Övervikt hos barn
Senast uppdaterad: Senast reviderad:
Sakkunnig:Stephan Rössner
Definition:
Övervikt hos barn förekommer vid iso-BMI mellan 25 och –<30, fetma vid iso-BMI ≥30
Förekomst:
En svensk rikstäckande studie (2008) för skolbarn i åldern sju till nio år och med svar från mindre än hälften av tillfrågade skolor visade en prevalens av övervikt på 17 %, varav 3 % hade fetma.
Symtom:
Övervikt bland barn leder till fysisk belastning och kan få psykiska och sociala konsekvenser.
Kliniska fynd:
Övervikten klassificeras i förhållande till åldersjusterat BMI som övervikt, fetma eller allvarlig fetma.
Diagnostik:
Blodtryck, midjemått och labvärden för bedömning av metabol påverkan bedöms för barn med fetma.
Behandling:
Motivation för beteendeförändring med ökad fysisk aktivitet, färre stillasittande aktiviteter och nya mat-/dryckesvanor med minskat energiintag. Vid fetma behövs ofta tvärdisciplinärt samarbete.
- Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for childhood overweight and obesity worldwide:international survey. BMJ 2000;320:1240-3 www.bmj.com
- Changes in Terminology for Childhood Overweight and Obesity; National Health Statistics Reports, Centers for Disease Control and Prevention: http://www.cdc.gov/nchs/data/nhsr/nhsr025.pdf
- Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among U.S. children and adolescents, 1999-2000. JAMA 2002; 288:1728-32. Journal of the American Medical Association
- Ogden CL, Carroll MD, Lawman HG et al. Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014. JAMA 2016; 315: 2292-9. pmid:27272581 PubMed
- Wijnhoven TM, van Raaij JM, Spinelli A et al. WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health. 2014 Aug 7;14:806. PMID: 25099430 PubMed
- Sjöberg A, Moraeus L, Yngve A, Poortvliet E, Al-Ansari U, Lissner L. Overweight and obesity in a representative sample of schoolchildren – exploring the urban– rural gradient in Sweden. Obes Rev. 2011;12(5):305-14. www.ncbi.nlm.nih.gov
- Lissner L, Sohlström A, Sundblom E, Sjöberg A. Trends in overweight and obesity in Swedish schoolchildren 1999–2005: has the epidemic reached a plateau? Obes Rev. 2010;11(8):553-9. www.ncbi.nlm.nih.gov
- Neovius M, Janson A, Rössner S. Prevalence of obesity in Sweden. Obes Rev. 2006;7(1):1-3 www.ncbi.nlm.nih.gov
- Marild S, Bondestam M, Bergström R, Ehnberg S, Hollsing A, Albertsson-Wikland K. Prevalence trends of obesity and overweight among 10-year-old children in western Sweden and relationship with parental body mass index. Acta Paediatr. 2004;93(12):1588-95 www.ncbi.nlm.nih.gov
- Niclasen BVL. Overvægt og fedme. Ugeskr læger 2005; 167: 1145-8. PubMed
- Simmonds M, Llewellyn A, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev. 2016;17(2):95-107. PMID: 26696565. PubMed
- Aggarwal B, Jain V. Obesity in Children: Definition, Etiology and Approach. Indian J Pediatr. 2017 Nov 25. PMID: 29177599 PubMed
- Sonne-Holm S, Sorensen TIA. Prospective study of attainment of social class of severely obese subjects in relation to parental social class, intelligence, and education. Br Med J 1986;292:586-9. PubMed
- Hediger ML, Overpeck MD, McGlynn A, et al. Growth and fatness at three to six years of age of childern born small- or large-for-gestational age. Pediatrics 1999; 104: e33. Pediatrics
- Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005; 115: 290-6. Pediatrics
- Malik VS, Schulze MB, Hu FB. Intake of sugar sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006; 84: 274-88. PubMed
- Capuccio FP, Taggart FM, Kandala NB, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008; 31: 619-26. PubMed
- Carter PJ, Taylor BJ, Williams SM, et al. Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study. BMJ 2011; 342: d2712. BMJ (DOI)
- www.ernæringsrådet.dk/ Den danske fedmeepidemi/2003 /juni 2004.
