Prevalence Of Excess Body Weight Research Articles

Abstract 15214: Commuting by Public Transportation is Associated With Lower Prevalence of Excess Body Weight, Hypertension, and Diabetes

Background: Physical activity reduces body weight and incidence of diabetes mellitus (DM). We examined associations of commuting mode with prevalence of excess body weight, hypertension and DM. Methods: We studied 16,397 subjects who had the annual health checkup offered to adult citizens of Moriguchi city, Osaka, Japan in 2012. The subjects were asked about their work (Is your work physically active, sedentary or "cannot say"?) and commuting mode (walking or cycling / bus or train / car driving). Odds ratios (OR) of prevalence of excess body weight (body mass index >25.0 kg/m 2 ), hypertension, and DM with 95% confidence intervals (CI) relative to the car driving group were calculated using logistic regression analyses adjusted for clinical variables. Results: There were 5,908 eligible workers. Characteristics of the subjects according to commuting mode are presented in the table. Compared to the car driving group, logistic regression analyses showed that the public transportation group had a significantly lower prevalence of excess body weight (OR=0.56, 95% CI=0.45 to 0.69, p<0.0001) after adjustment for basic covariates (age, sex, smoking status, hypercholesterolemia, and physical activity of work) and hypertension, a significantly lower prevalence of hypertension (OR=0.73, 95% CI=0.59 to 0.90, p=0.0035) after adjustment for basic covariates and excess body weight, and a significantly lower prevalence of DM (OR=0.66, 95% CI=0.44 to 0.99, p=0.0427) after adjustment for basic covariates, hypertension, excess body weight, and family history of DM. Conclusions: The use of public transportation was associated with lower prevalence of excess body weight, hypertension, and DM.

To be or not to be physically active: Insights for a real chance to have an appropriate body mass in a sample of teachers.

Studies on the relationship between physical activity (PA) and being overweight/obese are inconclusive. The purpose of this study was to examine the prevalence of excess body weight (EBW) and its association with daily PA level in a sample of 1506 Brazilian teachers. The PA level was analyzed with the International Physical Activity Questionnaire and EBW was categorized as a body mass index (BMI) ≥25 kg/m2 and called 'overweight'. Chi-squared test and odds ratios (OR) were applied in the analysis. The prevalence of persons who were overweight was lower as a function of higher PA levels and higher PA levels resulted in a lower prevalence of overweight for men and women, respectively. The authors found that for men, moderate (OR: 1.69; P = 0.03) and high (OR: 2.57; P = 0.002) PA levels were predictive for being in the normal body mass index (BMI) range. In women, a greater association of being in the normal BMI range was reported only for a moderate PA level (OR: 1.43; P = 0.004). Higher daily PA levels are associated with being in the normal BMI range. To date, these findings will have important public health implications for an effective plan for the prevention of weight gain in Brazilian teachers.

Excess body weight in children may increase the length of hospital stay

OBJECTIVES:To investigate the prevalence of excess body weight in the pediatric ward of University Hospital and to test both the association between initial nutritional diagnosis and the length of stay and the in-hospital variation in nutritional status.METHODS:Retrospective cohort study based on information entered in clinical records from University Hospital. The data were collected from a convenience sample of 91 cases among children aged one to 10 years admitted to the hospital in 2009. The data that characterize the sample are presented in a descriptive manner. Additionally, we performed a multivariate linear regression analysis adjusted for age and gender.RESULTS:Nutritional classification at baseline showed that 87.8% of the children had a normal weight and that 8.9% had excess weight. The linear regression models showed that the average weight loss z-score of the children with excess weight compared with the group with normal weight was −0.48 (p = 0.018) and that their length of stay was 2.37 days longer on average compared with that of the normal-weight group (p = 0.047).CONCLUSIONS:The length of stay and loss of weight at the hospital may be greater among children with excess weight than among children with normal weight.

Socio-demographic and dietary factors associated with excess body weight and abdominal obesity among resettled Bhutanese refugee women in Northeast Ohio, United States.

