Public Health Crisis, Prevention as a Cure.
Overweight and obese children have arguably become the primary health problem in developed nations and, to some
degree, in other parts of the world. The definitions of overweight and obesity in children differ between epidemiological
studies, but most scientists agree that children who are overweight exceed 20% (25% for obese) of their ideal body weight,
based on age, weight, height and frame. The body mass index (BMI) is typically used to derive and apply these percentages
to health risks. However, experts now indicate that it is not an absolute measurement and there is margin for error when
using BMI to calculate health risk depending on body-type (ectomorphic, mesomorphic or endomorphic) and bone
structure and density. The formulas for body mass index also vary, but a BMI of 25 or more is generally considered
overweight and 30 or more is considered obese.
You can calculate your BMI at http://www.preventdisease.com/healthtools/articles/bmi.html
As in adults, obesity in children causes hypertension, stroke, colon cancer, chronic inflammation, diabetes, increased blood
clotting tendency, and other cardiovascular disease risk factors. In one study, childhood obesity increased the risk of death
from heart disease in adulthood two-fold over several years.
Type 2 diabetes, once unrecognized in adolescence, now accounts for as many as half of all new diagnoses of diabetes in
some populations. This condition is almost entirely attributable to the pediatric obesity epidemic, through heredity and
lifestyle factors which affect individual risk. Psychosocial effects are also becoming more severe in children who are often
outcaste for being overweight resulting in depression and suicidal tendencies
Causes of Childhood Obesity
As in adults, a child's bodyweight is regulated by numerous physiological mechanisms that maintain balance between energy
intake and energy expenditure. Any factor that raises calorie intake or decreases energy expenditure by even a small amount
will cause obesity in the long-term. Genetic factors can also have a great effect on individual predisposition; however, rising
prevalence rates among genetically stable populations indicate that environmental and lifestyle factors such as physical
inactivity and diet must underlie the childhood obesity epidemic.
Preventing obesity in children ultimately involves eating less and being more physically active. Sounds simple? For several
decades now, governments have invested billions of dollars into programs to increase physical activity among youth and
the general public. Despite these government initiatives, and since the inception of such programs, children are more obese
today than ever before. Between television, video games, internet, fast-food, sedentary lifestyle and convenience, it is clear that
cultural factors have had incredible control and a negative impact on our health.
The limitation of current approaches to combat childhood obesity may also, in part, contribute to the problem. For example,
school-based programs might not be particularly efficacious. Most dietary interventions focus on reduction of fat intake,
even though dietary fat might not be an important cause of obesity. Very few pediatric studies have ever addressed the
effect of dietary composition on bodyweight, physical activity, and behavioural modification techniques combined. With
respect to physical activity, many studies have used conventional programmed exercise prescriptions, although increasing
lifestyle activity or reducing sedentary behaviours might be better for long-term weight control. Physical education
curriculums designed to create exercise environments that only mesh with sport or competition have isolated several
groups of children who are uncomfortable, uncoordinated or lack the athletic ability to enjoy these events. Moreover, a
plethora of school-based programs still emphasize non-locomotor and manipulative skills for physical education which are
very poor indicators in maintaining long-term health. Motor skills such as speed, strength and power which are integrated
with cardiovascular abilities have consistently shown to improve long-term health, yet an extremely large percentage of
curriculums fail to properly address or incorporate these skills.
Prevention as a Cure
Currently, more than 70% of children and youth are not active enough to lay a solid foundation for future health and
wellness. It's time for prevention to reverse this growing trend. This public-health crisis demands increased funding
for research into new dietary, physical activity, behavioural, socioeconomic and environmental approaches for the
prevention of child obesity and improved reimbursement for effective school-based programs and curriculums.
Children who grow into teenagers and then adults require more accountability for their own well-being through health
conscious decisions which are motivated by proper practical and theoretical applications. Substantial political and financial
contributions are imperative to invest in prevention more effectively to regulate revisions and mandate policies which affect
the governing bodies of education, school boards, and ultimately the schools themselves. Any procrastination or failure to
resolve these matters in the next decade will only lead to the further deterioration of human health and healthcare systems.
Proper leadership and effective communication regarding these preventive meausures may still reverse this trend and
consequently promote a healthier aging population.
Author: Marcel Bentivegna, C.S.C.S., NSCA-CPT
National Center for Health Statistics. Prevalence of overweight among children and adolescents: United States, 1999. http://www.cdc.gov/nchs/products/overwght99.htm.
Chinn S, Rona RJ. Prevalence and trends in overweight and obesity in three cross-sectional studies of British children, 1974-94. BMJ 2001; 322: 24-26. [PubMed]
Flegal KM, Troiano RP. Changes in the distribution of body mass index of adults and children in the US population. Int J Obesity 2000; 24: 807-18. [PubMed]
Bundred P, Kitchiner. Prevalence of overweight and obese children between 1989 and 1998: population based series of cross-sectional studies. BMJ 2001; 322: 1-4. [PubMed]
Strauss RS, Pollack HA. Epidemic increase in childhood overweight, 1986-1998. JAMA 2001; 286: 2845-48. [PubMed]
James WPT, Nelson M, Ralph A, Leather S. Socioeconomic determinants of health: the contribution of nutrition to inequalities in health. BMJ 1997; 314: 1545-49. [PubMed]
Gordon-Larsen P, McMurray RG, Popkin BM. Determinants of adolescent physical activity and inactivity patterns. Pediatrics 2000; 105: e83.
Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obesity 1999; 23 :(suppl) S2-11. [PubMed]
Strauss RS. Childhood obesity and self-esteem. Pediatrics 2000; 105: e15.
Erickson SJ, Robinson. Body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med 2000; 154: 931-35.
Field AE, Camargo CA, Taylor CB, et al. Overweight, weight concerns, and bulimic behaviors among girls and boys. J Am Acad Child Adolesc Psychiatry 1999; 38: 754-60. [PubMed]
Reybrouck T, Mertens. Assessment of cardiovascular exercise function in obese children and adolescents by body mass-independent parameters. Eur J Appl Physiol 1997; 75: 478-83.
Ontario Physical Health and Education Association. http://www.ophea.net/AS%20Brief%20Artice.pdf
Hill AJ, Silver EK. Fat, friendless and unhealthy: 9-year old children's perception of body shape stereotypes. Int J Obesity 1995; 19: 423-30. [PubMed]
Battle EK, Brownell KD. Confronting a rising tide of eating disorders and obesity: treatment vs prevention and policy. Addict Behav 1996; 21: 755-65. [PubMed]
Hill JO, Peters JC. Environmental contributors to the obesity epidemic. Science 1998; 280: 1371-74. [PubMed]
Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years: 1979-1999. Pediatrics 2002; 109: e81.