CHILDHOOD & ADOLESCENT OBESITY

The prevalence of overweight and obese children and adolescents in the United States has increased dramatically over the past twenty years. Recent data estimates that 17% of children in the U.S. are overweight and that an additional 16% are obese. Children who are overweight are at an increased risk for a number of adverse health consequences and health problems which may begin in childhood and persist throughout their lives. For example, we are seeing an alarming number of type II Diabetes Mellitus (caused by poor eating habits, obesity, and lack of exercise) in children, whereas in the past this was a disease of adult onset. Research has shown that overweight children are likely to remain overweight as adults.

In addition to measuring height and weight on all children and adolescents annually with a physical exam, the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend that Body Mass Index (BMI) should also be calculated for all children and adolescents once each year. BMI is the most widely recommended screening tool for classifying weight status (underweight, healthy weight range, overweight, obese, or morbidly obese) in both children and adults; it is a composite measure of height and weight. BMI varies by age and sex, therefore it is necessary to use sex-specific BMI-for-age percentiles when screening children and adolescents (BMI for adults is based on sex alone, without regards to age).

Any child or adolescent who is not in the healthy weight range should undergo further assessment and evaluation to identify any underlying medical causes and to develop weight management plans.

Parents and caregivers can promote healthy eating habits by:

1. Offering nutritious snacks such as fruits and vegetables, low-fat dairy products (cheeses, yogurt), whole grains, or nuts.
2. Encouraging children to learn about healthy food choices and to become autonomous in selecting foods and snacks.
3. Setting appropriate limits on children's choices.
4. Serving healthy, balanced meals and snacks for the family.
5. Setting a good example by eating a healthy diet themselves.

Promoting healthy lifestyle habits:

1. Encourage physical activity, including participation in organized exercise or sports, unstructured play and activity at home, household chores, and community events.
2. Exercise along with children; set a good example.
3. Limit TV, computer, and video-game time to a recommended 1-2 hours per day.
4. Be sure that children and adolescents are seen by their healthcare provider at least once each year for a complete physical exam.

Parents, caregivers, teachers, coaches, and others who are influential in children's lives should discuss health habits with children routinely and should become involved in movements to encourage politicians and policy makers from governmental organizations, schools, and youth organizations to include proper diet and regular physical activity in their programs.

Use the BMI calculator online to get an idea of where your children are in the BMI percentiles. If your children fall outside of the healthy ranges, consider an evaluation with their healthcare provider.