Childhood obesity: Is it time for action?

Abstract

The prevalence of obesity in children is increasing worldwide. In 2003, the International Obesity Task Force reported that worldwide 1 out of 10 children, aged 5–17 years, is overweight or obese [ [1] IOTF Childhood obesity – the new crisis in public health. International Obesity Task Force, London2003 Google Scholar ]. In England, between 1974 and 2002–2003, among children aged 5–10 years the prevalence of obesity increased from 1.8% to 6.0% in boys and from 1.3% to 6.6% in girls [ [2] Stamatakis E. Primatesta P. Chinn S. Rona R. Falascheti E. Overweight and obesity trends from 1974 to 2003 in English children: what is the role of socioeconomic factors?. Arch Dis Child. 2005; 90: 999-1004 Crossref PubMed Scopus (232) Google Scholar ]. The rising prevalence is observed even among 2- to 4-year-old British children in which the prevalence of obesity almost doubled (5–9%) in 10 years (1989–1998) [ [3] Bundred P. Kitchiner D. Buchan I. Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies. BMJ. 2001; 322: 326-328 Crossref PubMed Google Scholar ]. Moreover, between 1977 and 1997 in Britain in children aged 11–16 years, central obesity, measured by waist circumference, has increased at a greater rate than whole body fatness measured by body mass index, especially in girls [ [4] McCarthy H.D. Ellis S.M. Cole T.J. Central overweight and obesity in British youth aged 11–16 years: cross sectional surveys of waist circumference. Br Med J. 2003; 326: 624-626 Crossref PubMed Scopus (372) Google Scholar ]. In the United States, the 1999–2000 National Health and Nutrition Examination Survey (NHANES) indicates that perhaps 15% of children aged 6–11 years and of adolescents aged 12–19 years are overweight (defined as a body mass index greater than or equal to the age- and sex-specific 95th percentile) [ [5] Ogden C.L. Flegal K.M. Carroll M.D. Johnson C.L. Prevalence and trends in overweight among U.S. children and adolescents, 1999–2000. JAMA. 2002; 288: 1728-1732 Crossref PubMed Scopus (3255) Google Scholar ]. This represents an increase of 5 percentage points between NHANES III conducted in 1988–1994 and NHANES 1999–2000. A similar trend is reported in Australia, where between 1985 and 1995 the prevalence of obesity among children aged 7–15 years increased 4.6-fold among girls and 3.4-fold among boys [ [6] Magarey A.M. Daniels L.A. Boulton T.J. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust. 2001; 174: 561-564 PubMed Google Scholar ]. Countries undergoing rapid urbanization and economic development are experiencing double challenges: they have to fight both childhood undernutrition and a growing tide of obesity [ 7 de Onis M. Blossner M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr. 2000; 72: 1032-1039 PubMed Google Scholar , 8 Ebbeling C.B. Pawlak D.B. Ludwig D.S. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002; 360: 473-482 Abstract Full Text Full Text PDF PubMed Scopus (2187) Google Scholar , 9 Wang L. Kong L. Wu F. Bai Y. Burton R. Preventing chronic diseases in China. Lancet. 2005; 366: 1821-1824 Abstract Full Text Full Text PDF PubMed Scopus (355) Google Scholar ]. For example, in China, the prevalence of overweight and obesity among children aged 7–9 years increased from 1–2% in 1985 to 17% among girls and 25% among boys in 2000 [ [9] Wang L. Kong L. Wu F. Bai Y. Burton R. Preventing chronic diseases in China. Lancet. 2005; 366: 1821-1824 Abstract Full Text Full Text PDF PubMed Scopus (355) Google Scholar ]. In addition, obesity prevalence varies across socioeconomic strata. In developed countries, children of low socioeconomic status are more affected than their wealthy counterparts [ 2 Stamatakis E. Primatesta P. Chinn S. Rona R. Falascheti E. Overweight and obesity trends from 1974 to 2003 in English children: what is the role of socioeconomic factors?. Arch Dis Child. 2005; 90: 999-1004 Crossref PubMed Scopus (232) Google Scholar , 10 Strauss R.S. Pollack H.A. Epidemic increase in childhood overweight, 1986–1998. JAMA. 2001; 286: 2845-2848 Crossref PubMed Scopus (949) Google Scholar ]. The opposite is observed in developing countries: children in the upper socioeconomic strata are more likely than poor children to be obese [ 11 Salmon J. Timperio A. Cleland V. Venn A. Trends in children's physical activity and weight status in high and low socio-economic status areas of Melbourne, Victoria, 1985–2001. Aust N Z J Public Health. 2005; 29: 337-342 Crossref PubMed Scopus (150) Google Scholar , 12 Chhatwal J. Verma M. Riar S.K. Obesity among pre-adolescent and adolescents of a developing country [India]. Asia Pac J Clin Nutr. 2004; 13: 231-235 PubMed Google Scholar ].