prevalence of overweight and obesity in 2-6-year-old italian children maffeis c et al. 2005...
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Overweight
0,0%
5,0%
10,0%
15,0%
20,0%
25,0%
National reference I.O.T.F. C.D.C.
males
females
totale
Obesity
0,0%
2,0%
4,0%
6,0%
8,0%
10,0%
12,0%
14,0%
16,0%
18,0%
National reference I.O.T.F. C.D.C
males
females
totale
PREVALENCE OF OVERWEIGHT AND OBESITYIN 2-6-YEAR-OLD ITALIAN CHILDREN
Maffeis C et al. 2005 (submitted)
fat mass (%)
0-0.1-0.2 2 4 6 8 10 12 14 16 18
Age (years)
35
30
25
20
15
10
5
0
-0.8
male
female
pregnancy firstyear
adiposity rebound puberty
Dietz WH Am J Clin Nutr 1994
birth weight and type 2 diabetesin 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
Pre
vale
nce
(%
)
3.5 - 4.5
birth weight (kg)
> 4.5
25
age group (years)
5 - 9 10 - 14 15 - 19 20 - 29
(Mantel-Haenszel X2 test, controlled for age and sex)
energy requirementsin 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
referenceWeight
(kg)
TDEE
(kJ/day)
Metabolizable
EI (kJ/kg/d)
Diff. From
FAO (%)
4.5
4.5
4.7
4.5
1280
1270
1212
1205
17
13
21
19
year
energy(kcal/d)
energy intake
4000
3000
2500
1900 1920 1940 1960 1980 2000
3500
Bray G, 2004
0
5
10
15
20
25
0 5 10 15 20
maschi
femmine
variazioni della spesa energetica per l’accrescimento (EEG) espressa in rapporto alla spesa energetica totale (TEE), in funzione dell’età
età (anni)
EEG/TEE (%)
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/m2)
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
OR 95% CI P
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/m2)*
body mass index at the age of 11 yrs
< 15.5 -16.5 -17.5 >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
The infant: a model of physiological overfeeding
weight (g)
7,000
3,500
25
fatmass (%)
14
0 4age (months)
2
human milk:
fat = > 50% of EI
cho = < 40% of EI
1,750
fatmass (g)
500
protein requirements during the first year of file
1.8
0.6
proteinintake
(g/kg/d)
2.4
age (months)
0 4 8 12
Dupon C Am J Clin Nutr 2003
1.2
estimated protein intake from human milk
estimatedprotein needs
basis of weaning recommendations
months
0 3 6 9 12 15 18 21 24
breast milk
staple weaning foodand other grains
soft fruits and vegatables
meats and otherprotein rich foods
transitional period given regularly
0
20
40
60
80
PROTEIN
NUTRIENT INTAKE IN ITALIAN CHILDREN(%)
FAT CARBOHYDRATE
LARN
LARN
LARN
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
1 2 3 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
1 2 3 4
energy balance
time (days)
- 10
20
5 6 7
MJ MJ
high fat
medium fat
low fat
50
25
0
fatmass (%)
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 foodmore palatable
high energy density
less satiating
gross national products per capita/grouping of countries: fiftiles
0
200
400
600
THE SWEETING OF THE WORLD’S DIET
Popkin &Nielsen Obes Res 2004
kca
l/ca
pita
/day
add
ed
sug
ar I II III IV V
1962 2000
1978 -1994adolescents
soft drinks: + 70%milk: -65%
Warren, J. M. et al. Pediatrics 2003;112:e414
Mean differences in lunch intake after different breakfasts, compared with lunch intake after habitual breakfast
adiposity rebound
Kimm SYS, et al Lancet, 2005
livelli di attività fisica durante l’adolescenza possono influenzare significativamente il BMI e l’adiposità nell’età adulta.
lipidstore
G G
GLYCOGEN
GLYCOLYSIS
Acetyl CoA KC ox
FFA FFA
CO2
H+
ATPADP + Pi
O2
AcetylCoA
pre-pubertal physical activity of boys and girls
activityrelated energy
expenditure (kcal/day)
age (years)4 106 8
700
500
300
age (years)4 106 8
9
6
3
activity(h/week)
males
females
Goran MI, et al. Pediatrics 1998;101:887
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
INFLUENCE OF CHANGES IN SEDENTARY BEHAVIOR ON ENERGY AND MACRONUTRIENT INTAKE IN YOUTH
150
DECREASE PHASE
75
- 75
- 150
INCREASE PHASE
changes intargeted sedentary behavior from baseline(min/day)
Epstein LH, et al. AJCN 2005;81:361-6
BOYS GIRLS
Morningsnack
Afternoonsnack
0
10
20
30
40
Breakfast Lunch DinnerNight snack
percentage distribution of the energy intake among the different meals
Maffeis C, et al. Int J Obes 1999
conclusioni
• gli eccessi alimentari sono numericamente più rilevanti
delle carenze.
• l’energia 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 dell’esposizione al video e la regolare pratica
di uno sport sono importanti quanto un’alimentazione
equilibrata
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
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.