- Lissau I, Sørensen TI. Parental neglect during childhood and risk of obesity in young adulthood. Lancet 1994; 343: 324-7. PubMed
- Lissau I, Sørensen TI. School difficulties and risk of overweight and obesity in young adulthood: a ten year prospective study. Int J Obes Relat Metab Disord 1993; 17: 169-75. PubMed
- Bramsved R, Regber S, Novak D et al. Parental education and family income affect birthweight, early longitudinal growth and body mass index development differently. Acta Paediatr. 2018 Nov;107(11):1946-1952. PMID: 29315777 PubMed
- Armstrong J, Reilly JJ, Child Health Information Team. Breastfeeding and lowering the risk of childhood obesity. Lancet 2002; 359: 2003-4. PubMed
- Horta B, Bahr R, Martines J, Victioria C. Evidence of long-term effects of breastfeeding: systematic reviews and meta-analysis. Geneva: World Health Organisation; 2007.
- Maggie A. Stanislawski, Dana Dabelea, Brandie D. Wagner, Nina Iszatt, Cecilie Dahl, Marci K. Sontag, Rob Knight, Catherine A. Lozupone, Merete Eggesbø. Gut Microbiota in the First 2 Years of Life and the Association with Body Mass Index at Age 12 in a Norwegian Birth Cohort. MBio 2018; 9 (5) PMID: 30352933 PubMed
- Peterson CM, Su H, Thomas DM, et al. Tri-Ponderal Mass Index vs Body Mass Index in Estimating Body Fat During Adolescence. JAMA Pediatr. 2017 May 15. PMID: 28505241. PubMed
- Wangensteen T, Kolsgaard ML, Mattingsdal M, et al. Mutations in the melanocortin 4 receptor (MC4R) gene in obese patients in Norway. Exp Clin Endocrinol Diabetes 2009; 117: 266-73. PubMed
- Perbeck L, Mellgrim S. Lipödem – en ofta förbisedd men behandlingsbar sjukdom. Läkartidningen. 2017;114:ETHF www.lakartidningen.se
- Fredriks AM, van Buuren S, Fekkes M et al. Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? Eur J Pediatr. 2005 Apr;164(4):216-22. PMID: 15662504 PubMed
- Nowicka P, Pietrobelli A, Flodmark CE. Low-intensity family therapy intervention is useful in a clinical setting to treat obese and extremely obese children. Int J Pediatr Obes. 2007;2(4):211-7. www.ncbi.nlm.nih.gov
- Nowicka P, Höglund P, Pietrobelli A, Lissau I, Flodmark CE. Family Weight School treatment: 1-year results in obese adolescents. Int J Pediatr Obes. 2008;3(3):141-7. www.ncbi.nlm.nih.gov
- Danielsson P, Svensson V, Kowalski J, Nyberg G, Ekblom O, Marcus C. Importance of age for 3-year continuous behavioral obesity treatment success and dropout rate. Obes Facts. 2012;5(1):34-44 www.ncbi.nlm.nih.gov
- Flodmark CE, Marcus C, Mårild S. Behandling av barnfetma. I: Fetma, red Lindroos AK, Rössner S. Studentlitteratur Lund 2007
- Kelley GA, Kelley KS. Effects of exercise in the treatment of overweight and obese children and adolescents: a systematic review of meta-analyses. J Obes. 2013;2013:783103. PMID: 24455215. PubMed
- Dobbins M, Husson H, DeCorby, et al. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews 2013;2:CD007651. PMID: 23450577. PubMed
- Metcalf B, Henley W, Wilkin T. Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54). BMJ 2012;345:e5888. PubMed
- Wilfley DE, Tibbs TL, Van Buren DJ, et al. Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials. Health Psychol 2007; 26: 521-32. PubMed
- Oude LH, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane Database of Systematic Reviews 2009; 1: CD001872. Cochrane (DOI)
- Fowler-Brown A, Kahwati LC. Prevention and Treatment of Overweight in Children and Adolescents. Am Fam Physician 2004; 69: 2591-8. PubMed
- Maroney D, Golub S. Nurses' attitudes toward obese persons and certain ethnic groups. Percep Motor Skills 1992;75:387-91. PubMed
- O'Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents. A randomized trial. JAMA 2010; 303: 519-26. Journal of the American Medical Association
- James J, Thomas P, Cavan D et al. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ 2004; 328: 1237-43. British Medical Journal
- Mead E, Atkinson G, Richter B, et al. Drug interventions for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev. 2016; 11:CD012436. PMID: 27899001. PubMed
- Norgren S, Danielsson P, Jurold R, Lotborn M, Marcus C. Orlistat treatment in obese prepubertal children: a pilot study. Acta Paediatr. 2003;92(6):666-70. PMID: 12856974. PubMed
- Thakkar RK, Michalsky MP.. Update on bariatric surgery in adolescence.. Curr Opin Pediatr. 2015. pmid:25944309 PubMed
- Olbers T, Beamish A, Gronowitz E et al. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study. Lancet Diabetes Endocrinol. 2017 Mar;5(3):174-183. PMID: 28065734 PubMed
- Alqahtani A, Alamri H, Elahmedi M, Mohammed R. Laparoscopic sleeve gastrectomy in adult and pediatric obese patients: a comparative study. Surg Endosc. 2012 Nov;26(11):3094-100. PMID: 22648112 PubMed
- Veugelers PJ, Fitzgerald AL. Prevalence of and risk factors for childhood overweight and obesity. CMAJ 2005; 173: 607-13. PubMed
- Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, et al. Reducing obesity via a school-based interdisciplinary intervention among youth: planet health. Arch Pediatr Adolesc Med 1999; 153: 409-18. PubMed
- Sahota P, Rudolf MC, Dixey R, Hill AJ, Barth JH, Cade J. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 2001;323:1029-32. British Medical Journal
- Donnelly JE, Jacobsen DJ, Whatley JE, Hill JO, Swift LL, Cherrington A, et al. Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children. Obes Res 1996; 4: 229-43. PubMed
- Muller MJ, Asbeck I, Mast M, Langnase K, Grund A. Prevention of obesity-more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 2001;25 suppl 1:S66-74.
