time to make a difference Why bother? David Katz: Yale “ Today’s kids may become the first generation in the history of man to have a life expectancy projected to be less than that of their parents.” Definition of Obesity 0 -2 years: Wt/Ht 95%ile 2 – 18 years: BMI 95%ile At Risk: BMI 85 – 95%ile Adult Overweight: BMI 25 – 30 Obesity Class 1: BMI 30 – 34.9 (30#) Obesity Class 2: BMI 35 – 39.9 (50#) Obesity Class 3: BMI 40 (100#) Physiology of Fat Excess energy intake relative to energy consumed Excess 3500 kcal yields one pound of fat Excess 50 kcal a day yields 5# fat gain in one year. Where we are nowChildhood Obesity:  Past 40 Years Percent with BMI 95%ile AGE 6 – 11 12 - 19 1963 – 1970 4 % 5 % 1971 – 1974 4 6 1976 – 1980 7 5 1988 – 1994 11 11 1999 – 2000 15 15 Teen Obesity YRBS survey: 2005 28.8% have BMI above the 85%ile “at risk or already obese” Hospital Costs for Obesity Related complications: 1979 – 1981 $35 million/year 1997 – 1999 $127 million/year Where we are nowMaryland WIC age 2 – 5 June, 2006 Total Children 33,154 BMI: 5%ile 3% BMI: 5 – 85%ile 64% BMI: 85 – 95%ile 17% BMI: 95%ile 16% ( one in three at risk or obese) Where we are nowAdult Obesity Increase % With BMI 35 (Class 2) Age 1991 1998 %Inc 18 – 29 7.1 % 12.1% 69.9 30 – 39 11.3 16.9 49.5 40 – 49 15.8 21.2 34.3 50 – 59 16.1 23.8 47.9 60 – 69 14.7 21.3 44.9 70 11.4 14.6 28.6 Distribution of Adult Obesity: 2004 Adult Females: 57% have BMI 25