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Obezitenin Zirve Yaptığı 6-17 Yaş Aralığındaki Çocuklarda Obezite Gelişiminde Rol Oynayan Risk Faktörlerinin Değerlendirilmesi: Tek Merkez Deneyimi

Year 2023, Volume: 17 Issue: 3, 219 - 226, 29.05.2023
https://doi.org/10.12956/tchd.1130690

Abstract

Amaç: Obezite, çocuk ve adölesanların %25-30’unu etkileyen önemli bir sağlık problemidir. Bu çalışmada, Keçiören Eğitim ve Araştırma Hastanesi çocuk sağlığı ve hastalıkları polikliniğine başvuran 6-17 yaş aralığındaki çocuklarda hangi yaşlarda obezitenin zirve yaptığı ve obezite gelişiminde rol oynayan risk faktörlerinin (beslenme, aktivite, aile öyküsü) belirlenmesi amaçlanmıştır.Gereç ve Yöntemler: Çalışma kesitsel olarak planlanıp, Ekim 2019- Aralık 2019 tarihleri arasında Ankara Keçiören Eğitim ve Araştırma Hastanesi Pediatri Polikliniğine herhangi bir sebeple başvuran 3000 adet 6-17 yaş arası çocuklar ve velileri dahil edilmiştir.
Bulgular: Çocukların %78.6’sında obezite yok iken %21.4’ünde obezite mevcuttu. Doğum ağırlığı ile obezite arasında anlamlı ilişki bulunmuştur (p= 0.001). Televizyon izleme, bilgisayar ile uğraşma, video oyun oynama için ayrılan günlük sürenin ile obezite arasında anlamlı ilişki saptanmıştır (p<0.001). Spor, bisiklet sürme, dışarıda oynama gibi fiziksel aktiviteler ile obezite arasında anlamlı ilişki saptanmıştır (p=0.045). Obezite oranı fiziksel aktivite süresinin artması ile anlamlı derecede azalmıştır. Çalışmamızda annesi obez olan çocuklarda obezite 1.77 (1.25-2.50) kat, babası obez olan çocuklarda obezite 2.01 (1.42-2.85) kat daha fazla görülmüştür (p<0.001).
Sonuç: Tüm yaş gruplarında olduğu gibi çocukluk çağında da obezite görülme sıklığı giderek artmaktadır. Bu artışın önüne geçebilmek için gerekli önlemlerin en erken safhada alınması gerekmektedir. Çocuklarda obezitenin önlenmesi ve tedavisinin temelinde yeterli ve dengeli beslenme ve fiziksel aktivitenin önemi büyüktür. Öncelikli amaç yaşam tarzı değişikliği olmasına rağmen obeziteye bağlı ciddi komplikasyonların varlığında gereklilik halinde farmakoterapi veya cerrahi tedavi de denenebilmektedir.

