Childhood Obesity: Developing Strategies and Some Needed Research
The incidence of childhood obesity is so prevalent that, without any doubt, it can be called a true epidemic. The number of children who are overweight has more than doubled in the last two decades, with one child in every five identified as being overweight. (Torgan, C., 2002) Clearly, it will take a national effort at the level of the anti- smoking campaign if success is to be achieved.
While the problem is simply one of a long- term positive energy balance, there is a paucity of evidence- based research with regard to effective long- term intervention and prevention. (Journal of Pediatrics, 2002) Successful weight loss is easily achieved in the short run, but long- term success is rare.
Among the areas that need further study are the respective roles of both behavioral and environmental variables that contribute to obesity. The issue is complicated when such factors as ethnicity, gender, and socioeconomic status are introduced. An example of these types of data are that Mexican and African-American descent are more affected than other ethnic groups. (National Center for Health Statistics, 2002) There is some evidence that obesity is linked to familial patterns with both parents being classified as obese being much more predictive than if only one member is identified as such. (Maffeis, C., 1999) The implication is, of course, that the entire family should be involved in both the prevention and treatment of childhood obesity.
That there has been an increase in sedentary behavior and a reduction in required physical education classes is well documented. Approximately 20% of 14- to 16- year old girls have reported that they engage in one or less episodes of physical activity per week. (Goran, M. 2001) These same data demonstrated that both males and females who watched the most television also had the highest skinfold thicknesses and Body Mass Indexes. Children in this same age range reported their time spent watching television averaged 4 hours per day! It is not surprising that there is a major problem when these data are coupled with time spent on a computer and poor eating habits.
These documented trends may well continue as many public school systems continue to encounter budget cuts that lead to reductions in the number of physical education classes that are offered. It seems evident that some drastic measures must be taken to reverse these trends. Indeed, a major effort needs to occur in order to increase the number of physical education and health classes offered in the public schools.
From a research point-of-view, more effective approaches in helping youth adopt healthy behaviors needs to be examined. Data is needed to help establish the best practices and positive outcomes of a “Model” program.
Restraints in combating childhood obesity are not limited to the schools and local governments. Clinical intervention has also encountered obstacles that interfere with dealing effectively with obesity. (Journal of Pediatrics, 1999) These include the time available for counseling families, lack of effective treatment protocols, reimbursement, and the commitment of primary care providers to care for affected patients. All of these barriers need to be examined to determine how they can be overcome. Efforts to prevent and treat childhood obesity can no longer be ignored in the clinical setting.
Perhaps continued research activity will lead to a “Risk Factor Profile” for obesity similar to what has been developed for heart disease. Factors such as weight at certain chronological ages, Body Mass Index scores, ethnicity, socioeconomic status, and familial patterns are becoming evident.
While obesity remains a personal issue, at the same time schools, families, communities, corporations, and government all bear at least some responsibility for promoting healthier lifestyles. Clearly, there is much work to be done if the tide of childhood obesity is to be stemmed.
The United States Sports Academy has dedicated itself to joining in the battle against childhood obesity. Future articles are forthcoming that will hopefully contribute to our understanding of childhood obesity and how to develop effective strategies for its prevention. Prevention is of the utmost importance.
Goran, M. “Metabolic Precursors and Effects of Obesity in Children: A Decade of Progress.” AMERICAN JOURNAL OF CLINICAL NUTRITION, Vol. 73, No. 2: 2001, 158- 171.
JOURNAL OF PEDIATRICS (Editor’s Note), Vol 134, No 5: 2002, 535-537.
JOURNAL OF PEDIATRICS. “Barriers to the Treatment of Childhood Obesity: A Call to Action.” Vol 134, No 5, 1999.
Maffeis, C. “Childhood Obesity: The Genetic- Environmental Interface.” LIBRARY OF MEDICAL RESEARCH, CLINICAL ENDOCRINOLOGY AND METABOLISM. Vol 13: 1999, 31-46.
National Center for Health Statistics. Health, United States, 2002 with Chartbook on Trends in the Health of Americans, Table 71, Hyattsville, MD, 2002.
“Pediatric Obesity in the Clinical Setting: Epidemiology of Childhood Obesity.” http://www.priory.com/childobesity.htm
Torgan, C. “Childhood Obesity on the Rise.” March, 2003. http://www.nih.gov/news/wordonhealth/jun22/childhoodobesity.htm
That childhood obesity is now so prevalent that it is being considered an epidimic. According to the National Institutes of Health, the number of children that are overweight has doubled in the last three decades. There is an increase in the prevalence of type II diabetes amongst younger ages and overweight children are more than twice as likely to have higher levels of cholesterol than their slimmer counterparts.
(“What You Need to Know About: Childhood Obesity.” About E-News Letter, http://www.about.com, October 1, 2004.)