Studies of obesity and related health conditions among the Bhutanese, one of the largest refugee groups resettled in the United States in the past five years, are limited. This study examined the factors associated with excess body weight (body mass index ≥ 23 kg/m2) and abdominal obesity (waist circumference > 80 cm) in a community-based sample of 18–65 year old Bhutanese refugee women in Northeast Ohio. A Nepali-language questionnaire was used to measure socio-demographic and dietary factors. Height, weight, and waist circumference were measured to define excess body weight and abdominal obesity. The mean (±standard deviation) age of the 108 participants was 36.5 (±12.2) years and length of time in the U.S. was 19.4 (±11.9) months. Overall, 64.8% and 69.4% of the women had excess body weight and abdominal obesity, respectively. Age was significantly associated with both excess body weight (odds ratio: 1.10; 95% confidence interval: 1.05–1.16) and abdominal obesity (1.09; 1.04–1.14). Consuming meat (4.01; 1.14–14.60) was significantly associated with excess body weight but not abdominal obesity. These findings suggest the need for lifestyle and dietary change education programs among this new and vulnerable group to reduce the prevalence of excess body weight and abdominal obesity and their health consequences.

Obesity and Cancer: A Gut Microbial Connection

Multiple epidemiological studies have revealed that excess bodyweight, such as in people who are overweight or obese (defined by a body mass index higher than 25 kg/m(2)), is a major risk factor for not only diabetes and cardiovascular diseases but also cancer. Effective strategies for obesity prevention are therefore needed for cancer prevention. However, because the prevalence of excess bodyweight in most developed countries has been increasing markedly over the past several decades, with no signs of abating, alternative approaches are also required to conquer obesity-associated cancer. Therefore, we sought to understand the molecular mechanisms underlying obesity-associated cancer. Although several phenomena have been proposed to explain how obesity increases cancer risk, the exact molecular mechanisms that integrate these phenomena have remained largely obscure. Recently, we have traced the association between obesity and increased cancer risk to gut microbiota communities that produce a DNA-damaging bile acid. The analyses also revealed the role of cellular senescence in cancer, which we have been studying for the past few decades. In this review, we provide an overview of our work and discuss the next steps, focusing on the potential clinical implications of these findings.

Slowing down of adult body mass index trend increases in England: a latent class analysis of cross-sectional surveys (1992–2010)

The prevalence of excess body weight, commonly measured as body mass index (BMI)≥25 kg m(-2), has increased substantially in many populations worldwide over the past three decades, but the rate of increase has slowed down in some western populations. We address the hypothesis that the slowing down of BMI trend increases in England reflects a majority sub-population resistant to further BMI elevation. Pseudo-panel data derived from annual cross-sectional surveys, the Health Surveys for England (1992-2010). Trends in median BMI values were explored using regression models with splines, and gender-specific mixture model (latent class analysis) were fit to take an account of increasing BMI distribution variance with time and identify hidden subgroups within the population. BMI was available for 164 155 adults (men: 76 382; women: 87 773). Until 2001, the age-adjusted yearly increases in median BMI were 0.140 and 0.139 kg m(-2) for men and women, respectively, decreasing thereafter to 0.073 and 0.055 kg m(-2) (differences between time periods, both P-values<0.0001). The mixture model identified two components--a normal BMI and a high BMI sub-population--the proportions for the latter were 23.5% in men and 33.7% in women. The remaining normal BMI populations were 'resistant' with minimal increases in mean BMI values over time. By age, mean BMI values in the normal BMI sub-population increased greatest between 20 and 34 years for men; for women, the increases were similar throughout age groups (slope differences, P<0.0001). In England, recent slowing down of adult BMI trend increases can be explained by two sub-populations--a high BMI sub-population getting 'fatter' and a majority 'resistant' normal BMI sub-population. These findings support a targeted, rather than a population-wide, policy to tackle the determinants of obesity.

When Should Pediatricians Become Concerned About Childhood Obesity?

Objective: To analyze the chronological evolution of excess body weight (overweight and obesity) in order to raise public awareness within the different areas of intervention (family, school, business environment, health services) with the aim to take effective actions. Material and methods: Weight, height and body mass index (BMI) of 604 healthy subjects (307 males and 297 females) have been recorded at birth and at the age of 1, 2, 3, 4, 6, 8, 10, 12 and 14 years. The excess body weight has been calculated according to national references. Results: Prevalence of excess body weight at age 14 years was significantly higher (p<0.05) in males (29%) than in females (12.8%). BMI (kg/m2) was significantly higher (p<0.05) for both sexes in every period of age, except for birth and age 1 year, in those patients with excess body weight at age 14 with respect to patients with normal nutritional status of the same age. Those groups with excess body weight at age 14 showed BMI (Z-score) reaching overweight or obesity levels at age 4, and progressively increasing. Conclusions: Excess body weight would start at early stages in life, when dietary habits of the children depend almost exclusively on family habits, and would be aggravated during school attendance. Finally, a disproportionate weight increase occurs in adolescence probably related to unhealthy dietary habits and lifestyle.

