Childhood obesity research articles

Pmcid: pmc3278864childhood obesity: a global public health crisissameera karnik and amar kanekar1masters of public health program, american public university, east stroudsburg, pa, usa1department of health studies, east stroudsburg university of pennsylvania, east stroudsburg, pa, usacorrespondence to: ass. Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly article has been cited by other articles in ctintroduction:childhood obesity is a major public health crisis nationally and internationally. The purpose of this manuscript is to address various factors influencing childhood obesity, a variety of interventions and governmental actions addressing obesity and the challenges ahead for managing this s:in order to collect materials for this review a detailed search of cinahl, medline, eric, academic search premier databases was carried out for the time period s:some of the interventions used were family based, school based, community based, play based, and hospital based. Governments along with other health care organizations are taking effective actions like policy changing and environmentally safe interventions for children to improve physical sions:in conclusion, childhood obesity can be tackled at the population level by education, prevention and sustainable interventions related to healthy nutrition practices and physical activity ds: calorie imbalance, childhood obesity, interventions, physical activity, policy changingintroductionobesity is a major public health crisis among children and adults. Childhood-related obesity is an increasing concern with respect to the health and well-being of the child. Body mass index (bmi), a measure of weight with relation to height, is not only used as an outcome measure to determine obesity but also as a useful anthropometric index for cardiovascular risk. Childhood obesity is defined as a bmi at or above 95th percentile for children of same age and sex. 4] classifications of obesity in children depend upon the body composition of the child, as it varies with respect to age and sex of the child. 4]magnitude of the problemthe prevalence of childhood obesity is increasing in developed and underdeveloped countries. 5] the development in reducing the problem of obesity and overweight is monitored nationally by using data from national health and nutrition examination survey. 6] childhood obesity prevalence among preschool children between age group of 2-5-year-old girls and boys has increased from 5. 6] the data collected for the same period shows that the adolescent (age group 12-19 years) obesity has increased from 5. 6]figure 1graphically shows the increasing trend of obesity among children and adolescent population from 1963 to 2008. 1prevalence of obesity among us children and adolescents aged 2-19, for selected years 1963-1965 through 2007-2008[6]healthy people 2010 have ranked obesity as number one health problem showing that prevalence of childhood obesity has increased over the years. 7] increased prevalence of childhood obesity may have adverse morbidity and mortality implications in the adult life of the child. There has been increased prevalence of childhood obesity in england, especially among school children over last few decades. 9] childhood obesity is common in united kingdom and according to the health survey conducted in 2004, obesity among 2-10-year olds was 14% and among 11-15-year olds was 15%. Boolean search strategy where the key words entered for search were “factors” and “childhood obesity” “interventions” and “governmental actions” and “economic problems” in differing orders were used to extract studies for this narrative s influencing childhood obesitychildhood obesity is due to the imbalance between caloric intake of the child and the calories utilized (for growth, development, metabolism, and physical activities). Normally the amount of calories a child consumes through food or beverages, if not used for energy activities, leads to obesity. Obesity can be multifactorial in c factorsthere are certain genetic factors which may lead to obesity in children. It is seen that children and teens nowadays lack the required amount of physical activity; hence the calories are not used properly and can lead to obesity. 12]it is seen that sedentary lifestyle is an important factor for obesity, as many children spend most of their time in front of television sets, play video games, and watch computers.

