PREVALENCE OF OVERWEIGHT AND OBESITY IN 2-6-YEAR-OLD ITALIAN CHILDREN Maffeis C et al. 2005 (submitted)

Presentazione sul tema: "PREVALENCE OF OVERWEIGHT AND OBESITY IN 2-6-YEAR-OLD ITALIAN CHILDREN Maffeis C et al. 2005 (submitted)"— Transcript della presentazione:

1 PREVALENCE OF OVERWEIGHT AND OBESITY IN 2-6-YEAR-OLD ITALIAN CHILDREN Maffeis C et al. 2005 (submitted)

2 fat mass (%) 0-0.1-0.224681012141618 Age (years) 35 30 25 20 15 10 5 0 -0.8 male female pregnancy first year adiposity rebound puberty Dietz WH Am J Clin Nutr 1994

3 birth weight and type 2 diabetes in Pima Indian children and young adults Dabelea D et al. Diab Care 1999;22:944 20 15 10 5 0 < 2.5 2.5 - 3.5 Prevalence (%) 3.5 - 4.5 birth weight (kg) > 4.5 25 age group (years) 5 - 9 10 - 1415 - 1920 - 29 (Mantel-Haenszel X 2 test, controlled for age and sex)

4 energy requirements in breast fed infants compared with FAO recommendations Lucas et al. Wells & Davies Butte et al. Salazar et al. FAO/WHO/UNU Age (days) 35 36 32 34 402 421 383 391 485 reference Weight (kg) TDEE (kJ/day) Metabolizable EI (kJ/kg/d) Diff. From FAO (%) 4.5 4.7 4.5 1280 1270 1212 1205 17 13 21 19

5 year energy (kcal/d) energy intake 4000 3000 2500 190019201940196019802000 3500 Bray G, 2004

6 0 5 10 15 20 25 05101520 maschi femmine variazioni della spesa energetica per laccrescimento (EE G ) espressa in rapporto alla spesa energetica totale (TEE), in funzione delletà età (anni) EE G /TEE (%)

7 rapid weight gain during infancy and obesity in young adulthood in a cohort of African Americans Stettler N, et al. Am J Clin Nutr 2003 obese in young adulthood: rapid weight gain category (0 to 4 months): sex (F) birth weight (kg) gestational age (wk) firstborn status birth year maternal BMI (kg/m 2 ) maternal age (y) maternal education (y) 5.22 6.57 17.6 0.77 2.33 3.43 1.2 0.93 0.97 155, 17.6 1.83,23.5 2.22,140 0.35,1.68 0.54,10.2 1.01,11.7 1.04,1.39 0.83,1.03 0.69,1.37 0.008 0.004 0.007 0.5 0.3 0.049 0.013 0.16 0.9 Adjusted analysis OR95% CIP

8 Erikson JG, et al. BMJ 1999;318:427-31 catch-up growth in childhood and death from coronary heart disease: longitudinal study ponderal Index (kg/m 2 )* body mass index at the age of 11 yrs 17.5 < 25 - 27 - 29 > 29 2.7 1.5 2.2 1.0 3.3 3.2 1.6 1.7 3.7 4.0 1.8 1.5 5.3 2.7 3.2 1.9 * adjusted for length of gestation

9 The infant: a model of physiological overfeeding weight (g) 7,000 3,500 25 fat mass (%) 14 04 age (months) 2 human milk: fat = > 50% of EI cho = < 40% of EI 1,750 fat mass (g) 500

10 protein requirements during the first year of file 1.8 0.6 protein intake (g/kg/d) 2.4 age (months) 04812 Dupon C Am J Clin Nutr 2003 1.2 estimated protein intake from human milk estimated protein needs

11 basis of weaning recommendations months 0 3 6 9 12 15 18 21 24 breast milk staple weaning food and other grains soft fruits and vegatables meats and other protein rich foods transitional period given regularly