References

  • Aarons GA, Sklar M, Mustanski B, Benbow N, Brown CH. Scaling-out evidence-based interventions to new populations or new health care delivery systems. Implementation Science 2017;12: 111.
  • Wilhelmsen CK, Skalleberg K, Raanaas RK, Tveite H, Aamodt G. Associations between green area in school neighbourhoods and overweight and obesity among Norwegian adolescents. Prev Med Rep 2017;7:99-105.
  • Manandhar S, Suksaroj TT, Rattanapan C. The association between green space and the prevalence of overweight/obesity among primary school children. Int J Occup Environ Med 2019;10:1-10.
  • Barlow SE, Butte NF, Hoelscher DM, Salahuddin M, Pont SJ. Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices. Preventing chronic disease 2017;14:138–38.
  • Atlas of Childhood Obesity. October 2019. World Obesity Federation. http://s3-eu-west-1.amazonaws.com/woffiles/11996_Childhood_Obesity_Atlas_Report. (Erişim Tarihi: 11.03.2020).
  • COSI-TUR, (2016). Türkiye Çocukluk Çağı (İlkokul 2. Sınıf Öğrencileri) Şişmanlık Araştırması, Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Milli Eğitim Bakanlığı, Dünya Sağlık Örgütü Avrupa Bölge Ofisi, Sağlık Bakanlığı Yayın No: 1080, Ankara 2017.
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, https://hsgm. saglik.gov.tr/tr/obezite/turkiyede-obezitenin-gorulme-sikligi. (Erişim Tarihi: 05.03.2020).
  • Fleming TP, Watkins AJ, Velazquez MA, Mathers JC, Prentice AM, Stephenson J, et al. Origins of lifetime health around the time of conception: causes and consequences. Lancet 2018;391:1842–52.
  • Shafei AE, Nabih ES, Shehata KA, Abd Elfatah ESM, Sanad ABA, Marey MY, et. al. Prenatal exposure to endocrine disruptors and reprogramming of adipogenesis: an early-life risk factor for childhood obesity. Child Obes 2018;14:18–25.
  • Berger NA. Young adult cancer: influence of the obesity pandemic. Obesity (Silver Spring, Md) 2018;26(4):641–50.
  • Taşkın Kılınç G. Ankara’da Seçilmiş Okullarda Öğrencilerin Beslenme Özelliklerinin Beslenme Dostu Okul Olma Durumuna Göre Değerlendirilmesi. Ankara Üniversitesi Sağlık Bilimleri Enstitüsü Halk Sağlığı Hemşireliği Yüksek Lisans Tezi.2018.
  • Özcebe H, Bağcı Bosi T, Yardım N, Çelikcan E, Çelikay N, Keskinkılıç B, et al. Türkiye‘de çocuklarda fazla kiloluluk ve şişmanlık prevalansları. TAF Prev Med Bull. 2015;14(2):145–52.
  • Voerman E, Santos S, Patro Golab B, Amiano P, Ballester F, Barros H, et. al. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis. PLoS Med 2019;16:1002-744.
  • Savaşhan Ç, Sarı O, Aydoğan Ü, Muhammed E. İlkokul çağındaki çocuklarda obezite görülme sıklığı ve risk faktörleri. Türkiye Aile Hekim Derg. 2015;19(1):14–21.
  • Smego A, Woo JG, Klein J, Suh C, Bansal D, Bliss S, et. al. High body mass index in infancy may predict severe obesity in early childhood. J Pediatr 2017;183:87–93.
  • Mohaç G. KKTC Mağusa Bölgesi‘nde ilkokul öğrencilerinin bilgisayar oyun bağımlılığı ile obezite arasındaki ilişki. Doğu Akdeniz Üniversitesi, Lisansüstü Eğitim, Öğretim ve Araştırma Enstitüsü, Beslenme ve Diyetetik, Yüksek lisans tezi; 2015.
  • Jang M, Grey M, Sadler L, Jeon S, Nam S, Song H-J, et al. Obesity-risk behaviours and their associations with body mass index (BMI) in Korean American children. J Clin Nurs. 2018; 3408-3417.
  • Ergin A, Meydan Acımıs N, Ozdemir C, Akbay B, Kınacı Cimen Y, Uzuner N, Demireriden U. Obesity prevalence and associated factors in children at 6-14 years of age in a semi-rural area. Pam Med J 2019;12:475-484.
  • Au LE, Zhu SM, Nhan LA, Plank KR, Frongillo EA, Laraia BA, et. al. Household food insecurity is associated with higher adiposity among US schoolchildren ages 10–15 years: the Healthy Communities study. J Nutr 2019;149:1642–50.
  • Leonard SA, Petito LC, Rehkopf DH, Ritchie LD, Abrams B. Weight gain in pregnancy and child weight status from birth to adulthood in the United States. Pediatr Obes .2017;12:18-25.
  • Bray GA, Heisel WE, Afshin A, Jensen MD, Dietz WH, et al. The science of obesity management: an Endocrine Society scientific statement. Endocr Rev 2018;39:79–132.
  • Tambalis KD, Mourtakos S, Panagiotakos DB, Sidossis LS. Association of exclusive breastfeeding with risk of obesity in childhood and early adulthood. Breastfeed Med 2018.
  • Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et. al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139:56–528.
  • Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep 2019;68(6):1–77.
  • Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, et al. Cardiovascular health promotion in children: challenges and opportunities for 2020 and beyond: a Scientific Statement from the American Heart Association. Circulation 2016;134:236–55.
  • Anstey AH, Chen J, Elam-Evans LD, Perrine CG. Racial and geographic differences in breastfeeding—United States, 2011–2015. MMWR 2017;66:723–7.
  • WHO (2017). World Health Organization. Obesity and Overweight Fact Sheet, https://www.who.int/news-room/fact-sheets/detail/ obesity-and-overweight (Erişim Tarihi: 05.32.2020).
  • Baldridge AS, Huffman MD, Taylor F, Xavier D, Bright B, Van Horn LV, et. al. The healthfulness of the US packaged food and beverage supply: a cross-sectional study. Nutrients 2019;11:1704.
  • Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ 2017;356.
  • Hope S, Micali N, Deighton J, Law C. Maternal mental health at 5 years and childhood overweight or obesity at 11 years: evidence from the UK Millennium Cohort Study. International Journal of Obesity 2019; 43: 43–52.
  • Bates CR, Buscemi J, Nicholson LM, Cory M, Jagpal A, Bohnert AM. Links between the organization of the family home environment and child obesity: A systematic review. Obesity Reviews 2018;19: 716–27.
  • Sarni RS, de Souza FI, Schoeps Dde O, Catherino P, de Oliveira MC, Pessotti CF, Kochi C, Colugnati FA. Relationship between waist circumference and nutritional status, lipid profile and blood pressure in low socioeconomic level pre-school children. Arq Bras Cardiol 2006; 87(2): 153-8.
  • Woo KS, Chook P, Yu CW, Sung RY, Qiao M, Leung SS, Lam CW, Metreweli C, Celermajer DS. Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening. Int J Obes Relat Metab Disord 2004; 28(7): 852-7.
  • Ogden CL, Fryar CD, Hales CM, Carroll MD, Aoki Y, Freedman DS. Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013–2016. JAMA 2018;319:2410–8.
  • Warnakulasuriya LS, Fernando MMA, Adikaram AVN, Thawfeek ARM, Anurasiri WL, et al. Metformin in the Management of Childhood Obesity: A Randomized Control Trial. Childhood obesity 2018;14: 553–65.