- Mo-suwan L, Pongprapai S, Junjana C, Puetpaiboon A. Effects of a controlled trial of a school-based exercise program on the obesity indexes of preschool children. Am J Clin Nutr 1998; 68: 1006-11. PubMed
- Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 327: 1350-5. New England Journal of Medicine
- Guidelines for school and community programs to promote lifelong physical activity among young people. Centers for Disease Control and Prevention. <link src="http://www.cdc.gov/mmwr/preview/mmwrhtml/00046823.htm">MMWR Recomm Rep</link> 1997; 46(RR-6): 1-36.
- Baker JL, Olsen LW, Sørensen TIA. Body mass index i barndommen og risikoen for koronar hjertesygdom i voksenlivet - sekundærpublikation. Ugeskr Læger 2008; 170: 2434. PubMed
- Overweight, obesity, and health risk. National Task Force on the Prevention and Treatment of Obesity. Arch Intern Med 2000;160:898-904. PubMed
- Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101(3 pt 2): 518-25.
- Latner JD, Stunkard AJ. Getting worse: the stigmatization of obese children. Obes Res 2003; 11: 452-6. PubMed
- de Beer M, Hofsteenge GH, Koot HM, et al. Health-related-quality -of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr 2007; 96: 710-4. PubMed
- Persson M. Insulinresistens vanligt hos barn och ungdomar med fetma. Lakartidningen.se 2019-04-08 www.lakartidningen.se
- Ludwig DS, Ebbeling CB. Type 2 diabetes mellitus in children: primary care and public health considerations. JAMA 2001; 286: 1427-30. Journal of the American Medical Association
- Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002; 346: 802-10. New England Journal of Medicine
- Carpaij OA, van den Berge M. The asthma-obesity relationship: underlying mechanisms and treatment implications. Curr Opin Pulm Med. 2017 Nov 23. PMID: 29176481 PubMed
- Ibáñez L, Oberfield SE, Witchel SF et al. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Horm Res Paediatr. 2017 Nov 13;Vol.(6):307-331. PMID: 29156452 PubMed
- Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 1993; 329: 1008-12. New England Journal of Medicine
- Falkner NH, Neumark-Sztainer D, Story M et al. Social, educational, and psychological correlates of weight status in adolescents. Obesity Research 2001; 9: 32-42. PubMed
- Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA 2003; 289: 1813-9. Journal of the American Medical Association
- Harvey EL, Summerbell CD, Kirk SF et al. Dietitians' views of overweight and obese people and reported management practices. J Hum Nutr Diet 2002; 15: 331-7. PubMed
- Hesketh K, Wake M, Waters E. Body mass index and parent-reported self-esteem in elementary school children: evidence of a causal relationship. Int J Obes Relat Metab Disord 2004; 28:1233-7. PubMed
- Martin A, Saunders DH, Shenkin SD, et al. Lifestyle intervention for improving school achievement in overweight or obese children and adolescents. Cochrane Database Syst Rev. 2014 Mar 14;3:CD009728. doi: 10.1002/14651858.CD009728.pub2. DOI
- Stephan Rössner, professor emeritus och överläkare, överviktsenheten, Karolinska universitetssjukhuset
- Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet