Whanau Pakari is a unique multidisciplinary programme launched in January 2012 for obese children and adolescents.
Aim: To review baseline assessments, weight-related comorbidities and cardio-metabolic profile of Whanau Pakari participants.
Method: Baseline assessments from January 2012 to August 2014 were reviewed. Referral criteria were BMI>98th centile, or >91st centile with significant weight-related co-morbidities, age 5-16years. The assessments included health and lifestyle parameters.
Results: 240 assessments were reviewed. Average age was 10 years, with 53% female (n=126). Primary ethnicity was identified as Maori in 45% of patients, New Zealand European (45%), Pacific (3%), Asian (3%) and Other (4%).
Weight had a been a concern for an average of 3.7 years (n=207). Average BMI percentile was 99.6 (range 94-100), with an average BMI standard deviation score (SDS) of 3.1 (range 1.5-5.4). Average BMI of the accompanying adult was 33.6 (range 19.3-62.6). Acanthosis nigricans was present in 98 (41%) of the children.
Of the 224 mothers who responded, 89 (40%) smoked during pregnancy. Average birthweight was 3.45 kilograms.
A family history of weight problems was reported for 189 (79%) and of Type 2 Diabetes for 143 (60%) of the children.
Of the 238 children for whom casual blood pressure recordings were available, 45 (19%) had pre-hypertension, and 12 (5%) had hypertension (n=12). Pauses in breathing were reported by 48 (20%).
A baseline blood sample was obtained on 176 (73%) of the children. Average fasting serum insulin was 149pmol/L (range 12-1185). Insulin resistance (fasting insulin>80pmol/L) was present in 125 (71%). Average HbA1c was 34mmol/mol (range 25-94), including 1 Type 1 Diabetes patient and 2 with Type 2 Diabetes, and an average fasting glucose 5.2mmol/L (range 3.3-16.4).
Conclusion: Whanau Pakari has demonstrated concerning levels of weight-related comorbidities across all ethnicities with hypertension, likely obstructive sleep apnoea and insulin resistance of particular concern.