Obesity Prevention During Adulthood

Abstract

and overweight and obesity have increased steadily across all ages. As discussed in Chapters 18 through 20, it is important that obesity prevention efforts begin during childhood. However, the importance of obesity prevention in children should not overshadow the need and potential for prevention of excess weight gain in adults (Seidell, Nooyens & Visscher, 2005). The need for obesity prevention in U.S. adults is clear in recent trend data from national surveys conducted over the past 20 years. Based on data from the 1999–2002 National Health and Nutrition Examination Survey (NHANES), 65% of the U.S. population aged 20 years and older is overweight or obese (defined as having a body mass index [BMI] of 25 kg/m2 or more) compared with 46% seen in NHANES I, conducted between 1971 and 1974 (A.A. Hedley et al., 2004; National Center for Health Statistics/Division of Data Services, 2005). During the same time span, the percent obese (BMI 30 kg/m2) more than doubled—from about 15% in 1971–1974 (Flegal, Carroll, Ogden, & Johnson, 2002) to more than 30% in 1999–2002 (Hedley, 2004 #5741). Although some obese adults were obese as children, currently the high prevalence of obesity in U.S. adults is largely due to major weight gains that occur during adulthood. This is of concern as weight gain during adulthood contributes substantially to increased mortality and morbidity from obesity and has been related prospectively to the development of major health problems. For example, in the Nurses Health Study, regardless of BMI at baseline, women gaining 10 kg after the age of 18 were found to have a 70–150% increased risk of developing coronary heart disease and 20–60% greater risk of death from all causes compared with those who gained 3 kg (Manson et al., 1990; Manson et al., 1995). Prevention of weight gain in adults might significantly reduce the overall rates of mortality and morbidity associated with obesity. Table 21.1 identifies several other elements of the rationale for targeting adults with obesity prevention programs, based on a review of this issue by Seidell, Nooyens, and Visscher (2005). This chapter provides a perspective on how obesity prevention can be approached from young adulthood and, in women, through the perimenopause Chapter 21