14 Questions
What is the recommended goal for energy provision in obese pediatric inpatients?
Similar to non-obese counterparts
What is the preferred practical method to screen children for obesity?
BMI
What is a limitation of using BMI to screen for obesity in children?
Its strength as an indicator of adiposity decreases at younger ages
What is supported by tracking studies from childhood to adulthood?
The validity of BMI as a screening criterion for obesity
What is predicted by a ≥95th percentile on BMI for sex and age charts in childhood?
Adult BMI, obesity, adiposity, and mortality
What is the grade of the practice guideline for using BMI to screen children for obesity?
D
What is the primary concern related to nutrition support in hospitalized obese children?
Preventing complications associated with enteral or parenteral feedings
What is the recommended method to screen children for obesity according to the guideline recommendations?
Body mass index (BMI)
Why should obese pediatric inpatients be tested for potential laboratory abnormalities?
For safety reasons
What is a complication that may result from undernutrition in hospitalized obese children?
Energy and protein deprivation
What is the recommended method to assess energy requirements in obese hospitalized children?
Indirect calorimetry
Which organization recommends using the term obesity in children aged 2–20 years with a BMI ≥ 95th percentile?
American Academy of Pediatrics (AAP)
Why is it important to avoid overnutrition in hospitalized obese children?
To prevent complications such as hypophosphatemia and hyperglycemia
What is a potential complication of refeeding syndrome in obese children?
Hypophosphatemia
Study Notes
Pediatric Obesity
- Pediatric obesity has reached epidemic proportions in the United States.
- Obesity-related complications, such as diabetes, sleep apnea, and gallbladder disease, are increasingly diagnosed at discharge.
Causes and Complications
- The origin of pediatric obesity is multifactorial.
- Obesity leads to numerous complications affecting inflammatory processes and nutrient metabolism.
- Current estimations of nutrition status and requirements among obese patients remain unclear.
Diagnosis and Recommendations
- The Institute of Medicine (IOM) and the American Academy of Pediatrics (AAP) recommend using the term "obesity" in children aged 2-20 years with a BMI ≥ 95th percentile.
- BMI is the preferred practical method to screen children for obesity.
- BMI is a useful predictor of adiposity and medical complications of obesity, but it does not directly measure body fat.
Nutrition Support
- The role of nutrition support is to prevent complications associated with enteral or parenteral feedings.
- Undernutrition may result in energy and protein deprivation, while overzealous nutrition support may result in hypophosphatemia and hyperglycemia.
- Neither undernutrition nor overnutrition can be recommended during hospitalization of the obese child.
Practice Guidelines
- Pediatric obese inpatients may be at increased nutrition risk, and testing for potential laboratory abnormalities is recommended for safety reasons.
- Energy requirements of obese hospitalized children should be assessed using indirect calorimetry rather than predictive equations when possible.
- The goals for the provision of energy to the pediatric obese inpatient should be similar to their nonobese counterparts.
Assess your knowledge of obesity screening and energy provision recommendations for pediatric inpatients. Learn about the limitations of using BMI and the importance of tracking studies from childhood to adulthood.
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