Çocuk ve ergenlerde şişmanlık sorunu ve yaklaşım

Şişmanlık, vücutta aşırı yağ depolanmasının neden olduğu, bedensel olduğu kadar ruhsal komplikasyonlara ve toplum ekonomisine zararlı sonuçlara yol açabilen bir hastalıktır. Sendromik, endokrin ve diğer hastalıklara ikincil olabileceği gibi en yaygın nedeni dışsal olarak adlandırılan enerji alım-harcama dengesizliğidir. Tedavisi beslenme başta olmak üzere bir dizi yaşamsal düzenlemeyi ve yakın izlemi, önlenmesi ise toplumsal planda yapılacak girişimleri kapsar. Çocukluk çağında ilaç ve cerrahi tedavinin yeri ise yok denecek kadar azdır.

Approach to obesity in children and adolescents

Obesity is a disease caused by excess body fat deposition which can give rise to a series of physical and mental complications as well as to public economic problems. Although it may be secondary to genetic, endocrine or other diseases the most prevalent form is so called exogenous obesity which is attributed to the imbalance of energy intake and expenditure. The management comprises life style changes such as nutritional planning and close follow-up, preventation, on the other hand, actions at sociopolitical level. Medical and surgical therapy plays ignorable role in childhood obesity if any.

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  • 1. Skelton JA, Cook SR, Auinger P, Klein JD, Barlow SE. Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr 2009; 9: 322 9.
  • 2. Nagel G, Wabitsch M, Galm C, et al. Determinants of obesity in the Ulm Research on Metabolism. Exercise and lifestyle in children (URMEL-ICE). Eur J Pediatr 2009; 168: 1259-67.
  • 3. Semiz S, Özdemir ÖMA, Özdemir AS. Denizli merkezinde 6-15 yaş grubu çocuklarda obezite sıklığı. Pam Tıp Der 2008; 1: 1-4.
  • 4. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Pædiatrica 2006; 95: 194-8.
  • 5. Adegboye AR, Andersen LB, Froberg K, Sardinha LB, Heitmann BL. Linking definition of childhood and adolescent obesity to current health outcomes. Int J Pediatr Obes 2009; 22: 1-13.
  • 6. Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 2002; 75: 978-85.
  • 7. Hatipoglu N, Ozturk A, Mazicioglu MM, Kurtoglu S, Seyhan S, Lokoglu F. Waist circumference percentiles for 7-to 17-year-old Turkish children and adolescents. Eur J Pediatr 2008; 167: 383-9.
  • 8. Fuemmeler BF, Dedert E, McClernon FJ, Beckham JC. Adverse childhood events are associated with obesity and disordered eating: results from a U.S. population-based survey of young adults. J Trauma Stress 2009; 22: 329-33.
  • 9. Ntalla I, Dedoussis G, Yannakoulia M, et al. ADIPOQ gene polymorphism rs1501299 interacts with fibre intake to affect adiponectin concentration in children: The GENe-Diet Attica investigation on childhood obesity. Eur J Nutr 2009 Jun 19 [Epub ahead of print].
  • 10. Cotsapas C, Speliotes EK, Hatoum IJ, et al. GIANT Consortium. Common body mass index-associated variants confer risk of extreme obesity. Hum Mol Genet 2009; 18: 3502-7.
  • 11. Carotenuto M, Santoro N, Grandone A, et al. The Insulin Gene Variable Number of Tandem Repeats (INS VNTR) genotype and sleep disordered breathing in childhood obesity. J Endocrinol Invest 2009 Jul 2 [Epub ahead of print].
  • 12. Atkinson RL, Lee I, Shin HJ, He J. Human adenovirus-36 antibody status is associated with obesity in children. Int J Pediatr Obes 2009; 10: 1-4.
  • 13. Ahmed ML, Ong KK, Dunger DB. Childhood obesity and the timing of puberty. Trends Endocrinol Metab 2009; 20: 237-42.