Children are prone to sedentary lifestyle such as watching television, consuming more energy-dense foods or snacks with large portion sizes, and having reduced physical activity, giving rise to obesity. Health problems related to obesity are not only physical but psychological and social as well. Children feel depressed and are nervous about their obesity issue and this has a negative effect on their behavior. The complications caused due to childhood obesity are severe and could continue to affect the health of a child even in adulthood. It is essential that parents are aware of the potential risk the child is facing due to obesity and take actions to control the problem. Hence, making them aware of healthy intervention programs via the community is important to reduce childhood obesity. 17] these innovative interventions can encourage children to lead a healthy ood-obesity prevention interventionspreventive programs are conducted to control obesity in children and to modify the social and behavioral aspect of developing obesity. Some of the preventive programs revolve around educating the general population about healthy nutrition and providing information about health problems caused due to childhood obesity. 15] health care professionals can advise their patients, especially parents, about healthy child nutrition, tackling health problems due to childhood obesity, and benefits of breast feeding among newborn children to prevent weight gain. 21] federal or state actions to deal with childhood obesity are directing all the food vendors to provide exact calorie readable labels on their products, mentioning calories upfront on menus, restricting advertisements of unhealthy foods, and promoting healthy food making among parents. Children aged 7 years and younger with no secondary complications of obesity are advised weight management. Pharmacological therapy for children with obesity above the age of 12 years can include drugs like orlistat (which blocks fat from the intestine thus giving negative energy balance). 8] medical professionals are considering the benefits of bariatric surgery in extremely obese children to avoid complications of obesity in adulthood. According to a recent review about school-based interventions for obesity prevention, 17 out of 25 intervention studies were effective in reducing the body mass index. 23] some interventions targeting physical activity through physical education along with nutritional education worked in reducing obesity. 24]us governmental strategies to reduce childhood obesityaccording to the centers for disease control and prevention, identifying effective intervention strategies that can target both improvements in physical activity and providing nutritious diet to reduce childhood obesity are important. 21] interventions encouraging mothers to breastfeed their babies can be effective in reducing the risk of obesity in children. 21] the united states government is changing the health policies involving transportation, land use, education, agriculture, and economics so that it can have an important impact on healthy environment and health of people in turn reducing obesity. The first lady has also initiated an obesity prevention and control program titled ‘let's move’. Important data regarding evaluation of childhood obesity prevention schemes can be collected and can be used to make stronger and more effective strategies including policy building to reduce future childhood obesity rates. 25]conclusionschildhood obesity has become a public health crisis, not just in the united states but all over the world. Childhood obesity problem can be reduced by educating children and parents about healthy nutrition and encouraging them to be physically active.

Centers for disease control and prevention, overweight and obesity; childhood overweight and obesity, contributing factors. Centers for disease control and prevention (2011) [last retrieved on 2011 feb 03];cdc grand rounds: childhood obesity in the united states. The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Pubmed]articles from international journal of preventive medicine are provided here courtesy of wolters kluwer -- medknow s:article | pubreader | epub (beta) | printer friendly | journal of childhood ood obesity is a serious medical condition that occurs when a children is above normal weight for his age and height. There are several associated effects also like cholesterol problem, blood pressure, diabetes, journal of childhood obesity is an open access and peer reviewed journal that aims at providing complete and reliable information about the causes, cure, effects and prevention of childhood obesity and related effects by publishing articles, review papers, case reports and making them freely available for journal of childhood obesity deals with all fields of treating childhood obesity involving child nutrition, pediatrics obesity, skinfold thickness, insulin resistance, physical education, weight management, food choice, hypothyroidism, diabetes mellitus, fasting blood glucose, energy balance, journal process through editorial management system for quality publication. Editorial manager of childhood obesity journal is an online manuscript submission system which reviews and processes the articles and review papers; at least two independent reviewer’s approval is mandatory followed by editor approval is required for acceptance of any citable manuscript. Childhood obesity ing to the world survey statistics, childhood obesity statistics has dramatically multiplied in kids and quadrupled in teenagers in the previous 30 years. In some of the countries like virginia the obesity rate is steadily increasing but the obesity statistic rate two times more than the new national average. But according to the child obesity statistics there is no change in obesity prevalence in youth or adults between 2003-2004 and 2011-2012. Childhood obesity ood obesity can be prevented by the help of parents and other family members, by applying small changes in the daily food habits. Child hood obesity can be prevented by encouraging your child to develop new habits by