Assessment of Risk Factors for Obesity in Children Aged 6-17 Years Where Obesity Reaches Peak

Year 2023, Volume: 17 Issue: 3, 219 - 226, 29.05.2023
https://doi.org/10.12956/tchd.1130690

Abstract

Objective: Obesity is an important health problem affecting 25-30% of children and adolescents. This study, it was aimed to determine the age intervals in which obesity reaches to peak incidence and risk factors playing role in the development obesity among children and adolescents aged 6-17 years who presented to pediatrics outpatient clinic of Ankara Keçiören Training and Research Hospital.
Material and Methods: This cross-sectional study included 3.000 children and adolescents aged 6-17 years and their parents who presented with any reason to pediatrics outpatient clinic of Ankara Keçiören Training and Research Hospital between October, 2019 and December, 2019.
Results: Obesity was detected in 21.4% of children while 78.6% were not obese. A significant correlation was detected between birth weight and obesity (p=0.001). A significant correlation was found between obesity and time spent for TV, computer and video games per day (p<0.001). The obesity was significantly decreased by increasing duration of physical activity. In the study, the obesity incidence was 1.77-folds (1.25-2.50) higher in children with obese mother and 2.01-folds (1.42-2.85) in children with obese father.
Conclusion: The obesity incidence is progressively increasing in childhood as with other age groups. To prevent such increase, measures should be taken as early as possible. An adequate and balanced nutrition and physical activity are of important in prevention and treatment of obesity. Although primary goal is to achieve lifestyle modifications, pharmacotherapy or surgery may be attempted in the presence of severe obesity-related complications.

