Literature Review: Prevention and Control of Childhood Obesity

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Literature Reviews

Prevention and Control of Childhood Obesity

In quest of finding causes, preventions and control of childhood obesity, several health professionals have participated in the studies of obesity in children and teenagers. Below is a scrutiny of some data and pieces of information from few studies and articles. In the article Identification, Evaluation, and Management of Obesity in an Academic Primary Care Center, O’Brien et al performed a study to find out how other health workers were dealing with childhood obesity. The purpose of this study, according to the article, was to determine the rates of identification of obesity by pediatric residents, nurse practitioners, and faculty members in an academic primary care setting and to describe actions taken by these providers in their evaluation and management of obesity. Using a large primary care practice that serves predominantly urban minority (70% African Americans) and Medical Assistance insured (90%) population, located in a tertiary-care academic pediatric hospital, a two month retrospective medical record review of all health supervision visits for children 3 months to 16 years of age, was performed between December 1, 2001 and February 28, 2002. A weight greater than 120% of the 50th percentile of weight-for-height (for children5 years) was used to define obesity. Of the 2515 visits reviewed, 244 patients met the study definition of obesity, yielding an estimated prevalence of obesity visits of 9.7% among health supervision visits for children 3 months to 16 years of age. Only 53% (129 visits) of the reviewed visits of the 244 patients was documented as obesity by providers. Of the charts (69%) which contained adequate dietary viewing, only 15% included a description of the child’s activity level and Television viewing. Obesity was noted in the physical examination in 39% of cases. For the 129 children identified with obesity, 81% of cases contained an adequate dietary history, whereas 27% contained a description of the child's activity level or television viewing. Obesity was noted in the physical examination in 64% of cases. Most children identified as obese by their providers received some management specific to their obesity, including education, screening, and specialist referral. Dietary changes were recommended for 71%, increased activity for 33%, and limitation of television viewing for only 5%. Eighty-three percent of providers recommended close follow-up monitoring. Other recommendations included referral to a dietitian (22%), screening laboratory studies (13%), a food diary (9%), endocrine referral (5%), or preventive cardiology referral (3%). Provider identification of obesity was affected by the age of the patient and by the degree of obesity. Obesity identification was lowest among preschool children (31%) and highest among adolescent patients (76%). Although the prevalence of childhood obesity has reached epidemic proportions, the study showed that it was under recognized and undertreated by pediatricians. They failed to identify obesity in one-half of the visits, only few of them recommended laboratory studies and other necessary screenings and follow up. This study highlights the need for increased awareness and identification of obesity in the primary care setting, especially among younger children and those with mild obesity. However, it is not a clear cut evidence of the management of obesity by pediatricians.

In the article Obesity threatens a generation- Catastrophe of Shorter Span, Higher Health Cost, Susan Levin and Rob Stein points out the likely effect of obesity on life expectancy and health care cost in U.S. The article states that the rate of increase in obesity has tripled in children between the ages of 6 and 19 years in the last decade. According to W. H. Dietz, director of the Division of Nutrition, Physical Activity and Obesity at the federal Centers for Disease Control and Prevention, a huge burden...
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