using sedentary life styles. Together, we work towards optimum health of your child growth and ls of child health care informatics research: journal of nursing and healthcare research , multimedia healthcare inc , australian healthcare association , british journal of hospital medicine. In addition, research also indicates a role for childhood eating behaviour on adult of the research also shows that most of the children’s eating behaviour in the western world are unsatisfactory. The helena (healthy lifestyle in europe by nutrition in adolescents) study gives new insights into the food and lifestyle habits of young people in food choice and five countries and shows surprising similarities, as well as some key differences, across ls related to food y of food and nutrition, engineering in agriculture, environment and food, european food research and technology, food additives and contaminants - part a chemistry, analysis, control, exposure and risk assessment, global food security child obesity and depression. The surgeon general has highlighted both pediatric obesity and depression as major public health issues in recent reports. In the 2000 year report on children and mental health, the surgeon general emphasized that reoccurance of childhood depression episodes is common and depression “may leave behind psychological scars that increase vulnerability throughout early life. In 2003, the surgeon general testified on “the child obesity and depression crisis in america” that the annual cost of obesity in the us in the year 2000 was 117 billion dollars, and that obesity epidemics have been followed by pediatric epidemics of type 2 diabetes and hypertension. Later, studies also suggested that childhood obesity may be associated with some specific family characteristics, such as family cohesion, conflict, disorganisation, a lack of interest in social and cultural activities, and parental neglect. Thus, no clear pattern of family dynamics has consistently been associated with us studies examining the role of family and parental factors in childhood obesity have often been limited by small sample sizes, and a single measure of family function/dysfunction. However, regularly consuming fattening junk food can be addictive for children and lead to complications like obesity, chronic illness, low self-esteem and even depression, as well as affecting how they perform in school and extracurricular ls related to junk ation journal, japanese circulation journal, cyta - journal of food, food engineering reviews, sensing and instrumentation for food quality and safety weight reduction is a useful remedy that is applied in case of obesity and overweight. Weight reduction is also done through surgeries namely gastric bypass surgery, bariatric surgery, ls related to weight reduction journal, international journal of disaster risk reduction weight loss loss surgery is the bariatric surgery may be an option for adults with severe obesity. Body mass index (bmi), a measure of height in relation to weight, is used to define levels of obesity.

Clinically severe obesity is a bmi > 40 or a bmi > 35 with a serious health problem linked to obesity. The weight loss surgery food and drug administration (fda) has approved use of an adjustable gastric band (or agb) for patients with bmi > 30 who also have at least one condition linked to obesity, such as heart disease or surgery to produce weight loss is a serious decision. Regular physical exercise helps an individual to be free from health related problems such as obesity, diabetes, high blood pressure, high cholesterol, etc. Those persons appear to be pear shaped and their obesity is referred to as gynoid obesity. In rodents, brown adipose tissue plays an essential role in non-shivering thermogenesis and in energy dissipation that can serve to protect against diet-induced obesity. Synthetic reactions produce phospholipids and sing childhood obesity with (s):  tabitha n s, substance p and some other delicate neurochemical regulators of body weight and (s):  vardanyan gs, shaljyan al, saharyan av, aghajanov lic parameters and orexigenic/anorexigenic factors of obesity in prader-willi (s):  elena bogova, natalya volevodz, valentina peterkova and ilin to bottle-feeding parents could defer (s):  pauline ood obesity ood obesity behavior in obesity and history and child fat cted/indexed foundation for medical education and published work is licensed under a creative commons attribution 4. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. All in all, there is an urgent need to initiate prevention and treatment of obesity in uctionchildhood obesity has reached epidemic levels in developed countries. In some european countries such as the scandinavian countries the prevalence of childhood obesity is lower as compared with mediterranean countries, nonetheless, the proportion of obese children is rising in both cases [4]. The highest prevalence rates of childhood obesity have been observed in developed countries, however, its prevalence is increasing in developing countries as well. The prevalence of childhood obesity is high in the middle east, central and eastern europe [5]. For instance, in 1998, the world health organization project monitoring of cardiovascular diseases (monica) reported iran as one of the seven countries with the highest prevalence of childhood obesity. Kg/yr, twofold increase in prevalence of obesity1971–19746–19nhanes i [68]relatively stable1976–19806–19nhanes ii [68]relatively stable1988–19946–19nhanes iii [68]doubled to 11%1999–20006–19nhanes iv [68]increased by 4%. And obesity in childhood have significant impact on both physical and psychological health; for example, overweight and obesity are associated with hyperlipidaemia, hypertension, abnormal glucose tolerance, and infertility. Overweight children followed up for 40 [11] and 55 years [12] were more likely to have cardiovascular and digestive diseases, and die from any cause as compared with those who were tion of childhood obesityalthough definition of obesity and overweight has changed over time [13, 14], it can be defined as an excess of body fat (bf).