References

  • Aarons GA, Sklar M, Mustanski B, Benbow N, Brown CH. Scaling-out evidence-based interventions to new populations or new health care delivery systems. Implementation Science 2017;12: 111.
  • Wilhelmsen CK, Skalleberg K, Raanaas RK, Tveite H, Aamodt G. Associations between green area in school neighbourhoods and overweight and obesity among Norwegian adolescents. Prev Med Rep 2017;7:99-105.
  • Manandhar S, Suksaroj TT, Rattanapan C. The association between green space and the prevalence of overweight/obesity among primary school children. Int J Occup Environ Med 2019;10:1-10.
  • Barlow SE, Butte NF, Hoelscher DM, Salahuddin M, Pont SJ. Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices. Preventing chronic disease 2017;14:138–38.
  • Atlas of Childhood Obesity. October 2019. World Obesity Federation. http://s3-eu-west-1.amazonaws.com/woffiles/11996_Childhood_Obesity_Atlas_Report. (Erişim Tarihi: 11.03.2020).
  • COSI-TUR, (2016). Türkiye Çocukluk Çağı (İlkokul 2. Sınıf Öğrencileri) Şişmanlık Araştırması, Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Milli Eğitim Bakanlığı, Dünya Sağlık Örgütü Avrupa Bölge Ofisi, Sağlık Bakanlığı Yayın No: 1080, Ankara 2017.
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, https://hsgm. saglik.gov.tr/tr/obezite/turkiyede-obezitenin-gorulme-sikligi. (Erişim Tarihi: 05.03.2020).
  • Fleming TP, Watkins AJ, Velazquez MA, Mathers JC, Prentice AM, Stephenson J, et al. Origins of lifetime health around the time of conception: causes and consequences. Lancet 2018;391:1842–52.
  • Shafei AE, Nabih ES, Shehata KA, Abd Elfatah ESM, Sanad ABA, Marey MY, et. al. Prenatal exposure to endocrine disruptors and reprogramming of adipogenesis: an early-life risk factor for childhood obesity. Child Obes 2018;14:18–25.
  • Berger NA. Young adult cancer: influence of the obesity pandemic. Obesity (Silver Spring, Md) 2018;26(4):641–50.
  • Taşkın Kılınç G. Ankara’da Seçilmiş Okullarda Öğrencilerin Beslenme Özelliklerinin Beslenme Dostu Okul Olma Durumuna Göre Değerlendirilmesi. Ankara Üniversitesi Sağlık Bilimleri Enstitüsü Halk Sağlığı Hemşireliği Yüksek Lisans Tezi.2018.
  • Özcebe H, Bağcı Bosi T, Yardım N, Çelikcan E, Çelikay N, Keskinkılıç B, et al. Türkiye‘de çocuklarda fazla kiloluluk ve şişmanlık prevalansları. TAF Prev Med Bull. 2015;14(2):145–52.
  • Voerman E, Santos S, Patro Golab B, Amiano P, Ballester F, Barros H, et. al. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis. PLoS Med 2019;16:1002-744.
  • Savaşhan Ç, Sarı O, Aydoğan Ü, Muhammed E. İlkokul çağındaki çocuklarda obezite görülme sıklığı ve risk faktörleri. Türkiye Aile Hekim Derg. 2015;19(1):14–21.
  • Smego A, Woo JG, Klein J, Suh C, Bansal D, Bliss S, et. al. High body mass index in infancy may predict severe obesity in early childhood. J Pediatr 2017;183:87–93.
  • Mohaç G. KKTC Mağusa Bölgesi‘nde ilkokul öğrencilerinin bilgisayar oyun bağımlılığı ile obezite arasındaki ilişki. Doğu Akdeniz Üniversitesi, Lisansüstü Eğitim, Öğretim ve Araştırma Enstitüsü, Beslenme ve Diyetetik, Yüksek lisans tezi; 2015.
  • Jang M, Grey M, Sadler L, Jeon S, Nam S, Song H-J, et al. Obesity-risk behaviours and their associations with body mass index (BMI) in Korean American children. J Clin Nurs. 2018; 3408-3417.
  • Ergin A, Meydan Acımıs N, Ozdemir C, Akbay B, Kınacı Cimen Y, Uzuner N, Demireriden U. Obesity prevalence and associated factors in children at 6-14 years of age in a semi-rural area. Pam Med J 2019;12:475-484.
