Impact of nutritional education program for overweight and obese pediatric patients in Lampang hospital
Keywords:
Overweight, Obesity, metabolic complication, dyslipidemiaAbstract
Background: Situation of childhood obesity according to WHO1 data in 2022, 37 million children under the age of 5 years were found to be obese, with nearly half of them living in Asia. Among children aged 5-19 years, 390 million were found to be obese. In Thailand2, the number of children with overweight and obesity has also increased. Therefore, Lampang Hospital has provided individual nutritional educational program for these patients to monitor pediatric patients those with overweight and obesity.
Objective: To monitor weight, BMI, and BMI-SDS in overweight and obese pediatric patients aged 5-15 years after receiving nutritional education program for one year. To identify the incidence of metabolic complications in overweight and obese pediatric patients. To evaluate the association between changes in BMI-SDS and metabolic complications.
Methods: The study is a retrospective study, collecting data from the medical records in Lampang hospital for overweight and obese patients between August 1, 2019, and April 30, 2023. All patients received individual nutritional education program from a nutritionist 3-4 times per year.
Results: Ninety patients with overweight and obesity were followed up for at least one year. The average age at initial diagnosis was 9.5±2.6 years. The mean weight and weight-SDS were 56.2±21.2 kg and 4.1±1.9, respectively. The mean BMI and BMI-SDS were 27.7±5.7 kg/m² and 3.6±1.3, respectively. Metabolic complications at initial diagnosis included prediabetes in 8.9% of patients, dyslipidemia in 56.2%, elevated liver enzymes in 42.6%, and fatty liver detected by ultrasound in 21.4%. Comparing before and after one year of nutritional education program, the mean BMI-SDS significantly decreased from 3.6±1.3 to 3.2±1.2 (p<0.001). The number of obese patients decreased from 86 (95.6%) at initial diagnosis to 75 (83.4%) at one year follow-up. Furthermore, an increase in BMI-SDS was associated with dyslipidemia at one year follow-up. (OR 2.71, 95% CI 1.12-6.59, p=0.027).
Conclusion: Overweight and obese pediatric patients at Lampang Hospital showed a significant decrease in BMI-SDS after receiving continuous nutritional education program for one year. Half of the patients were found to be dyslipidemia. Patients with a reduction in BMI-SDS at one year had better blood sugar and lipid levels than those with an increase in BMI-SDS.
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