There is no consensus on a cutoff point for excess fatness of overweight or obesity in children and adolescents. European researchers classified overweight as at or above 85th percentile and obesity as at or above 95th percentile of bmi [18]. In research, techniques include underwater weighing (densitometry), multi-frequency bioelectrical impedance analysis (bia) and magnetic resonance imaging (mri). Although, these methods are less accurate than research methods, they are satisfactory to identify risk. In addition, bmi fails to distinguish between fat and fat-free mass (muscle and bone) and may exaggerate obesity in large muscular children. While health consequences of obesity are related to excess fatness, the ideal method of classification should be based on direct measurement of fatness. Although methods such as densitometry can be used in research practice, they are not feasible for clinical settings. Waist circumference, as a surrogate marker of visceral obesity, has been added to refine the measure of obesity related risks [25]. Waist circumference seems to be more accurate for children because it targets central obesity, which is a risk factor for type ii diabetes and coronary heart disease. To the best of our knowledge there is no publication on specific cut off points for waist circumference, but there are some ongoing of obesityalthough the mechanism of obesity development is not fully understood, it is confirmed that obesity occurs when energy intake exceeds energy expenditure. There are multiple etiologies for this imbalance, hence, and the rising prevalence of obesity cannot be addressed by a single etiology. However, environmental factors, lifestyle preferences, and cultural environment seem to play major roles in the rising prevalence of obesity worldwide [26–29]. In a small number of cases, childhood obesity is due to genes such as leptin deficiency or medical causes such as hypothyroidism and growth hormone deficiency or side effects due to drugs (e. Overweight and obesity are mostly assumed to be results of increase in caloric intake, there is not enough supporting evidence for such phenomenon. However, a small caloric imbalance (within the margin of error of estimation methods) is sufficient over a long period of time to lead to obesity. With concurrent rise in childhood obesity prevalence in the usa, the national health and nutrition examination survey (nhanes) noted only subtle change in calorie intake among us children from the 1970s to 1988–1994. For many years it has been claimed that the increase in pediatric obesity has happened because of an increase in high fat intake, contradictory results have been obtained by cross-sectional and longitudinal studies. The main objection to the notion that dietary fat is responsible for the accelerated pediatric obesity epidemic is the fact that at the same time the prevalence of childhood obesity was increasing, the consumption of dietary fat in different populations was decreasing. Although fat eaten in excess leads to obesity, there is not strong enough evidence that fat intake is the chief reason for the ascending trend of childhood dietary is a growing body of evidence suggesting that increasing dairy intake by about two servings per day could reduce the risk of overweight by up to 70% [43]. There are few data reporting the relation between calcium or dairy intake and obesity among n 1970 and 1997, the united state department of agriculture (usda) surveys indicated an increase of 118% of per capita consumption of carbonated drinks, and a decline of 23% for beverage milk [47]. Soft drink intake has been associated with the epidemic of obesity [48] and type ii diabetes [49] among children. Physical has been hypothesized that a steady decline in physical activity among all age groups has heavily contributed to rising rates of obesity all around the world.

