CHILDHOOD OBESITY IN THE MALTESE ISLANDS Victoria Farrugia Sant Angelo

Transcription

1 CHILDHOOD OBESITY IN THE MALTESE ISLANDS Victoria Farrugia Sant Angelo

2 Definition of obesity Complex, multifactorial chronic disease that develops from a combination of genetic and environmental components. It involves the integration of social, behavioural, cultural, physiological, metabolic and genetic factors.

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5 The Global Situation over the Years Based on the Health Behaviour in School- Age Children survey carried out by WHO every 4 years

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9 Previous Maltese Surveys Bellizzi M. et al (5 year olds and adults) Buttigieg A. (3 year-olds) Baluci C. (6 and 10 year-olds) Health Behaviour in School-age Children Study (WHO) Above study repeated 2007 Grech V. et al National School-Entry BMI Survey (6-7 year olds) 2008 European Growth Surveillance Initiative Malta Study 2010 EGSI Follow-up Study

10 RESULTS % 5 YEAR-OLDS OBESE 28.5% ADULTS OBESE % 3 YEAR-OLDS OBESE % 6 YEAR-OLDS OBESE 21.5% 10 YEAR-OLDS OBESE % YEAR-OLDS O/WEIGHT OR OBESE % YEAR-OLDS O/WEIGHT OR OBESE % 6-7 YEAR-OLDS O/WEIGHT OR OBESE % 7-8 YEAR-OLDS O/WEIGHT OR OBESE % 7-8 YEAR-OLDS O/WEIGHT OR OBESE 42% 9-10 YEAR-OLDS O/WEIGHT OR OBESE

11 Methods of Assessment Surveys carried out: 2007 Children aged Same children (in collaboration with WHO) 2010 Children aged 7 8 AND same cohort as above

12 WHERE? STATE SCHOOLS CHURCH SCHOOLS INDEPENDENT SCHOOLS

13 HOW? WEIGHT WITHOUT SHOES USING STANDARD DIGITAL SCALES HEIGHT WITHOUT SHOES USING STANDARD PORTABLE STADIOMETERS

14 Digital scales

15 Stadiometer

16 METHOD CALCULATION OF BMI (Body Mass Index) Weight in Kg Height X Height in m EXCEL (MS Office)

17 Overweight = Kg/m 2 Obese = >19Kg/m 2 For boys aged 7-8 years

18 Overweight = Kg/m 2 Obese = >19.5Kg/m 2 For girls aged 7-8 years

19 Maltese National BMI Surveillance in 2 Age Cohorts P ercen tag e Year 2007 Year 2008 Year 2010 Yr 2010 F/U Assessment Years Year 2007 Year 2008 Year 2010 Yr 2010 F/U Same cohort of children measured at 6, 7 and 9 years shown in Red Different cohort of children measured at 7 years in 2010

20 Comparing O/Wt and Obesity in same group of children in 2008 and 2010 O/W & Obesity Comparison % Overweight & Obe esity 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% Year Boys Girls

21 Does type of school make a difference? 60 O/W & Obesity Comparison Boys by School Type O/W & Obesity Comparison for Girls by School Type 50 % O / W & O b e s i t y State Church Ind. Gozo % O / W & O b e s i t y State Church Ind. Gozo School Type School Type

22 Does residential district make a difference? Comparison Total O/W & Obese by district 50 Percentage Year 2008 Year D1 D2 D3 D4 D5 D6 District

23 Maltese Children aged 7-8 years P ercen tag e O/Wt % Obese % O/Wt & Obese 5 0 Girls 2008 Boys 2008 Girls 2010 Boys 2010

24 How do we compare with other countries? Overweight & Obesity % in 5-13 year-old Children

25 Studies show that: 25 50% of obese adolescents develop into obese adults If a child enters puberty obese, he/she will remain obese The earlier the onset of obesity in childhood, the greater the likelihood of obesity and its complications in adulthood

26 The Obesity Epidemic In 2005, WHO predicted 150 million adults and 15 million children worldwide would be obese by the end of The annual rate of increase in the prevalence of obesity in children and adolescents is rising steadily It is now 10 times that of the 1970 s

27 The Obesity Epidemic Childhood obesity is an important predictor of adult obesity 60% of obese children will become obese adults Metabolic and cardiovascular risk profiles track from childhood into adult life

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29 Causes of Obesity

30 Complications Many obesity-related health conditions once thought to affect only adults are now being seen in children with increasing frequency: Type 2 Diabetes Non-alcoholic fatty liver disease Hypertension Coronary artery plaque formation Sleep apnoea Polycystic ovary disease

31 Psychological complications Stigmatization Loneliness Sadness Bullying Low self-esteemesteem Academic failure

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33 Complications Glueck CJ, 2009:Long term metabolic complications of childhood obesity

34 Economic Burden In the European Region, obesity related medical costs reach 2-4% of national health expenditure Obese individuals incur medical costs that are 30% greater than normal weight persons

35 Economic Burden Malta Health budget million spent on obesity-related direct costs This figure will continue to rise if the current trend in obesity prevalence continues to increase Indirect costs must also be taken into consideration

36 Economic Burden Direct costs related to associated illnesses Indirect costs: Absenteeism Loss of productivity Premature death Indirect costs can amount to up to twice the direct costs

37 Treatment Diet with reservation in children Physical exercise highly recommended Medical treatment not available Surgery not in children RESULTS OF TREATMENT FOR OBESITY ARE VERY POOR

38 Targets de Mello, D et al: J. Pediatr. (Rio J.) vol.80 no.3 Porto Alegre May/June 2004

39 Pre-historic Malta

40 Malta Quo Vadis?

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