  • 14. Rowland K, Wallace R. Clinical inquiries: Which factors increase the risk of an infant becoming an overweight child? J Fam Pract 2009; 58: 383-4.
  • 15. Zhang X, Liu E, Tian Z, et al. High birth weight and overweight or obesity among Chinese children 3-6 years old. Prev Med 2009; 49: 172-8.
  • 16. Fiorito LM, Marini M, Francis LA, Smiciklas-Wright H, Birch LL. Beverage intake of girls at age 5 y predicts adiposity and weight status in childhood and adolescence. Am J Clin Nutr 2009; 90: 935-42.
  • 17. Garipagaoglu M, Budak N, Süt N, Akdikmen O, Oner N, Bundak R. Obesity risk factors in Turkish children. J Pediatr Nurs 2009; 24: 332-7.
  • 18. Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey. JAMA 998; 279: 938-42.
  • 19. Teich S, Michalsky MP. Chronic diseases in childhood obesity: risks and benefits of early intervention. Preface. Semin Pediatr Surg 2009; 18: 125.
  • 20. Taylor J. The impact of childhood obesity on heart disease. Eur Heart J 2009; 30: 1817-8.
  • 21. Codoner-Franch P, Boix-Garcia L, Simo-Jorda R, Del Castillo-Villaescusa C, Maset-Maldonado J, Valls-Belles V. Is obesity associated with oxidative stress in children? Int J Pediatr Obes 2009; 28: 1-8.
  • 22. Rademacher ER, Jacobs DR Jr, Moran A, Steinberger J, Prineas RJ, Sinaiko A. Relation of blood pressure and body mass index during childhood to cardiovascular risk factor levels in young adults. J Hypertens 2009; 27: 1766 74.
  • 23. Rana AR, Michalsky MP, Teich S, Groner JI, Caniano DA, Schuster DP. Childhood obesity: a risk factor for injuries observed at a level-1 trauma center. J Pediatr Surg 2009; 44: 1601-5.
  • 24. Pasquali SK, Marino BS, Pudusseri A, et al. Risk factors and comorbidities associated with obesity in children and adolescents after the arterial switch operation and Ross procedure. Am Heart J 2009; 158: 473-9.
  • 25. Fiorino EK, Brooks LJ. Obesity and respiratory diseases in childhood. Clin Chest Med 2009; 30: 601-8.
  • 26. Verçoza AM, Baldisserotto M, de Los Santos CA, Poli-de-Figueiredo CE, d'Avila DO. Cardiovascular risk factors and carotid ıntima-media thickness in asymptomatic children. Pediatr Cardiol 2009; 30: 1055-60.
  • 27. Ross KR, Hart MA, Storfer-Isser A, et al. Obesity and obesity related co morbidities in a referral population of children with asthma. Pediatr Pulmonol 2009; 44: 877-84.
  • 28. Boneberger A, von Kries R, Milde-Busch A, Bolte G, Rochat MK, Rückinger S; for the GME Study Group. Association between peer relationship problems and childhood overweight/obesity. Acta Paediatr 2009 Aug 13 [Epub ahead of print].
  • 29. Babaoğlu K, Hatun S, Arslanoğlu I, et al. Evaluation of glucose intolerance in adolescents relative to adults with type 2 diabetes mellitus. J Pediatr Endocrinol Metab 2006; 19: 1319-26.
  • 30. Zenzen W, Kridli S. Integrative review of school-based childhood obesity prevention programs. J Pediatr Health Care 2009; 23: 242-58.
  • 31. Heitmann BL, Koplan J, Lissner L. Childhood obesity: successes and failures of preventive interventions. Nutr Rev 2009; 67 Suppl 1: 89-93.
  • 32. Wong WW, Abrams SH, Mikhail C, et al. An ınnovative summer camp program ımproves weight and self-esteem in obese children. J Pediatr Gastroenterol Nutr 2009; 49: 493-7.