Obesity prevention in children and adolescents – Current recommendations

Abstract Introduction The epidemic of obesity in children and adolescents is one of the major problems of 21st century society. About 70–80% of young people diagnosed with obesity in adolescence will become obese adults. In Poland, an excess of body weight affects every 7th teenager aged 13–15 (13.3%). The prevalence of excess body weight in 14–15 year olds has increased over the past 10 years by about 2.0% and obesity by 1.5%. Aim This work aimed at demonstrating the merits of obesity prevention and rehabilitation. Discussion The effectiveness of the prevention of obesity and being overweight among children and adolescents depends on early diagnosis, which involves screening in elementary, middle and high schools as well as the implementation of effective prevention programs and education. The planning of treatment for obese children should be guided by their family history, environment, neurological and physical examinations and the hitherto rehabilitation for the delineation of an optimal individualized rehabilitation program. In addition, laboratory tests should be taken into account for a complete assessment concerning the current condition of the child. Conclusions The prevention of obesity requires early diagnosis and rehabilitation as well as effective obesity prevention programs and education.

Health Risk Behaviors Among Five Asian American Subgroups in California: Identifying Intervention Priorities

This analysis assessed the prevalence of excess body weight, physical inactivity and alcohol and tobacco use in Asian American subgroups. Using 2005 California Health Interview Survey data, we estimated the prevalence of body mass index (BMI) categories using both standard and World Health Organization-proposed Asian-specific categories, physical inactivity, and alcohol and tobacco use for Chinese (n = 1,285), Japanese (n = 421), Korean (n = 620), Filipino (n = 659) and Vietnamese (n = 480) Americans in California. About 80% of Japanese and Filipino American men and 70% of Korean American men were "increased/high risk" by Asian-specific BMI categories. Most Asian American subgroups were more likely to walk for transportation than non-Hispanic whites, but less likely to report other physical activities. Highest smoking and binge drinking prevalences were among Korean, Vietnamese and Filipino American men and Japanese and Korean American women. These results suggest risk profiles for each Asian American subgroup to consider when setting priorities for health promotion programs.

Temporal trends in overweight and obesity of children and adolescents from nine Provinces in China from 1991–2006

To assess temporal changes in mean body mass index (BMI) and the impact of socio-economic status on the prevalence of overweight and obesity among Chinese children and adolescents in nine provinces between 1991 and 2006. Analysis of height and weight data in children and adolescents aged 7-17 years with complete information on age, gender, region, height and weight from consecutive China Health and Nutrition Surveys (CHNS). Measurements were recorded in 1991, 1993, 1997, 2000, 2004 and 2006. Household income data in 2006 were included in the analysis of the impact of socio-economic status on the prevalence of overweight and obesity in children and adolescents. BMI cut-offs recommended by IOTF were used to define childhood overweight and obesity, as well as the Chinese cut-offs. The Cochrane-Mantel-Haenszel test for trend was used to examine the temporal trends in the prevalence of childhood overweight and obesity. Generalised estimating equations analysis was performed to assess the changes in BMI during the study period after adjusting for age, sex, region and income. In Chinese children and adolescents mean BMI steadily increased from 17.4 kg/m(2) (95% CI: 17.3-17.5) in 1991 to 18.3 kg/m(2) (95% CI: 18.1-18.5) in 2006, after adjusting for age, sex, region and income level. There was a corresponding increase in the prevalence of overweight and obesity from 5.2% in 1991 to 13.2% in 2006. The greatest increase occurred among male children and adolescents in whom the prevalence of excess body weight tripled from 4.8% in 1991 to 15.4% in 2006, compared with 5.4% and 11.0% in females over the same period. In 2006, those from higher income families tended to have the highest prevalence of overweight and obesity. The prevalence of overweight and obesity among Chinese children and adolescents has increased steadily over the past 15 years with the increase being apparent in all age, sex and income groups. However, the most noticeable increase was in children from urban areas and those from higher income backgrounds.

