We identified original research, reviews, and commentaries by searching computer databases—eg, Medline, PsycINFO, Agricola, Lexis-Nexis—and by reviewing issues of journals that publish obesity research. We directed special attention towards publications since 1997. Research developments and published work were also identified by discussions with specialists in the areas of paediatric obesity, nutrition, and public health. We obtained information with respect to fastfood consumption from
SeminarChildhood obesity: public-health crisis, common sense cure
Section snippets
International epidemic of childhood obesity
The definitions of overweight and obesity in children differ between epidemiological studies, making comparisons of cross-sectional prevalence data difficult. Nevertheless, several studies have examined change in prevalence within populations over time, and the results of these analyses are astounding. Rates have increased 2·3-fold to 3·3-fold over about 25 years in the USA, 2·0-fold to 2·8-fold over 10 years in England, and 3·9-fold over 18 years in Egypt (figure 1).1, 2, 3, 4, 5, 6, 7 The
Complications of childhood obesity
Childhood obesity is a multisystem disease with potentially devastating consequences (figure 2).16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 Several complications warrant special attention.
As with adults, obesity in childhood causes hypertension, dyslipidaemia, chronic inflammation, increased blood clotting tendency, endothelial dysfunction, and hyperinsulinaemia.25, 26, 27, 28, 29 This clustering of cardiovascular disease risk factors,
Causes of childhood obesity
Bodyweight is regulated by numerous physiological mechanisms that maintain balance between energy intake and energy expenditure.53 These regulatory systems are extraordinarily precise under normal conditions—eg, a positive energy balance of only 500 kJ (120 kcal) per day (about one serving of sugar-sweetened soft drink) would produce a 50-kg increase in body mass over 10 years. Thus, any factor that raises energy intake or decreases energy expenditure by even a small amount will cause obesity
Prevention and treatment
Prevention and treatment of obesity ultimately involves eating less and being more physically active. Though this action sounds simple, long-term weight loss has proven exceedingly difficult to achieve. A US National Institutes of Health consensus statement indicated that adults who remain in conventional weight loss programmes can realistically expect a maximum weight loss of only 10% (a small fraction of excess adiposity). About half of this modest weight loss is regained within a year, and
The toxic environment
6 years ago, Battle and Brownell wrote, “it is hard to envision an environment more effective than ours [in the USA] for producing … obesity”.150 This statement probably applies to much of the developed world and, increasingly, to some developing countries. Several pervasive environmental factors promote energy intake and limit energy expenditure in children, undermining individual efforts to maintain a healthy bodyweight.
Conclusion
Almost three decades ago, an editorial in The Lancet called for efforts to prevent obesity in childhood.164 Since then, the worldwide prevalence of childhood obesity has risen several-fold. Obese children develop serious medical and psychosocial complications, and are at greatly increased risk of adult morbidity and mortality. The increasing prevalence and severity of obesity in children, together with its most serious complication, type 2 diabetes, raise the spectre of myocardial infarction
Search strategy
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