childhood obesity
Introduction
Introduction to Pediatric Obesity Simple obesity in children refers to the long-term consumption of energy, which leads to excessive accumulation of body fat, and the standard of weight exceeds the normal age and the same height and normal children. Simple obesity in children is a chronic disease with multiple causes of excessive body fat, which is a common nutritional imbalance phenomenon health search. Simple obesity is closely related to lifestyle. It is a chronic disease characterized by excessive hypertrophy and accumulation of whole body fat tissue characterized by excessive nutrition, lack of exercise and behavioral deviation. Can occur at any age, more common in infants, 5-6 years old and puberty. The standard for childhood obesity generally refers to two standard deviations of body weight that exceeds the average body weight of healthy children of the same sex, healthy age or the same height; or more than 20% of the average body weight of the same age and same sex. Clinically, obesity caused by excessive diet is called simple obesity. basic knowledge Sickness ratio: 10-20% Susceptible people: children Mode of infection: non-infectious Complications: hyperlipidemia, hypertension, coronary heart disease, fatty liver, pediatric diabetes
Cause
Pediatric obesity
Eat more (25%):
The main cause of obesity is overeating. The intake of human heat exceeds the consumption, so the remaining heat energy is converted into fat accumulation in the body. Parents of obese parents often have the same tendency. Members of a family are often accustomed to eating abundance. Members of a family are often accustomed to eating abundant foods. Children have developed eating habits since childhood, and obesity occurs over time.
Too much rest (20%):
Lack of exercise, lack of proper activities and physical exercise are also important factors for obesity. Children who are overweight children do not like exercise. Most of the obese children we observe are simple obesity with less movement and more food. During the recovery of hepatitis or other diseases, there are often too many rests and too little exercise, so that the weight increases day by day, and the heavier the more difficult it is, the vicious circle is formed.
Genetic factors (25%):
Parents of obese children tend to be fat. If parents are significantly more than normal, about two-thirds of the offspring are obese. If one of the shuangguan is obese, the offspring show obesity about 40%.
Disease factors (15%):
Neuropsychiatric disorders Occasionally, obesity occurs after encephalitis. Obesity may also occur after hypothalamic disease or frontal lobe resection. Emotional trauma (such as death of a loved one or low academic performance) or mental abnormalities may sometimes occur in children.
Prevention
Pediatric obesity prevention
1. Population prevention
The primary prevention of childhood obesity starts from two aspects. First, through the various social organizations and media to carry out universal social mobilization in the population, so that people have a correct understanding of pediatric obesity (neither numbness, nor nervous fear), change Poor lifestyle, eating habits and unreasonable dietary structure have greatly reduced the risk factors of childhood obesity in the population, thus controlling the occurrence of obesity. On the other hand, it is to improve the identification of people who are susceptible to risk factors, and timely provide medical supervision to control the progress of childhood obesity.
2, infant prevention
Emphasis on breastfeeding. When feeding artificially, moderate feeding should be carried out according to the actual needs of the baby.
3. Preschool prevention
Develop good habits and eating habits. Do not eclipse sugar, high fat, high heat food. Develop the habit of participating in various physical activities and labor. For example, if you can walk, don't take the car. Go up and down the building and climb the building yourself. Don't take the elevator. Develop a habit of exercising every day.
4, puberty and early youth prevention
This is a critical period and a dangerous period. Especially for girls, in addition to increased body fat, psychological pressure, worry, and conflicts. The focus of health education during this period was to strengthen guidance on nutrition knowledge and dietary arrangements, guidance on exercise prescription training, and correct understanding of obesity.
Complication
Pediatric obesity complications Complications hyperlipidemia hypertension coronary heart disease fatty liver pediatric diabetes
Hyperlipidemia occurs in children with long-term obesity, which leads to arteriosclerosis, hypertension, coronary heart disease, fatty liver, diabetes and other adult diseases. Obesity ventilated syndrome can occur in severely obese people; occasionally extremely obese children The weight is up to 4 to 5 times the standard weight. Due to excessive fat, the thoracic and diaphragmatic movements are restricted, resulting in rapid breathing, reduced alveolar ventilation, hypoxemia, polycythemia, purpura, and increased heart. Large and congestive heart failure, known as Pickweckian syndrome, can cause death.