Prevalência e fatores associados à obesidade abdominal e ao excesso de peso em adultos maranhenses

To determine the prevalence of excess body weight and abdominal obesity and assess the association with socioeconomic, demographic and behavioral factors among adults of Maranhão, Brazil. Multistage cluster sample investigated through a household survey on 1,005 adults aged 20 to 59 years (393 men and 612 women). Anthropometric measures: weight, height and waist circumference (WC) were assessed. Abdominal obesity was defined as WC > 80 for women and WC > 94 for men. Body mass index (BMI), weight in kilograms divided by the square of height in meters, > 25 kg/m² was considered excess body weight. The dependent variable was divided into four categories: normal BMI and WC, excess body weight only (EBW), abdominal obesity only (AO) and abdominal obesity with excess body weight (AOEBW). Multinomial logistic regression was used for statistical analysis and estimates took the complex sampling design into account. Among men the prevalence of AO was 1.3%, EBW 20.3% and AOEBW 27.5%. Among women 15.5% presented AO, 1.3% EBW and 42.0% AOEBW. There was a significant statistical difference among sexes (p value < 0.001). In the multivariable analysis, among men, schooling > 9 years and living with a partner were factors associated with higher prevalence of EBW. Age > 35 years, family income > two minimum wages and living with a partner were associated with higher prevalence of AOEBW. Among women, age > 35 and living with a partner were factors associated with AO. Age > 35 years, living with a partner and schooling < 9 years were associated with a higher prevalence of AOEBW. the prevalence of EBW was higher among men whereas AO prevailed among women. Factors associated with excess body weight, abdominal obesity and both excess body weight and abdominal obesity varied.

Lifestyle changes and reduction of colon cancer incidence in Europe: A scenario study of physical activity promotion and weight reduction

Background Across Europe, there are over 300,000 new cases of colorectal cancer annually. Major risk factors include excess body weight (usually expressed by a high body mass index, BMI) and physical inactivity (PA). In this study we modelled the potential long-term effects on colon cancer incidence of changes in prevalence of excess body weight and physical inactivity in seven European countries across Europe with adequate data. Methods We addressed the impact of interventions aimed at preventing weight gain and increasing physical activity on colon cancer incidence using the Prevent model as refined in the FP-6 Eurocadet project. Relative risk (RR) estimates were derived from meta-analyses; sex- and country-specific prevalences of BMI and PA were determined from survey data. Models were made for Czech Republic, Denmark, France, Latvia, the Netherlands, Spain and the United Kingdom. Results In a hypothetical scenario in which a whole population had obtained an ideal weight distribution in the year 2009, up to 11 new cases per 100,000 person-years would be avoided by 2040. The population attributable fractions (PAF) for excess weight were much higher for males (between 13.5% and 18.2%) than for females (2.3–4.6%). In contrast, using the optimum scenario where everybody in Europe would adhere to the recommended guideline of at least 30 min of moderate PA 5 d per week, the PAFs for PA in various countries were substantially greater in women (4.4–21.2%) than in men (3.2–11.6%). Sensitivity analyses were performed assuming underreporting of BMI by using self-reports (difference of 5 and 0.8 percent-points in males and females, respectively), using different risk estimates (between 5.8 and 11.5 percent-points difference for BMI for men and women, respectively, and up to 11.6 percent-points difference for PA for women). Interpretation Changes in lifestyle can indeed result in large health benefits, including for colon cancer. Two interesting patterns emerged: for colon cancer, achieving optimum BMI levels in the population appears to offer the greatest health benefits in population attributable fractions in males, while increased physical activity might offer the greatest fraction of avoidable cancers in females. These observations suggest a sex-specific strategy to colon cancer prevention.

Estado nutricional e associação do excesso de peso com gênero e idade de crianças e adolescentes.