Numerous studies have shown that sedentary behaviors like watching television and playing computer games are associated with increased prevalence of obesity [51, 52]. In addition, increased proportions of children who are being driven to school and low participation rates in sports and physical education, particularly among adolescent girls [51], are also associated with increased obesity prevalence. In response to the significant impact that the cultural environment of a child has on his/her daily choices, promoting a more active lifestyle has wide ranging health benefits and minimal risk, making it a promising public health tionalmost all public health researchers and clinicians agree that prevention could be the key strategy for controlling the current epidemic of obesity [55]. Prevention may include primary prevention of overweight or obesity itself, secondary prevention or avoidance of weight regains following weight loss, and prevention of further weight increases in obese individuals unable to lose weight. Until now, most approaches have focused on changing the behavior of individuals on diet and exercise and it seems that these strategies have had little impact on the growing increase of the obesity age group is the priority for starting prevention? Therefore it would be more sensible to initiate prevention and treatment of obesity during childhood. Of all aspects of behavior in the home environment, however, television viewing has been researched in greatest detail [57–59]. Of dietary pattern and tv appears that gains can be made in obesity prevention through restricting television viewing. Recent efforts in preventing obesity include the initiative of using school report cards to make the parents aware of their children's weight problem. Summary of prevention and intervention strategies is presented in table sionobesity is a chronic disorder that has multiple causes. It is believed that both over-consumption of calories and reduced physical activity are mainly involved in childhood ntly, primary or secondary prevention could be the key plan for controlling the current epidemic of obesity and these strategies seem to be more effective in children than in adults. However, further research needs to examine the most effective strategies of intervention, prevention, and treatment of obesity. These strategies should be culture specific, ethnical, and consider the socio-economical aspects of the targeting al health and nutrition examination ational monitoring of trends and determinants in cardiovascular ctrical impedance ic resonance state department of ledgementswe would like to thank claire vayalumkal for her helpful comments and careful reading of the final s' contributionsall authors had equal contribution in writing this s’ affiliations(1)population health research institute, mcmaster university(2)school of nursing and department of clinical epidemiology and biostatistics, mcmaster university(3)department of clinical epidemiology and biostatistics, and population health research institute, mcmaster ncesnicklas ta, t. 2001, 20: articlepubmedgoogle scholarparsons tj, power c, logan s, summerbell cd: childhood predictors of adult obesity: a systematic review. 1999, 23: google scholarwhitaker rc, wright ja, pepe ms, seidel kd, dietz wh: predicting obesity in young adulthood from childhood and parental obesity. Articlepubmedgoogle scholarkelishadi r, pour mh, sarraf-zadegan n, sadry gh, ansari r, alikhassy h, bashardoust n: obesity and associated modifiable environmental factors in iranian adolescents: isfahan healthy heart program - heart health promotion from childhood. Articlepubmedgoogle scholaralnuaim ar, bamgboye ea, alherbish a: the pattern of growth and obesity in saudi arabian male school children. 1996, 20: scholarmccarthy hd, ellis sm, cole tj: central overweight and obesity in british youth aged 11-16 years: cross sectional surveys of waist circumference. 1992, 327: articlepubmedgoogle scholarflegal km, carroll md, ogden cl, johnson cl: prevalence and trends in obesity among us adults, 1999-2000. 1994, 59: google scholarflodmark ce, lissau i, moreno la, pietrobelli a, widhalm k: new insights into the field of children and adolescents' obesity: the european perspective (vol 28, pg 1189, 2004). 1990, 44: google scholardeurenberg p, pieters jj, hautvast jg: the assessment of the body fat percentage by skinfold thickness measurements in childhood and young adolescence. S0899-9007(96) articlepubmedgoogle scholareckel rh, krauss rm: american heart association call to action: obesity as a major risk factor for coronary heart disease.

1998, 67: google scholarlink k, moell c, garwicz s, cavallin-stahl e, bjork j, thilen u, ahren b, erfurth em: growth hormone deficiency predicts cardiovascular risk in young adults treated for acute lymphoblastic leukemia in childhood. 1995, 311: articlepubmedpubmed centralgoogle scholarbellisle f, rolland-cachera mf, deheeger m, guilloud-bataille m: obesity and food intake in children: evidence for a role of metabolic and/or behavioral daily rhythms. 2002, 21: articlepubmedgoogle scholarpereira ma, jacobs drj, van horn l, slattery ml, kartashov ai, ludwig ds: dairy consumption, obesity, and the insulin resistance syndrome in young adults: the cardia study. Food and consumers economics division, economic research service, us department of agriculturegoogle scholarludwig ds, peterson ke, gortmaker sl: relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. S0140-6736(00) articlepubmedgoogle scholargittelsohn j, wolever tm, harris sb, harris-giraldo r, hanley aj, zinman b: specific patterns of food consumption and preparation are associated with diabetes and obesity in a native canadian community. Articlepubmedgoogle scholartremblay ms, willms jd: is the canadian childhood obesity epidemic related to physical inactivity?. 