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2 Assessing Risk for Obesity in Young Children
Pages 35-58

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From page 35...
... include using the World Health Organization (WHO) growth charts for children from birth to age 23 months and the CDC growth charts for ages 2 to 5 years; the CDC growth charts can be used to calculate and plot body mass index (BMI)
From page 36...
... . Parents interact with pediatricians and other health care providers in the early stages of child growth more than with any other pro Early Childhood Obesity Prevention Policies 36
From page 37...
... Health care professionals and pediatricians are best positioned to identify excess weight in young children. The interaction between parents and health care providers gives parents an opportunity to become aware of their child's excess weight early on to allow time for intervention and prevention.
From page 38...
... . On the other hand, the data for the WHO growth charts were collected from a large cohort of children from birth to age 2 living in various cultures who were raised in an optimal health Early Childhood Obesity Prevention Policies 38
From page 39...
... found that only 59.7 percent of pediatric medical records contain CDC's BMI-for-age growth charts and that resident physicians are more likely than attending physicians to document and plot BMI data for their patients. These statistics emphasize the need for physicians to be trained to consistently calculate BMI percentiles and plot them on growth charts to monitor children's growth.
From page 40...
... Those whose measurements exceed the 95th percentile or fall below the 5th percentile, both red zones, are obese or underweight, respectively. And children whose BMI falls in the yellow area, between the 85th and 95th percentiles, are consid Early Childhood Obesity Prevention Policies 40
From page 41...
... SOURCE: CDC, 2010. Figure 2-2-Bitmapped 41 Assessing Risk for Obesity in Young Children
From page 42...
... In fact, a survey conducted by Jelalian and colleagues (2003) found that Early Childhood Obesity Prevention Policies 42
From page 43...
... Because health care professionals routinely document serial measures of weight and length and screen for abnormalities in weight status using published growth charts, practical tools based on the growth charts can be useful in assessing risky weight gain in infancy even before children reach the cutoffs for overweight or obesity. In a study of height and weight data for more than 44,000 children from ages 1 to 24 months and at ages 5 and 10 years, Taveras and colleagues (in press)
From page 44...
... . Early Childhood Obesity Prevention Policies 44
From page 45...
... Nonetheless, there are a number of possible reasons for the association between maternal prepregnancy obesity and childhood obesity, most but not all of which suggest that policies producing more favorable prepregnancy weight would reduce the risk of obesity in children. One pathway concerns the effect of mater 45 Assessing Risk for Obesity in Young Children
From page 46...
... This is not merely a matter of academic interest but an opportunity to Early Childhood Obesity Prevention Policies 46
From page 47...
... To the extent that the association indicates some bio logically based fetal programming, it has important implications for gestational influences that include maternal diabetes, as well as chemicals, drugs, and micro organisms that have metabolic consequences. To the extent that the association is behavioral, the potential exists to incorporate particular educational components into prenatal care, using the marker of maternal obesity as an indication that the child may benefit from intervention.
From page 48...
... There is also clear evidence that excessive GWG is associated with an increased risk of excessive weight retention and its sequelae in the mother following pregnancy, as well as with elevated infant weight and the resulting increased risk of Cesarean delivery. For the purposes of this discussion, the question is whether improved compliance with the GWG guidelines, particularly not exceeding the recommend ed weight gain, would have beneficial effects beyond the potential reduction in Early Childhood Obesity Prevention Policies 48
From page 49...
... However, the evidence regarding whether gestational diabetes, a far more common condition, has an independent effect on childhood obesity is much less certain. Furthermore, even when an association is observed, it is not clear whether that increased risk of childhood obesity is a by-product of the strong relationship between elevated prepregnancy BMI and risk of gestational diabetes, with the elevated maternal BMI rather than the gestational diabetes resulting in obesity in the offspring, or whether the association may reflect an independent effect of gestational diabetes.
From page 50...
... Thus there is a clear basis for supporting actions to improve the detection and control of diabetes in pregnancy and no apparent risk of harm, and such poli cies may also help reduce the risk of obesity in young children. Early Childhood Obesity Prevention Policies 50
From page 51...
... Although a statistical association between maternal smoking and childhood obesity appears to exist, the exact reasons for this association are not straight forward. Among the possible bases for the association, only some would predict that reductions in smoking would reduce the risk of early childhood obesity.
From page 52...
... :972-978. Early Childhood Obesity Prevention Policies 52
From page 53...
... 2005. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.
From page 54...
... Washington, DC: The National Academies Press. Early Childhood Obesity Prevention Policies 54
From page 55...
... 2010. Determinants of childhood obesity and association with maternal perceptions of their children's weight status: The "genesis" study.
From page 56...
... :47-59. Early Childhood Obesity Prevention Policies 56
From page 57...
... 2010. Screening and counseling for childhood obesity: Results from a national survey.
From page 58...
... :1994-1998. Early Childhood Obesity Prevention Policies 58


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