The aim of this study was to assess the nutritional status and the association of excess body weight (EBW) with gender and age among children and adolescents from the town of Vilhena, Rondonia, Brazil. A total of 5,883 students, including children (6 to 11 years) and adolescents (12 to 17 years), from public schools participated in the study. Body weight and height were measured and the body mass index was calculated for subsequent classification of nutritional status. The t-test was used for comparison between genders and the chi-square test and Poisson regression were used to evaluate the association between EBW, gender, and age. Data were analyzed with the SPSS 11.0 program at a level of significance of p &lt; 0.05. The prevalence of EBW was 19.3% among children and 17.4% among adolescents. EBW was significantly associated with gender and age among children. In addition, the prevalence of EBW was higher among girls (PR = 1.81, 95% CI 1.49 to 2.21) than among boys. Adolescent girls also presented a higher prevalence ofEBW than boys (PR = 1.81, 95% CI 1.49 to 2.21). The prevalence of EBW increased linearly in children (6 to 11 years) and decreased in adolescents (15 to 17 years). These results suggest that the prevalence of overweight is high among children and adolescents from northern Brazil.

Estado nutricional e associação do excesso de peso com gênero e idade de crianças e adolescentes

The aim of this study was to assess the nutritional status and the association of excess body weight (EBW) with gender and age among children and adolescents from the town of Vilhena, Rondonia, Brazil. A total of 5,883 students, including children (6 to 11 years) and adolescents (12 to 17 years), from public schools participated in the study. Body weight and height were measured and the body mass index was calculated for subsequent classification of nutritional status. The t-test was used for comparison between genders and the chi-square test and Poisson regression were used to evaluate the association between EBW, gender, and age. Data were analyzed with the SPSS 11.0 program at a level of significance of p < 0.05. The prevalence of EBW was 19.3% among children and 17.4% among adolescents. EBW was significantly associated with gender and age among children. In addition, the prevalence of EBW was higher among girls (PR = 1.81, 95% CI 1.49 to 2.21) than among boys. Adolescent girls also presented a higher prevalence of EBW than boys (PR = 1.81, 95% CI 1.49 to 2.21). The prevalence of EBW increased linearly in children (6 to 11 years) and decreased in adolescents (15 to 17 years). These results suggest that the prevalence of overweight is high among children and adolescents from northern Brazil.

Prevalência de sobrepeso e obesidade em homens adultos segundo dois critérios de diagnóstico antropométrico

To determine and compare overweight and obesity by two anthropometric criteria, BMI and %Fat, of adults aged 20 to 40 years old. Data were collected from 400 subjects enrolled on distinct exercise training programs in Curitiba, Parana. Subjects were organized in 4 age groups from age 20 to 40 years old. BMI and %Fat overweight and obesity criteria were those of WHO (2000) and Lohman (1992), respectively. For such, weight, stature and fours skin folds (triceps, subescapula, iliac crest and medial calf) data were collected. The excess of body weight prevalence was significantly higher (p<0.05) for %Fat (66.2%) than for BMI (45.6%) of which 53.2% were overweight and 13% obese. For BMI, the prevalence of overweight and obesity were, respectively, 36.3% and 9.3%. Accordingly to the %Fat diagnostic, a subject between ages 35-39 years old has a 300% and 45% chance of being classified as obese and overweight, respectively, than a subject aged from 20-24 years old. Likewise, for BMI, a subject has a 46% chance of being classified as overweight at the age 30-34 years old than a subject between ages 20-24 years old. This study found a prevalence of excess body weight for one out of three at the moment of enrollment. The risk of obesity, as excess of body weight, can better be identified by %F than BMI.

Prevalência de sobrepeso e obesidade em homens adultos segundo dois critérios de diagnóstico antropométrico

To determine and compare overweight and obesity by two anthropometric criteria, BMI and %Fat, of adults aged 20 to 40 years old. Data were collected from 400 subjects enrolled on distinct exercise training programs in Curitiba, Parana. Subjects were organized in 4 age groups from age 20 to 40 years old. BMI and %Fat overweight and obesity criteria were those of WHO (2000) and Lohman (1992), respectively. For such, weight, stature and fours skin folds (triceps, subescapula, iliac crest and medial calf) data were collected. The excess of body weight prevalence was significantly higher (p<0.05) for %Fat (66.2%) than for BMI (45.6%) of which 53.2% were overweight and 13% obese. For BMI, the prevalence of overweight and obesity were, respectively, 36.3% and 9.3%. Accordingly to the %Fat diagnostic, a subject between ages 35-39 years old has a 300% and 45% chance of being classified as obese and overweight, respectively, than a subject aged from 20-24 years old. Likewise, for BMI, a subject has a 46% chance of being classified as overweight at the age 30-34 years old than a subject between ages 20-24 years old. This study found a prevalence of excess body weight for one out of three at the moment of enrollment. The risk of obesity, as excess of body weight, can better be identified by %F than BMI.

