Obesity in Children

Childhood obesity is a serious problem in the United States because of its association with detrimental social and physical outcomes and its rising prevalence in recent years. Although several proposed methods for determining childhood obesity exist, the most widely used is to define childhood obesity as equal to or above the 95th percentile on the body mass index (BMI). Epidemiological studies employing the BMI method suggest that approximately 11% to 15% of children in the United States are obese. Estimates suggest that the prevalence of childhood obesity has risen by 4% over the previous decade (Centers for Disease Control and Prevention, 2004). Although obesity rates have increased for both sexes and all racial–ethnic groups studied, it appears that rates of obesity may be higher among minority groups, including African Americans and Mexican Americans, when compared to whites.

Childhood obesity has multiple possible causes, which can be best understood by considering the combined effect of societal, genetic, and behavioral factors. Two important trends in society may increase the risk for childhood obesity. The first issue deals with consumption. The Food Guide Pyramid, created by the U.S. Department of Agriculture (USDA) and supported by the Department of Health and Human Services (HHS), outlines the recommended intakes for five food groups, with foods listed from bottom to top in order of portion size. According to the pyramid, carbohydrates from grains should be eaten in the greatest quantity, followed by fruits and vegetables, protein and dairy, and fats. Only 1% of children are meeting the nutritional intake recommendations from the Food Guide Pyramid, suggesting deficits in proper nutrition. This may be related to the availability and ingestion of convenient, inexpensive, flavorful, and high-fat foods.

The second societal trend is that children lead a more sedentary lifestyle, partly because of monetary cutbacks in America's physical education programs. Research supports the idea that childhood obesity is related to increased time engaged in sedentary activities such as television watching, video game playing, and working on computers. The research demonstrates that child obesity is linked to video games and the level of body fat is related to television watching. In addition, research indicates that the more time a child spends engaging in such sedentary activities the greater the likelihood that the child will be obese; and that the relation between lack of physical exercise and being overweight begins early, during the preschool years. Within this environment, certain children may be at particular risk for obesity. Genetic variables play a role in childhood obesity as these variables may influence metabolism, muscle characteristics, and taste preferences. For example, infants are born with a preference for salty and sweet tastes, and excess consumption of these preferred foods would likely lead to obesity (Birch & Fisher, 1998). Further, parental feeding behaviors affect children's eating habits. Once parents put their children on a solid food diet, they have the ability to create food preferences in their children. For example, children whose diet is greatly restricted are more likely to eat large portions of those forbidden foods when given the freedom of choice, [Page 356]creating a possible future pattern of overeating (Birch & Fisher, 1998).

...