Preventing Childhood Obesity Health in the Balance (2005) / Chapter Skim
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1 Introduction
1 Introduction
Pages 21-53
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From page 21... ...
. Given this steady trajectory toward a healthier childhood and healthier children, we begin the 21st century with a startling setback—an epidemics IThe tetm "epidemic" is used in tcfetence to childhood obesity as thete have been an unexpected and excess nombet of cases on a steady inctease in tecent decades.
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From page 22... ...
Thus, we need to acknowledge the sensitive personal dimension of height and weight, while also viewing weight as a public health issue, especially as the weight levels of children, as a population, are proceeding on a harmful upward trajectory. The as yet unabated epidemic of childhood obesity has significant ramifications for children's physical health, both in the immediate and long term, given that obesity is linked to several chronic disease risks.
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because it increases lifetime risk for type 2 diabetes and other serious chronic disease conditions (Narayan et al., 2003) , thereby potentially reversing the positive trend achieved with the reduction of infectious diseases over the past century.
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How to proceed similarly in meeting the formidable childhood obesity challenge is the focus of this institute of Medicine (IOM) report.
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An understanding of these contexts, particularly regarding therr potential to be modified and how they may facilitate or impede development of a comprehensive obesity prevention strategy, is therefore essential. This next section provides a useful background to understand the multidimensional nature of the childhood obesity epidemic.
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. Over the same period, men's labor force participation rates declined slightly from 78 percent to 74 percent (Population Reference Bureau, 2004b)
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. lilting Patterns As economic demands and the rapid pace of daily life increasingly constrain people's time, food trends have been marked by convenience, shelf stability, portability, and greater accessibility of foods throughout the entire day (Food Marketing institute, 1996, 2003; French et al., 2001; Sloan, 2003)
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A more in-depth discussion of caloric intake, energy balance, energy density, Dietary Guidelines for Americans, and the Food Guide Pyramid is included in Chapters 3, 5, and 7.
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. National surveys conducted over the past several decades suggest an increase in population-wide physical activity levels among American men, women, and older adolescents; however, a large proportion of these populations still do not meet the federal guidelines for recommended levels of total daily physical activity.3 The data for children's and youth's leisure time and physical activity levels reveal a different picture than the adult physical activity trend data that are summarized in Table 1-2.
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SOURCES: Putnam et al., 2002; USDA, 2003. 60 1 Carbohvdrates 10 o 1971-1974 1976-1990 1999-1994 1999-2000 Survey years FIGURE 1-2 Percentage of calories from macronutrient intake for carbohydrates, protein, and total fat among adult men and women, 1970-2000 SOURCE: CDC, 2004a.
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Most available information is on the physical activity levels of high school youth, with limited data available on levels in younger children. Based on the Youth Risk Behavior Survey (YRBS)
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. An estimated 61.5% of children aged 9 to 13 Yeats do not participate in any organized physical activity during theit nonschool hours and 22.6% do not engage in any fteetime physical activity based on the 2002 YMCLS (CDC, 2003a)
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, a nationally representative survey of children aged 9 to 13 years and their parents, which revealed that 61.5 percent of youth in this age group do not participate in any organized physical activity during their nonschool hours and 22.6 percent do not engage in any free-time physical activity (CDC, 2003a)
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The 1999 HealthStyles Survey found that among participating households, 25 percent of children aged 5 to 15 years who lived within a mile of school either walked or bicycled at least once during the previous month (CDC, 2002)
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From page 39... ...
of children aged zero to six years had three or more televisions, one-third (36 percent) had a television in their bedrooms, and nine out of ten children in this age range had watched television or DVDs (Rideout et al., 2003)
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, television viewing represents a significant amount of discretionary time among children and youth, which is a sedentary and modifiable activity (see Chapter 8)
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, includes obesity-related topics ranging from popular diets and quick weight loss strategies to litigation against fast food restaurants to reports of new programs, policies, and research findings. The media coverage on obesity is viewed by the public, parents, and other stakeholder groups in a variety of ways, depending on their personal beliefs regarding issues such as personal responsibility, the role of government and other institutions in promoting personal freedoms, media influences, free speech and the rights of advertisers, and the ways in which parents should raise their children, as well as on consequent responses to various population level approaches being proposed to address obesity While some people place a high value on the individual's right to choose what, when, where, and how to eat and be active, others are looking for advice, information, and enhanced opportunities, and may even favor government interventions that facilitate healthier choices (Kersh and Morone, 2002)
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Recent opinion polls indicate that a large number of adults and parents are very concerned or somewhat concerned about childhood obesity (Field Research Corporation, 2003; Widmeyer Polling 8: Research, 2003)
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. Childhood obesity presumably engenders more support for societal-level approaches because children, who are thought to have less latitude in food and activity choices than adults, are unlikely to be blamed by society for becoming obese.
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From page 44... ...
, and this experience gives us not only the confidence that childhood obesity too can be moderated, even prevented, but supplies us with some of the needed tools. This solid public health history of achievements is exemplified in Box 1-1 (CDC, 1999; Appendix D)
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. Even with this progress, however, we continue to record over 42,000 deaths a year from motor vehicle collisions (U.S.
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. Additional reports, including those central to preventing childhood obesity (e.g., school-based programs, community fruit and vegetable consumption, consumer literacy, and food and nutrition policy)
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Such insights are presented as part of the committee's charge to use theoretical and empirical findings to assess the potential utility of specific approaches within a comprehensive childhood obesity prevention strategy. This report provides a broad-based examination of the problem of obesity in children and youth, and it presents an action plan—with recommendations on the roles and responsibilities of numerous stakeholders and many sectors of society—for addressing this problem.
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2003a. Physical activity levels among child en aged 9-13 Yeats United States, 2002.
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2002. Childhood obesity: Pob ic-health ctisis, common sense cme.
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IFIC International Food Information Cooncil)
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1999. The sptead of the obesity epidemic in the United States, 1991-199 8.
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1987. Elementaty school principals' perceptions of childhood obesity.
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From page 53... ...
2005a. Childhood obesity—What can we learn f om existing data on societal t ends.
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