Preventing Childhood Obesity Health in the Balance (2005) / Chapter Skim
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2 Extent and Consequences of Childhood Obesity
2 Extent and Consequences of Childhood Obesity
Pages 54-78
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From page 54... ...
This chapter's discussion of these questions informs the recommendations throughout the remainder of this report. PREVALENCE AND TIME TRENDS Because direct measures of body fat are neither feasible nor available for nationwide assessments of the prevalence of obesity, the National Health and Nutrition Examination Surveys (NHANES)
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From page 55... ...
The increase in obesity prevalence has been particularly striking since the late 1970s. The obesity epidemic affects both boys and girls and has occurred in all age, race, and ethnic groups throughout the United States (Ogden et al., 2002a)
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From page 56... ...
NOTE: Obesity is defined as a BMI at or above the age- and gender-specific 95th percentile cutoff points from the 2000 CDC BMI charts. Weight-for-length is used to track children aged 6 to 23 months (under 2 years of age)
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From page 57... ...
NOTE: Obesity is defined as a BMI at or above the age- and gender-specific 95th percentile cutoff points from the 2000 CDC BMI charts. Weight-for-length is used to track children aged 6 to 23 months (under 2 years of age)
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From page 58... ...
As discussed below, certain ethnic minority populations, children in low-socioeconomic-status families, and children in the country's southern region tend to have higher rates of obesity than the rest of the population. Either the factors driving the obesity epidemic are more pronounced on these highrisk populations and communities, or therr children and adolescents may be more sensitive to, or less able to avoid, the causal factors when present.
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and the National Longitudinal Study of Adolescent Health (Goodman, 1999; Goodman et al., 2003) —have suggested that family socioeconomic status is inversely related to obesity prevalence in children and that the effects of socioeconomic status and race or ethnicity were independent of other variables.
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From page 61... ...
Shifts in the Population BMI Distribution Researchers can monitor changes in the nature of the obesity epidemic by comparing the BMI distribution curves derived from population-based surveys and noting shifts in any particular distribution over time. A shift toward higher BMls over the entire distribution would indicate that virtually everyone is becoming heavier, with lean individuals gradually moving into the overweight range, overweight individuals moving into the obese range, and the number of obese individuals becoming more severely obese.
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Thus, with the childhood obesity epidemic characterized by a disproportionate number of children at the extreme ranges of BMI, there are likely to be higher obesity-related morbidity rates in children than if the epidemic mostly resulted from an upward shift in BMI across their entire population.
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NOTE: Percents for adults are age-adjusted. Obesity for children is defined as a BMI at or above the age- and gender-specific 95th percentile BMI cutpoints from the 2000 CDC BMI charts.
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From page 64... ...
, have paralleled childhood and youth obesity prevalence, suggesting that the epidemics may be linked. The observation that children and adults are both experiencing epidemics of obesity over the same time frame has important implications for understanding causes and formulating prevention interventions.
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From page 65... ...
. Although much remains to be learned about the mechanisms of intergenerational obesity, these data suggest that it may be important to consider the promotion of healthy body weights among pregnant mothers as part of childhood obesity prevention efforts, and obesity research efforts should examine prevention interventions for pregnant mothers who are obese as well as for their children.
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From page 66... ...
. This sort of treatment, which is hypothesized to produce adverse emotional consequences such as low self-esteem, negative body image, and depressive symptoms for obese children, is not limited to peers; it may also come from adults, including parents, teachers, and health-care providers (Strauss et al., 1985)
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From page 67... ...
Some of these conditions produce clinical symptoms in obese children, while others do not; however, the metabolic and physiologic changes associated with childhood obesity, along with the obesity itself, tend to track into adult life and eventually enhance the risks of disease, disability, and death. In 2000, it was estimated that 400,000 deaths were attributed to poor diet and physical inactivity in the United States (MoLdad et al., 2004)
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From page 68... ...
The childhood obesity epidemic may result in increased risk of type 2 diabetes. One study found that for each adolescent diagnosed with type 2 diabetes, there are 5 others with impaired fasting glucose, an indicator of insulin resistance below the diagnostic threshold for type 2 diabetes (FagotCampagna et al., 2001)
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From page 69... ...
It is possible that if the childhood obesity epidemic continues at its current rate, conditions related to type 2 diabetes—such as blindness, amputation, coronary artery disease, stroke, and kidney failure—will become ordinary in middle-aged people. Additionally, risk factors for cancer in obese adults, such as hormone alterations, may be present in obese children and contribute to a higher incidence of certain types of cancer later in life (Gascon et al., 2004)
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From page 70... ...
. Affective factors, such as depressive symptoms, are also the likely mediators of the observed association between adult obesity and traumatic childhood experiences (e.g., physical abuse, sexual abuse)
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. The direct health-care costs of physical inactivity, which contribute to the obesity epidemic, have been estimated to exceed $77 billion annually (Pratt et al., 2000)
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. The direct economic burden of obesity in youth aged 6 to 17 years has been estimated, based on the 1979-1999 National Hospital Discharge Survey (Wang and Dietz, 2002)
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From page 73... ...
; predictions indicate that diet and physical inactivity will ultimately overtake tobacco as the leading cause of death in the future. Obesity-associated annual hospital costs for children and youth were estimated to have more than tripled over a two-decade period, rising from $35 million (1979-1981)
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From page 74... ...
Body mass index, deptessive symptoms, and ovetweight concetns in elementaty school child en. Arch Pedietv Adolesc Med 154(9)
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2002. Ptedicting ovetweight and obesity in adolthood f om body mass index valoes in childhood and adolescence.
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1999. The sptead of the obesity epidemic in the United States, 1991-1998.
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2001. The assouanon between childhood deptession and adulthood body mass index.
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J Am Med Assoc 281(11)
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