Symptom
Pediatric obesity symptoms common symptoms excessive fat emotional eating severe obesity hereditary obesity adolescent obese infants weight gain too fast endocrine dysfunction
1. The disease is the peak of infancy, preschool age and puberty.
2, the child's appetite is hyperthyroidism, eating a large amount of food, like eating fat, lazy in activities.
3, the appearance of obesity is tall, not only the weight exceeds the same age, but the height and bone age are in the same height of the same age, and even exceed.
4, subcutaneous fat distribution is even, the accumulation of fat on the cheeks, shoulders, chest and breast and abdominal wall is significant, limbs with thighs, upper arms thick and thin limbs.
5, the boy may be due to the accumulation of fat in the perineum, the penis is buried, and is mistaken for the development of the external genital dysplasia, the child's sexual development is mostly normal, smart.
6, severe obesity can appear obesity ventilatory syndrome.
Examine
Pediatric obesity check
1. Anthropometric indicators
Such as waist circumference hip, big / calf circumference, subcutaneous fat thickness of the arm circumference, etc., excessive behavior, deviation.
2, serum cholesterol increased
Triacylglycerol and cholesterol are mostly increased, and in severe cases, beta lipoprotein can also be increased.
3, endocrine disorders
Often hyperinsulinemia, hyperglycemia often develops earlier, blood growth hormone levels are reduced, so the final height is often slightly lower than normal children, obesity girls are prone to various menstrual disorders.
4, immune function is reduced
In particular, the number of T and B lymphocytes decreased, and the cellular immune function decreased significantly. The delayed skin reaction may turn negative and the neutrophil function decreased.
Diagnosis
Diagnosis and diagnosis of childhood obesity
Diagnostic criteria
Those who weigh more than 20% to 30% of the standard weight calculated by height are mildly obese, more than 30% to 50% are moderately obese, and more than 50% are severely obese. Occasionally, the weight of extremely obese children is 4 to 5 times of the standard weight. Due to excessive fat, the movement of the thoracic and diaphragm muscles is restricted, resulting in rapid breathing, reduced alveolar ventilation, hypoxemia, and polycythemia. Purpura, enlarged heart and congestive heart failure, known as Pickweckian syndrome, can cause death.
Differential diagnosis
Identification with secondary obesity, except for certain endocrine, metabolic, genetic, secondary obesity caused by central nervous system diseases or obesity caused by the use of drugs. From the history, symptoms and signs, laboratory tests can be identified. The main points of identification: the above diseases are pathological diseases, and simple obesity is a lifestyle disease.
1. Endocrine diseases
Hypothyroidism, hypothalamic and hypothalamic lesions, adrenal hyperfunction, male gonads and diarrhea are all obese, but various endocrine diseases also have their own characteristics, easy to identify pathological changes related to endocrine and metabolism, not simply The early manifestations of obesity are even more of a cause. The glucose tolerance curve, which can be distinguished from functional hyperinsulinemia, which is often seen in obese individuals. Such as suspected and endocrine diseases, combined with the disease to do endocrine function tests, skull X-ray, fundus examination. In obese children, plasma immunoglobulin, complement C3 and C4, and lymphocytes T and B were all lower than non-obese children. At the same time, plasma copper and zinc levels were subclinical and lacked supplements with zinc and copper. After the improvement. Menarche in obese girls is significantly earlier than non-obese girls of the same age.
2, with obesity syndrome
Such as Prader-Willi syndrome, with obesity, low muscle tone, short stature, small hands and feet, mental retardation, hypogonadism, strabismus, etc. as its main symptoms. Laurence-Moon-Biedl syndrome has symptoms such as obesity, mental retardation, visual impairment, and finger toe deformity.
3, other
Obesity can also occur when growth disorders or physical activity are small, and energy needs are reduced, such as long-term bed rest when suffering from bone or nervous system diseases.
