Pediatric Overweight and Obesity : Comorbidities, Trajectories, Prevention and Treatments

It is still necessary to write to teach and also to read to learn. This will be demonstrated in this excellent work by Professor Manuel Moya on childhood obesity, that this clinical and social issue that the Pediatrics of the last century has transferred to the twenty-first century.By subtitling the book as Comorbidities, Trajectories, Prevention and Treatments, the Author warns that its objective is not only didactic and scientific, in a context of great actuality, but also practical, since it is providing a very useful tool for all those interested in preventing or eradicating the problem. The beneficiaries of his reading should be not only specialists in endocrinology and nutrition, but also pediatricians and doctors who take care of children and young people, patients in the age of development, with the known high risk of suffering from overweight or established obesity, and its close and distant consequences, with which it is possible to begin to master by modifying lifestyle and eating habits. Foreword Foreword (1) Preface Acknowledgements Contents Chapter 1: Pediatric Overweight and Obesity: Basis for an Early Modification of Their Development Introduction Concept Assessment in Pediatric Ages Raw and Percentile BMI BMI z-Score Relative Body Mass Index (rBMI) BMI Percentage (% BMI) Assessment of Body Fat and Its Distribution Milestones in the History of Obesity with Special Reference to Childhood Obesity Current Stage References Chapter 2: Epidemiology in Different Scenarios Introduction Epidemiological Growth of Obesity in the General Population Epidemiological Evolution of Pediatric Obesity Developments in the European Region References Chapter 3: Etiologic Factors Introduction Obesity due to Positive Energy Balance Food Surplus Energy Density of Food Current Interest of Macronutrients in Energy Intake Eating Patterns Fast Food Increased Portion Sizes Physical Activity (PA) Obesity from Genetic and Medical Causes Monogenic Obesities Genetic Variations Syndromic Obesity Risk Factors References Chapter 4: Pathogenesis Bioenergy Balance and Its Measurement Physiological Basis Calorimetry Other Factors Affecting the Energy Balance Appetite Regulation Physiological Basis Signals from the GI Tract Sweet Taste and Aroma Perception Signals Initiated in Adipose Tissue Adipose Tissue Functional and Cellular Basis White Adipose Tissue (WAT) Metabolism in Lipid Tissue Lipogenesis Lipolysis WAT Locations Adipokines and WAT-Derived Hormones Brown Adipose Tissue (BAT) Origin Location Function Assessment of the BAT’s Activity Other Pathogenetic Aspects of Interest Epigenetic Modifications Body Weight Regulation Independent of Conventional Homeostasis References Chapter 5: Clinical Features Introduction Clinical Findings Puberty and Associated Disorders Gynecomastia Sleep Disorders Obstructive Sleep Apnea (OSA) Sleep Duration and Obesity Psychosocial Problems: Stigma Bullying Low Self-Esteem Musculoskeletal Disorders Vitamin D Additional Determinations Genetic Studies Blood Pressure and Cardiovascular Assessment Assessment of Physical Activity Specific Anthropometry: Abdominal Fat Assessment Evaluation of the Central Fat Content Evaluation of Body Composition References Chapter 6: Comorbid Conditions of Pediatric Obesity Concept Prevalence Prevalence of Selected Comorbidities Causes of Comorbid Conditions Feeding Physical Activity Importance and Stages of Insulin Resistance (IR) in Relation to the Development of Comorbidities Genomic Bases Biochemical Basis Metabolic Syndrome (MS) Non-alcoholic Fatty Liver Disease (NAFLD) Prevalence of NAFLD HGNA Histology Clinical Aspects Evolution Cardiovascular Disease Hypertension Respiratory Disorders Pickwick’s Syndrome Type 2 Diabetes (T2D) Preventive and Therapeutic Approach to Pediatric Obesity Comorbidities References Chapter 7: Evolution, Trajectories, and Prognosis of Pediatric Obesity Introduction Body Mass Index (BMI) Trajectories Excess Weight Maintenance Prognosis Prognosis of Pediatric Obesity Immediate or Present Prognosis Final Considerations References Chapter 8: Prevention Introduction Types of Prevention Implementation of the Prevention of Pediatric Obesity General Approach Individual Approach Who? How Prevention Can Be Carried Out at the Individual Level Reduced Dietary Intake Increased Physical Activity (PA) Physical Inactivity and Sedentary Lifestyle Inadequate Sleep Involving Parents and the Family Environment Results Final Considerations References Chapter 9: General Treatment of Pediatric Obesity Introduction Initial Approach (See Also Chaps. 5 and 6) Non-drug Therapeutic Approach Lifestyle Change Modification of Eating Habits Physical Activity (PA) Drug Treatment Bariatric Surgery (BS) Bariatric Surgery in Adolescents Final Considerations References Chapter 10: Pediatric Obesity: Where Do We Stand Now? Socioeconomic Aspects in Relation to the Development of Pediatric Obesity Medical Aspects Increasing Awareness of Obesity Energy Intake Treatment Final Reflection References This book focuses on the worldwide frequent and growing problem with its projective trajectory that encompasses pediatric overweight and obesity. Through the ten chapters it offers in the first four a comprehensive state of art of the bases of pediatric obesity in order to support the following ones with new and proved clinical issues, as recent complementary features on anthropometry and food intake and new safe treatments. This books discusses comorbidities, trajectories, prevention, extended periods and treatment. For effective prevention, clues are given to routinely screen all comorbidities that are already present in overweight or obese children but frequently overlooked. This volume will be of benefit to pediatricians, endocrinologists and all healthcare providers interested in the care of children and adolescents.