2003, statistics canadagoogle scholarmuller mj, mast m, asbeck i, langnase k, grund a: prevention of obesity--is it possible?. Articlepubmedgoogle scholargortmaker sl, peterson k, wiecha j, sobol am, dixit s, fox mk, laird n: reducing obesity via a school-based interdisciplinary intervention among youth: planet health. Articlepubmedgoogle scholarzametkin aj, zoon ck, klein hw, munson s: psychiatric aspects of child and adolescent obesity: a review of the past 10 years. S0929-693x(01) articlepubmedgoogle scholarge k, t t, c t, t k: prevalence and trends in overweight and obesity among children and adolescents in thessaloniki, greece. Use cookies to improve your experience with our information about our cookie of childhood   |   october and effect in childhood obesity: solutions for a national epidemic. Michael wieting, do, and effect in childhood obesity: solutions for a national journal of the american osteopathic association, october 2008, vol. In addition, childhood obesity has serious psychosocial consequences, such as low self-esteem, lower quality of life, and depression. As a result of these and many other factors, childhood obesity has reached epidemic the 1970s, the rate of obesity more than doubled among us children aged 2 to 5 years,1,4 and recent data from studies conducted by the centers for disease control and prevention (cdc)5-7 indicate that this increased prevalence of obesity applies to all ethnicities in this age group. 4 according to the institute of medicine, more than 9 million children and young adults older than 6 years are overweight or ood obesity increases the risk of multiple acute and chronic medical problems as well as psychological issues, all of which can persist into adulthood and adversely affect quality of life. Health issues related to obesity are also linked with decreased life estimated 9 million overweight children—including 4. In the past 3 decades, the annual cost of managing obesity-related diseases among children and adolescents increased more than threefold, from $35 million in 1979-1981 to $127 million in 1997-1999. However, the cdc estimates that a 10% weight loss could decrease an overweight person's lifetime medical costs by $2200 to $ present review explores the factors that contribute to childhood obesity and presents options for prevention through education, regulation, and the increased involvement of osteopathic physicians and other healthcare of childhood cause of childhood obesity is certainly debated. Some researchers have pointed to socioeconomic factors,1 while advocacy groups have accused mass media as the culprit for marketing junk food to children. Regardless of the outcomes of this debate, these key factors have likely worked together to increase the prevalence of childhood overweight and , gender, and societal y among children and adolescents is spreading across lines of race, gender, and socioeconomic status, but the greatest increase in prevalence is currently seen among african american, hispanic, and native american children. The prevalence of obesity is particularly high among mexican american males (more than 27% of children and adolescents) and african american females (22% of children and 29% of adolescents). 22 obese children are five times more likely to avoid participating in sports and other school activities and have lower emotional, social, and school al factors also play a role in childhood obesity.

For example, in 2005, only 45% of ninth grade and 22% of 12th grade students attended daily physical education limited physical activity during and after school contributes to childhood obesity. 27 as a result, only 21% of school children attend physical education classes each low levels of physical activity have been shown to contribute to obesity and consequent circulatory problems. As little as 3 hours of aerobic exercise per week significantly reduced the effects of obesity on blood vessels. Furthermore, children in schools with more frequent physical education activity were more likely to have normal body r, some studies32,33 have suggested that physical education classes are not enough to curb childhood obesity. Studies32,33 suggest that increased afterschool activity outdoors in parks or sport facilities may be more effective in preventing childhood ns about advertising on children's television were first raised in the early 1970s by action for children's television, a children's advocacy group that urged the federal trade commission (ftc) to limit or forbid direct advertising to children. A lancet survey51 showed that for each additional serving of sugar-sweetened beverage children consumed, the frequency of childhood obesity and average body mass index (bmi) increased. In fact, dental caries is the single most common chronic childhood disease and is five times more common than described, schools provide an increasing amount of unhealthy fast food to their students. Such diets—which are often energy dense, low in fiber, and high in fat—have also been reported to contribute to childhood professional health organizations and advocacy groups support legislation that would address the growing problem of childhood obesity. In considering both sides of the regulation issue, as well as research outside the realm, osteopathic physicians and other healthcare providers can work with their patients and community leaders to influence nutritional and physical activity standards to fight the cy and strategies have been suggested to curb the problem of childhood obesity. In june 2007, the expert committee on the assessment, prevention, and treatment of child and adolescent overweight and obesity,28,55 which comprises representatives from 15 national health and nutrition organizations, issued recommendations for the assessment (figure 1) and treatment (figure 2) of overweight and obese us department of agriculture approves school meal programs, but they do not regulate the nutritional content of most snacks and other high-calorie foods. The center for consumer freedom (ccf), an advocacy group underwritten largely by food makers, opposes federal intervention and insists that advertising aimed at children is not a main contributing factor for childhood obesity. 