  • 33. Martin LJ, Burke SM, Shapiro S, et al. The use of group dynamics strategies to enhance cohesion in a lifestyle intervention program for obese children. Public Health 2009; 9: 277.
  • 34. Whitaker RC, Dietz WH. Role of the prenatal environment in the development of obesity. J Pediatr 1998; 132: 768-76.
  • 35. Metzger MW, McDade TW. Breastfeeding as obesity prevention in the United States: A sibling difference model. Am J Hum Biol 2009 Aug 19 [Epub ahead of print].
  • 36. Galvez MP, Hong L, Choi E, Liao L, Godbold J, Brenner B. Childhood obesity and neighborhood food-store availability in an inner-city community. Acad Pediatr 2009; 9: 339-43.
  • 37. Kuhle S, Allen AC, Veugelers PJ. Perinatal and childhood risk factors for overweight in a provincial sample of Canadian Grade 5 students. Int J Pediatr Obes 2009; 28: 1-9. [Epub ahead of print]
  • 38. Blom-Hoffman J, Wilcox KR, Dunn L, Leff SS, Power TJ. Family ınvolvement in school-based health promotion: bringing nutrition ınformation home. School Psych Rev 2008; 37: 567-77.
  • 39. Guldbrandsson K, Modig Wennerstad K, Rasmussen F. Municipal policies and plans of action aiming to promote physical activity and healthy eating habits among school children in Stockholm, Sweden: a cross-sectional study. Implement Sci 2009; 4: 47.
  • 40. Magnus A, Haby MM, Carter R, Swinburn B. The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children. Int J Obes 2009; 33: 1094-102. [Epub ahead of print].
  • 41. Edwards NM, Schwarzenberg SJ. Designing and implementing an effective pediatric weight management program. Rev Endocr Metab Disord 2009; 10: 197 203. [Epub ahead of print].
  • 42. Wald AB, Uli NK. Pharmacotherapy in pediatric obesity: Current agents and future directions. Rev Endocr Metab Disord 2009; 10: 205-14. [Epub ahead of print].
  • 43. McDuffie JR, Calis KA, Booth SL, Uwaifo GI, Yanovski JA. Effects of orlistat on fat-soluble vitamins in obese adolescents. Pharmacotherapy 2002; 22: 814-22.
  • 44. Berkowitz RI, Fujioka K, Daniels SR, et al. Sibutramine Adolescent Study Group. Effects of sibutramine treatment in obese adolescents: a randomized trial. Ann Intern Med 2006; 145: 81-90.
  • 45. Srinivasan S, Ambler GR, Baur LA, et al. Randomized, controlled trial of metformin for obesity and insulin resistance in children and adolescents: improvement in body composition and fasting insulin. J Clin Endocrinol Metab 2006; 91: 2074-80.
  • 46. Inge TH, Krebs NF, Garcia VF, et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics 2004; 114: 217-23.
  • 47. Cliff DP, Okely AD, Morgan PJ, Jones RA, Steele JR. The impact of child and adolescent obesity treatment interventions on physical activity: a systematic review. Obes Rev. 2009 Jul 28 [Epub ahead of print].
  • 48. Yackobovitch-Gavan M, Nagelberg N, Phillip M, Ashkenazi-Hoffnung L, Hershkovitz E, Shalitin S. The influence of diet and/or exercise and parental compliance on health-related quality of life in obese children. Nutr Res 2009; 29: 397-404.
  • 49. Sondike SB, Copperman N, Jacobson MS. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. J Pediatr 2003; 142: 253-8.
  • 50. Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med 2003; 157: 773-9.
  • 51. Spieth LE, Harnish JD, Lenders CM, et al. A low-glycemic index diet in the treatment of pediatric obesity. Arch Pediatr Adolesc Med 2000; 154: 947-51.
  • 52. Zeybek C, Celebi A, Aktuglu-Zeybek C, et al. The effect of low carbohydrate dıet on left ventrıcular dıastolıc functıon ın obese chıldren. Pediatr Int 2009; Aug 7 [Epub ahead of print].