  • Au LE, Zhu SM, Nhan LA, Plank KR, Frongillo EA, Laraia BA, et. al. Household food insecurity is associated with higher adiposity among US schoolchildren ages 10–15 years: the Healthy Communities study. J Nutr 2019;149:1642–50.
  • Leonard SA, Petito LC, Rehkopf DH, Ritchie LD, Abrams B. Weight gain in pregnancy and child weight status from birth to adulthood in the United States. Pediatr Obes .2017;12:18-25.
  • Bray GA, Heisel WE, Afshin A, Jensen MD, Dietz WH, et al. The science of obesity management: an Endocrine Society scientific statement. Endocr Rev 2018;39:79–132.
  • Tambalis KD, Mourtakos S, Panagiotakos DB, Sidossis LS. Association of exclusive breastfeeding with risk of obesity in childhood and early adulthood. Breastfeed Med 2018.
  • Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et. al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139:56–528.
  • Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep 2019;68(6):1–77.
  • Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, et al. Cardiovascular health promotion in children: challenges and opportunities for 2020 and beyond: a Scientific Statement from the American Heart Association. Circulation 2016;134:236–55.
  • Anstey AH, Chen J, Elam-Evans LD, Perrine CG. Racial and geographic differences in breastfeeding—United States, 2011–2015. MMWR 2017;66:723–7.
  • WHO (2017). World Health Organization. Obesity and Overweight Fact Sheet, https://www.who.int/news-room/fact-sheets/detail/ obesity-and-overweight (Erişim Tarihi: 05.32.2020).
  • Baldridge AS, Huffman MD, Taylor F, Xavier D, Bright B, Van Horn LV, et. al. The healthfulness of the US packaged food and beverage supply: a cross-sectional study. Nutrients 2019;11:1704.
  • Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ 2017;356.
  • Hope S, Micali N, Deighton J, Law C. Maternal mental health at 5 years and childhood overweight or obesity at 11 years: evidence from the UK Millennium Cohort Study. International Journal of Obesity 2019; 43: 43–52.
  • Bates CR, Buscemi J, Nicholson LM, Cory M, Jagpal A, Bohnert AM. Links between the organization of the family home environment and child obesity: A systematic review. Obesity Reviews 2018;19: 716–27.
  • Sarni RS, de Souza FI, Schoeps Dde O, Catherino P, de Oliveira MC, Pessotti CF, Kochi C, Colugnati FA. Relationship between waist circumference and nutritional status, lipid profile and blood pressure in low socioeconomic level pre-school children. Arq Bras Cardiol 2006; 87(2): 153-8.
  • Woo KS, Chook P, Yu CW, Sung RY, Qiao M, Leung SS, Lam CW, Metreweli C, Celermajer DS. Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening. Int J Obes Relat Metab Disord 2004; 28(7): 852-7.
  • Ogden CL, Fryar CD, Hales CM, Carroll MD, Aoki Y, Freedman DS. Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013–2016. JAMA 2018;319:2410–8.
  • Warnakulasuriya LS, Fernando MMA, Adikaram AVN, Thawfeek ARM, Anurasiri WL, et al. Metformin in the Management of Childhood Obesity: A Randomized Control Trial. Childhood obesity 2018;14: 553–65.
There are 35 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section ORIGINAL ARTICLES
Authors

Onur Kaşlı 0000-0002-5620-8199

Ayşe Derya Buluş 0000-0003-2865-4420

Mesut Koçak 0000-0002-5620-8199

Ugur Ufuk Isin 0000-0003-1684-1624

Early Pub Date May 3, 2023
Publication Date May 29, 2023
Submission Date June 23, 2022
Published in Issue Year 2023 Volume: 17 Issue: 3

Cite

Vancouver Kaşlı O, Buluş AD, Koçak M, Isin UU. Assessment of Risk Factors for Obesity in Children Aged 6-17 Years Where Obesity Reaches Peak. Türkiye Çocuk Hast Derg. 2023;17(3):219-26.


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