12 0 20 40 60 80 PROTEIN NUTRIENT INTAKE IN ITALIAN CHILDREN (%) FATCARBOHYDRATE LARN

13 covert manipulation of dietary fat and energy density: effect on substrate flux and food intake in men eating ad libitum 0 - 5 0 5 10 15 123 4 fat balance time (days) Stubb RJ, et al. AJCN 1995; 62:316-29. - 10 20 5 6 7 0 - 5 0 5 10 15 123 4 energy balance time (days) - 10 20 5 6 7 MJ high fat medium fat low fat

14 50 25 0 fat mass (%) 10 30 50 lipid intake (% of energy intake) Maffeis C et al. Int J Obes 96 r = 0.28 P< 0.01 Gazzaniga JM, et al.AJCN 93 Klesges RC et al. AJCN 94 fatty food more palatable high energy density less satiating

15 gross national products per capita/grouping of countries: fiftiles 0 200 400 600 THE SWEETING OF THE WORLDS DIET Popkin &Nielsen Obes Res 2004 kcal/capita/day added sugar I II IIIIVV 19622000 1978 -1994 adolescents soft drinks: + 70% milk: -65%

16 Warren, J. M. et al. Pediatrics 2003;112:e414 Mean differences in lunch intake after different breakfasts, compared with lunch intake after habitual breakfast

17 adiposity rebound

18 Kimm SYS, et al Lancet, 2005 livelli di attività fisica durante ladolescenza possono influenzare significativamente il BMI e ladiposità nelletà adulta.

19

20 lipid store GG GLYCOGENGLYCOGEN GLYCOLYSISGLYCOLYSIS Acetyl CoA KC ox FFA CO 2 H+H+ ATPADP + Pi O2O2 Acetyl CoA

21 pre-pubertal physical activity of boys and girls activity related energy expenditure (kcal/day) age (years) 41068 700 500 300 age (years) 41068 9 6 3 activity (h/week) males females Goran MI, et al. Pediatrics 1998;101:887

22 TV viewing, TV in the bedroom and overweight risk For each additional hour per day of TV/video viewed (adjusted for age, sex, parental education, race) the odds ratio of children having a BMI > 85th percentile was 1.06. Almost 40% of children had a TV set in their bedroom (OR 1.31) Dennison BA, et al.Pediatrics 2002

23 INFLUENCE OF CHANGES IN SEDENTARY BEHAVIOR ON ENERGY AND MACRONUTRIENT INTAKE IN YOUTH 150 DECREASE PHASE 75 - 75 - 150 INCREASE PHASE changes in targeted sedentary behavior from baseline (min/day) Epstein LH, et al. AJCN 2005;81:361-6 BOYSGIRLS

24 Morning snack Afternoon snack 0 10 20 30 40 BreakfastLunchDinner Night snack percentage distribution of the energy intake among the different meals Maffeis C, et al. Int J Obes 1999

25 conclusioni gli eccessi alimentari sono numericamente più rilevanti delle carenze. lenergia richiesta per la crescita è molto contenuta (2 - 8 aa). bevande zuccherate e alimenti ad alta densità calorica sono fattori di rischio di obesità è consigliabile moderare gli apporti energetici del pasto serale La limitazione dellesposizione al video e la regolare pratica di uno sport sono importanti quanto unalimentazione equilibrata

26 ENERGY-DENSE SNACK (EDS) FOOD INTAKE IN ADOLESCENCE: LONGITUDINAL RELATIONSHIP TO WEIGHT AND FATNESS Phillips SM et al. Obes Res 2004;12:461-72 relationship between total EDS food consumption and SDS BMI or %BF: no significant relationship between soda consumption and SDS BMI or %BF: significant relationship between EDS food consumption and TV viewing: significant

27 SNACK FOOD INTAKE DOES NOT PREDICT WEIGHT CHANGE AMONG CHILDREN AND ADOLESCENTS Field AE et al. Int J Obes 2004;28:10:1210 prospective study of 8203 girls and 6774 boys, 9-14 y of age in 1996. boys consumed more snack foods than girls after controlling for Tanner stage, age, height change, activity, and inactivity, there was no relationship between intake of snack foods and subsequent changes in SDS BMI.