The US Obesity “Epidemic”: Metaphor, Method, or Madness?

In 2000, US Secretary of Health and Human Services Secretary Tommy Thompson mobilized the US public health infrastructure to deal with escalating trends of excess body weight. A cornerstone of this effort was a report entitled The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. The report stimulated a great deal of public discussion by utilizing the distinctive public health terminology of an epidemic to describe the growing prevalence of obesity in the US population. We suggest that the ensuing controversy was fueled in part by the report’s ambiguous usage of the evocative term “epidemic.” In some passages, the report seems to use “epidemic” in a literal sense, suggesting that rising prevalence of excess body weight should be defined technically as a disease outbreak. Other passages of the report present the same key term metaphorically, leaving readers with the impression that the epidemic language is invoked primarily for rhetorical effect. Here, we explore dynamics and implications of both interpretations. This analysis sheds light on the ongoing public argument about the appropriate societal response to steadily increasing body sizes in the US population; likewise, it capitalizes on the accumulated knowledge that the field of public health has garnered from combating diverse historic epidemics. Our interdisciplinary approach deploys critical tools from the fields of rhetoric, sociology and epidemiology. In particular, we draw from metaphor theory and public address scholarship to elucidate how the Call to Action frames public deliberation on obesity. We turn to the applied public health literature to develop a reading of the report that suggests a novel approach to the problem—application of the Epidemic Investigation protocol to streamline the public health response and reframe the public argument about obesity.

Association between Excess Bodyweight and Intake of Red Meat and Vegetables among Urban and Rural Adult Chinese in Nanjing, China

The objective of this study was to examine the association of red meat and vegetable consumption with excess bodyweight. This is a cross sectional study, conducted between October 2000 and March 2001. Participants included 23,316 local residents aged 35 and above from 45 administrative villages randomly selected from urban and rural areas of Nanjing, China, with a population of 5.6 million. The response rate was 90.1%. Logistic regression model was used for the analysis. The prevalence of excess body weight, overweight and obesity was 34.1%, 28.2% and 6.0%, respectively. After adjustment for age, educational attainment, family average income, occupational and leisure-time physical activity, smoking, drinking, consumption of white meat, consumption of rice and cooking oil as well as fruits, participants in the moderate or higher level of red meat consumption were more likely to have excess body weight (OR: 1.13 (95% CI =1.02, 1.26) and 1.15 (1.02, 12.9) for males; 1.11 (0.98, 1.25) and 1.25 (1.10, 1.42) for females respectively), compared with those in the lower level of red meat consumption. There was no statistically significant association for consumption of vegetables. Consumption of more red meat was suggested to be a factor contributing to body weight gain in China. For residents who want to have healthy body weight, it is important to consume less red meat in the process of socioeconomic transition.

Evidence of a possible link between obesogenic food advertising and child overweight

A recent review of the literature concluded that advertising of foods on television may influence children's food choices and encourage unhealthy diets, but the review acknowledged there was a lack of clear evidence in coming to this conclusion. The present paper examines ecological evidence for a link between advertising to children and the risk of overweight using data from surveys of advertising on children's television and estimates of the prevalence of overweight among children, in the USA, Australia and eight European countries. A significant association was found between the proportion of children overweight and the numbers of advertisements per hour on children's television, especially those advertisements that encourage the consumption of energy-dense, micronutrient-poor foods (r = 0.81, P < 0.005). A weaker, negative association was found between the proportion of children overweight and the number of advertisements encouraging healthier diets (r = -0.56, P < 0.10). The quantity of advertising on children's television appears to be related to the prevalence of excess body weight among children. Furthermore, the content of the advertising appears to have a specific effect. The findings justify the need for taking precautionary measures to reduce children's exposure to obesogenic marketing practices.

Primary prevention of type 2 diabetes in people of South Asian origin: potential roles of schools

Children, like adults of South Asian origin are at increased risk of developing type 2 diabetes and other conditions associated with insulin resistance. The rising prevalence of excess body weight in children is of special concern as a promoter of insulin resistance. This article considers the evidence and need to develop and implement healthy lifestyle interventions in schools.