Optimum BMI and Healthy Weight

The concept of optimum BMI can be applied to populations. For countries such as the United States, where undernutrition is not as common as in developing countries,3 a BMI-distribution median of around 21 kg m2 may be optimal (WHO, 2000). Population weight goals for obesity prevention in adults can also be stated in terms of decreasing the proportion that exceed the threshold of 30 kg m2, although this goal includes both preventing new cases of obesity and reducing weight among those already...

Public Health Lessons Learned

The purpose of this paper is not to suggest specific intervention strategies to prevent childhood obesity, but rather to learn from other public health experiences and to glean lessons that might help inform efforts to prevent childhood obesity. There is certainly no shortage of theories, models, and approaches to help guide public health program planning. There are multiple health behavior theories that are commonly used to guide public health efforts (Glanz et al., 2002), and popular planning...

References

AACAP (American Academy of Child and Adolescent Psychiatry). 2001. Children and Watching TV. Facts for Families, No. 54. Online . Available accessed June 7, 2004 . AAP (American Academy of Pediatrics). 2001. Children, adolescents, and television. Pediatrics 107(2) 423-426. AAP. 2003. Prevention of pediatric overweight and obesity. Pediatrics 112(2) 424-430. AAP. 2004. Pediatric Nutrition Handbook. 5th ed. Washington, DC AAP. Abramovitz BA, Birch LL. 2000. Five-year-old girls' ideas about...

Social and Emotional Health

While childhood obesity may not result in recognized clinical symptoms until later in life, the social and emotional correlates often have immediate effects on children's lives. Research on the short- and long-term impacts of obesity on children's emotional and social functioning has been extensively reviewed (French et al., 1995 Dietz, 1998b Must and Strauss, 1999 Puhl and Brownell, 2001 Styne, 2001 Must and Anderson, 2003 Schwartz and Puhl, 2003), and the collective body of research clearly...

Industry

American children and youth represent dynamic and lucrative markets. For example, food and beverage sales to young consumers exceeded 27 billion in 2002 (U.S. Market for Kids' Foods and Beverages, 2003). Simi larly, young people are major consumers of the products and services of the entertainment, leisure, and recreation industries. Providing young consumers and their families with the knowledge and skills to make informed and prudent choices in these marketplaces could be a key obesity...

Introduction

As a nation, we are experiencing an epidemic of obesity that is unprecedented in its magnitude or rapidity. Overweight and obesity not only plague the majority of adults, but children are becoming increasingly overweight, with corresponding decrements in health status and quality of life. While the problem clearly exists, the causes are less clear. There is little clarity about the relative importance of possible causative factors such as changes in dietary patterns, increases in fast food and...

Genetic Variation and Biological Considerations

Obesity has long been recognized to occur in families, and having overweight or obese parents increases a child's risk of being obese. After age 3, parental obesity is a stronger predictor of a child's future obesity as an adult than is the child's current weight (Whitaker et al., 1997). Nonetheless, the familial clustering of obese individuals does not alone predict an individual's weight characteristics, which reflect the combined effects of genetic variations, the common or shared...

Health Care Costs

A RAND study has calculated that the costs imposed on society by people with sedentary lifestyles (i.e., the external costs generated) may be greater than those imposed by smokers (Keeler et al., 1989). More recent computations of national health-care expenditures related to obesity and overweight in adults showed large lifetime external costs related to these conditions. After adjusting for inflation and converting estimates to 2004 dollars, the national direct and indirect health-care costs...

Implications For Children And Society At Large

Many of us consider our weight and height as personal statistics, primarily our own, and occasionally our physician's concern. Our weight is something we approximate on forms and applications requiring this information. Body size has been a cosmetic issue rather than a health issue throughout most of human history, but scientific study has changed this view. One's aesthetic preference for a lean versus a plump body type may be related to personal taste, cultural and social norms, and...

Public Health Precedents

Public health problems of comparably broad scope and complexity have been successfully addressed in the past (Economos et al., 2001), and this experience gives us not only the confidence that childhood obesity too can be moderated, even prevented, but supplies us with some of the needed tools. This solid public health history of achievements is exemplified in Box 1-1 (CDC, 1999 Appendix D). Many of these problems were not apparent at first, and grew to become an accepted part of life before...

Community Stakeholders and Coalitions

Community-Based Interventions Framework and Evidence Base Ecological frameworks, which have been applied across a variety of settings and public health issues to change people or change the environment (Glanz, 1997), suggest that it is important to involve individuals, organizations, communities, and health policy makers in producing desired effects on health (Baker and Brownson, 1998). Given the interactive nature of virtually all elements of a community, most effective interventions act at...

Shifts in the Population BMI Distribution

Researchers can monitor changes in the nature of the obesity epidemic by comparing the BMI distribution curves derived from population-based surveys and noting shifts in any particular distribution over time. A shift toward higher BMIs over the entire distribution would indicate that virtually everyone is becoming heavier, with lean individuals gradually moving into the overweight range, overweight individuals moving into the obese range, and the number of obese individuals becoming more...

Healthy Home Environment

Parents (defined broadly to include primary caregivers) have a profound influence on their children by fostering certain values and attitudes, by rewarding or reinforcing specific behaviors, and by serving as role models. A child's health and well-being are thus enhanced by a home environment with engaged and skillful parenting that models, values, and encourages healthful eating habits and a physically active lifestyle. Economic and time constraints, as well as the stresses and challenges of...

An Organizing Framework For Public Health Interventions

To learn from the lessons of other public health experiences and determine whether there is any utility or relevance for preventing childhood obesity, it is useful to have a conceptual framework to organize the experiences, principles, and strategies. In the 2000 Surgeon General's Report, Reducing Tobacco Use, a framework was developed to categorize the different types of tobacco control interventions DHHS, 2000 . This framework reviewed the evidence within the following categories educational,...

Health Care Insurers Health Plans and Quality Improvement and Accrediting Organizations

Until recently, health-care concerns had largely focused on the treatment as opposed to the prevention of obesity, particularly the severe forms of adult obesity. But epidemiologic data showing increases in the numbers of obese children and youth, along with a rise in the prevalence of type 2 diabetes formerly termed adult onset diabetes and increased hypertension in children Muntner et al., 2004 , have raised awareness that childhood obesity might be best addressed from a prevention...

BOX 62 Kids Off the Couch

Kids Off the Couch is a community collaborative pilot project in Modesto, California, that works with parents and caregivers to prevent obesity in children up to 5 years of age. The project's goal is to influence behavioral changes in food selection and physical activity among parents and primary caregivers. The program provides parents and caregivers with Information on the risks of childhood obesity Tools to assist their children in achieving normal growth and healthy development Hands-on...