This paper examines the childhood obesity epidemic in the United States, drawing on public health research, federal health agency data, and Institute of Medicine recommendations. It defines obesity and overweight using CDC BMI criteria, reviews health consequences including Type II diabetes, cardiovascular disease, and psychosocial harm, and traces rising prevalence trends from the 1970s through 2000. The paper then outlines a comprehensive framework of evidence-based prevention strategies proposed by the Institute of Medicine for local governments, covering healthy food access, reduction of calorie-dense foods, increased physical activity, and public awareness campaigns. The role of collaborative research initiatives such as the National Collaborative on Childhood Obesity Research (NCCOR) is also discussed.
Child obesity is a major public health problem in the United States, involving "multiple and interrelated factors associated with childhood overweight and obesity" (Berkowitz & Borchard, 2009). The Centers for Disease Control and Prevention (CDC) describe children as being at risk for overweight if they are above the 85th percentile body mass index (BMI), and defines childhood overweight as a BMI at or above the sex- and age-specific 95th percentile BMI cut points from the 2000 CDC Growth Charts (Berkowitz & Borchard, 2009).
Health problems associated with childhood obesity include Type II diabetes, an increased risk of elevated cholesterol, asthma, joint problems, depression, and anxiety. Physical and psychosocial effects of moderate to severe overweight can include hyperlipidemia, accelerated growth followed by stunting, early onset of puberty in females, obstructive sleep apnea, pancreatitis, gallbladder disease, hypertension, polycystic ovary syndrome, and long-term damage to the cardiovascular system (Berkowitz & Borchard, 2009).
Myers and Vargas (2000) report that a 20-year epidemiologic Bogalusa Heart Study "identified that atherosclerosis, a major cause of heart disease in adults, has its origins in early childhood" (as cited in Berkowitz & Borchard, 2009). Overweight or obese students are more likely to experience decreased scholastic performance and absenteeism, increased rates of sadness, loneliness, and nervousness, as well as a greater likelihood of smoking and drinking alcohol compared to obese children whose self-esteem increased or remained unchanged (Berkowitz & Borchard, 2009). Factors that contribute to children being overweight or obese include race, ethnicity, parental knowledge and dietary habits, and environmental influences (Berkowitz & Borchard, 2009).
BF β Body Fat
BMI β Body Mass Index
Childhood obesity is defined by Dehghan, Akhtar-Danesh, and Merchant (2005) as "an excess of Body Fat (BF)."
Dehghan, Akhtar-Danesh, and Merchant (2005) document changes in the prevalence of overweight and obesity in the United States beginning in 1973 and running through 2000, as summarized below.
USA β Changes in Obesity Prevalence (Selected Studies)
1973β1994 | Ages 5β24 | Bogalusa Study: Mean level increased 0.2 kg/yr; twofold increase in prevalence of obesity.
1971β1974 | Ages 6β19 | NHANES I: Relatively stable.
1976β1980 | Ages 6β19 | NHANES II: Relatively stable.
1988β1994 | Ages 6β19 | NHANES III: Doubled to 11%.
1999β2000 | Ages 6β19 | NHANES IV: Increased by 4%.
Source: Dehghan, Akhtar-Danesh, and Merchant (2005)
While "the mechanism of obesity development is not fully understood, it is confirmed that obesity occurs when energy intake exceeds energy expenditure. There are multiple etiologies for this imbalance, and the rising prevalence of obesity cannot be addressed by a single etiology" (Dehghan, Akhtar-Danesh, & Merchant, 2005). Genetic factors also influence a child's susceptibility to obesity. However, environmental factors, lifestyle preferences, and cultural environment appear to play major roles in the rising prevalence of obesity worldwide.
In a small number of cases, childhood obesity results from genetic conditions such as leptin deficiency, or from medical causes such as hypothyroidism and growth hormone deficiency, or as a side effect of drugs such as steroids. Most of the time, however, personal lifestyle choices and cultural environment significantly influence obesity (Dehghan, Akhtar-Danesh, & Merchant, 2005).
"NCCOR launch and federal research coordination"
"Nine IOM strategies for improving children's nutrition"
"Six IOM strategies to increase children's activity"
There is presently an epidemic of overweight and obesity among children in the United States, which requires that children's needs for healthy eating and physical exercise be addressed proactively so as to bring about a reduction in the number of overweight and obese children. This initiative is critically important for the psychological, physical, and mental well-being of children.
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