61,62 as stated in one study,63 “it is often assumed that the increase in pediatric obesity has occurred because of an increase in caloric intake. The ccf points to scientific evidence63-65 which shows that the most meaningful contributor to childhood obesity is a lack of physical izing the potential impact of soft drinks, the ccf cites another study,64 which revealed that children from schools with and without sales of soft drinks consumed an average of 33. The researchers maintain that the extra gram of sucrose accounted for approximately 4 calories and conclude that soft drink consumption in schools is not associated with increased risk of overweight. The ccf also cites a harvard study65 of more than 14,000 adolescents that found no link between soft-drink consumption and obesity. 66 the group argues that holding restaurants and food companies responsible for food choices is irrational and attempts to make food sellers, manufacturers, or distributors liable for obesity. This group opposes linking food advertising to childhood obesity, stating that decisions regarding “good” and “bad” foods belong in the hands of responsible osteopathic athic physicians, their allopathic counterparts, and other healthcare professionals have numerous opportunities to encourage children, adolescents, and their parents to engage in healthy lifestyles, to influence their awareness of obesity as a health issue, and to offer education regarding prevention and treatment options. However, in order for healthcare professionals to play a pivotal role in combating childhood obesity, their approach will have to go beyond routine medical office is important to recognize the influence of family, educational, social, cultural, environmental, economic, and political forces on the health of children. Systematic threats to the health of us children, including obesity, cannot be adequately addressed by individual efforts that are limited to the clinical office setting. The implementation of catch programs has been responsible for efforts to reduce fat content of school lunches, increase physical activity and the number of physical education classes, and influence students' self-reported eating habits and levels of physical e healthy lifestyle choicesprovide nutritional fitness and psychological counseling to overweight adolescentsreplace television with fun and simple exerciseenhance awareness about the scope and complications of childhood obesity and its effect on school performancemodify school policy regarding foods served in school lunchescreate obesity clinics and clinic-based healthy lifestyle aap also advocates for physicians to assume leadership positions where they can serve as agents of change in the abundant areas of opportunity in childhood obesity prevention. Such efforts include promoting physical activity in many settings, decreasing availability of low-nutrition foods in schools, working with policymakers to support healthy lifestyles for children, and encouraging research into mechanisms to prevent overweight and obesity in athic physicians, who are in key positions to take roles as leaders and advocates, should consider using their influence to emphasize that preventing obesity is as important as other well-accepted health strategies such as routine immunizations. The american osteopathic association recently took steps to support some of these efforts (resolution b02 [m/2008]—pediatric obesity; resolution b03 [m/2008]—pediatric obesity/measurement; and resolution b04 [m/2008]—pediatric nutrition).

Likewise, we may wish to assess the effect of advertising aimed at youth regarding poor nutritional choices, such as discontinuing the availability of high sugar–content beverages in is no universal agreement among stakeholders regarding how best to address the issue of childhood obesity. Because obesity is a complex sociocultural issue, many advocate that only a multifaceted approach spearheaded at the federal level will offer the best opportunity to address this pervasive tive strategies have to be directed at children, parents, school systems, and educators. Abundant evidence demonstrates the benefit of behavioral change to combat obesity and its researchers and medical practitioners agree that exercise and appropriate nutrition are essential for obesity prevention and optimal health. Federal agencies such as the us department of health and human services could train childhood educators on obesity prevention and provide grants to promote collaborative services to at-risk youth. Likewise, increased physical activity may help prevent and reduce childhood obesity, but recommending more exercise will not have much impact if physical education programs are not available. Key part of any multifaceted solution to the childhood obesity problem may be to consider national guidelines to regulate the advertising and marketing of foods. The current epidemic of childhood obesity, if left unchecked, may result in today's children having shorter and less healthy lives than their parents.