Family-oriented Diabetes/Obesity Prevention in Children and Adolescents

Transcription

1 Family-oriented Diabetes/Obesity Prevention in Children and Adolescents Presented by: Angela Manderfeld, MS, RD, LD, CDE ANTHC Diabetes Nutrition Consultant B-3, Thursday, September 27 th, am-12pm

2 OBJECTIVES State 2 signs a child is at increased risk of developing Type 2 diabetes State 3 healthy behaviors families can do to prevent disease and maintain their health State 3 education tools you have for patients in your office

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4 WE NEED TO TAKE ACTION. Life expectancy is decreasing 1 out of 3 children born after 2000 will get diabetes.

5 THE PERFECT STORM HIT HARD!

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7 DIABETES IN CHILDREN

8 Characteristics of Adolescents with T2DM Most are minority (AA, AI, H) Mean age: 13 years Obese > 80% history of T2DM in a first degree relative > 60% have physical evidence of insulin resistance; (acanthosis nigricans) Co-morbidities hypertension, elevated lipids, sleep apnea, fatty liver disease, PCOS Frequent pre-existing psychiatric diagnoses/medications

9 ACANTHOSIS NIGRICANS Develops mainly from high insulin levels This means your body is having to work really hard to process your blood sugar. A sign of increased risk for developing diabetes armpit neck

10 WHAT IS HAPPENING IN THE BODY? 1. You eat food and some turns to glucose (sugar) Cells in Pancreas overproducing insulin to try and keep up, over time gets tired and have trouble making insulin Glucose 2. The sugar goes to the blood vessel 3. The pancreas makes insulin to get the glucose into your cells. Cells in the body are resistant to insulin Dinneen SF. Diabet Med. 1997; 14 (Suppl 3): S19-24.

11 The Type II Family Diet high in fat, low in fiber Binge eating prevalent No routine exercise most with no activity whatsoever 3-5 hours/day TV Insulin resistance prevalent among unaffected family members

12 HOW DO WE FIX IT?

13 What is the Goal? Stop weight gain, child will grow taller Weight reduction of 5-7% of starting weight

14 How do we fix it? Identify habits Cultural and familial aspects of eating Identify barriers to change Meaning of food in the family Underlying family stress, violence, depression Identify availability What foods are available in community/household

15 STEP 1: HEALTHY CONVERSATIONS Discuss health concerns about BMI/weight Focus on the entire family, not the child Whole family to make a plan Ask a lot of questions, avoid lectures

16 WHO SHOULD BE TALKING ABOUT IT? Only 22% of parents with an overweight or obese child recall a healthcare professional telling them their child was too heavy Nearly a quarter, 22% of parents are uncomfortable discussing the risks of being overweight with their kids. For parents of kids ages 8 to 12, only sex is a more uncomfortable topic.

17 BMI FACTS Growth patterns are individual. Growth patterns over time are more important than a single measurement (repeat every 6 months). Growth is one sign of general health. A child s growth often reflects family growth patterns BMI growth charts are used 2-19 yr old

18 HEALTHY CONVERSATIONS My child is just big boned Taking a moment to explain the growth chart and how it has a range and allows for big boned. Your child s weight is increasing faster than they can grow and we need to take steps to keep the weight where it is and give the body some time to grow taller.

19 INTERACTIVE RESOURCES FOR KIDS

20 STEP 2: HEALTHY EATING Encourage traditional foods Discuss portions Plate Activity Books Focus on foods to add to the diet Engage whole family Family dinners Community Events

21 WHAT S GOING ON IN AK? In the 1950 s local foods provided adults with up to half and children with about one-third of their energy intake. In it was found that Inupiaq and Yu pik adults in the Norton Sound region obtained only 15% of their energy from local foods. Johnson JS, et al. Dietary intake of Alaska Native people in two regions and implications for health : The Alaska Native Dietary and Subsistence Food Assessment Project. International Journal of Circumpolar Health 68:2 2009

22 WHAT S GOING ON IN AK? Daily seal oil and salmon consumption were associated with lower prevalence of glucose Higher intakes of the omega-3 fatty acids may afford some degree of protection against coronary heart disease. Johnson JS, et al. Dietary intake of Alaska Native people in two regions and implications for health : The Alaska Native Dietary and Subsistence Food Assessment Project. International Journal of Circumpolar Health 68:2 2009

23 Non-starchy Vegetables (No effect blood sugar) Grains, Beans & Starchy Vegetables Lean Protein/ Healthy Fats

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25 WHAT FOOD GROUPS DO YOUR CUPPED HANDS REPRESENT?

26 WHICH FOOD GROUP DOES YOUR FIST REPRESENT?

27 WHICH FOOD GROUP DOES YOUR PALM REPRESENT?

28 YOUR HANDS ARE YOUR VERY OWN PERFECT MEASURING TOOLS!

29 LET S REVIEW!

30 MY PLATE

31 children-over-five.html

32 LABEL READING What should families be focusing on?

33 RESOURCES FOR KIDS

34 MIRROR GAME Stand up / Pair up Decide who will be the leader, who will be the follower

35 HEALTHY CONVERSATIONS It is NOT appropriate to put a child on a diet. The WHOLE family is responsible for making changes. Focus on WHAT they SHOULD be eating. Focus on WAYS to INCREASE activity.

36 OBJECTIVES State 2 signs of increased risk of diabetes in children State 3 ways families can make healthier changes State 3 education tools you have for patients in your office

37 THANK YOU!