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Screening and prevention of childhood obesity – practical considerations
Care of obese children by their primary health care providers requires a thorough medical evaluation that begins with appropriate identification of overweight. Most practitioners used multiple methods to assess overweight. Different methods as clinical impression, weight-for-age percentile, weight-for-height percentile, change in weight velocity, Body Mass Index (BMI) percentile, skinfold thickness, and waist circumference are used. After a clinician identifies overweight in a child, the next step is to identify current medical problems and risk factors for future disease. Further medical assessment may include: medical history and physical examination, measurement of arterial pressure, examination to look for orthopedic problems and type 2 diabetes or insulin resistance. Some conditions require additional testing: laboratory tests, bone radiographs or sleep studies. Increased prevalence of overweight in Romanian children (24.5% of children aged 7-11 years old in our studies carried out in Moldavia region) points to the need for educational efforts to increase awareness of medical risks and for tools to facilitate more complete evaluation during office visits. Clinicians need help incorporating these assessments into the constraints of a standard office visit and national guidelines for screening recommendations are required. Current international best practice suggests that the prevention and management of obesity requires a range of co-ordinated actions to improve diet and physical activity levels in the early years, at school, in the family and community
Key words: childhood obesity, screening, prevention