The Obesity Epidemic Among American Youth: A 21st Century Health Crisis and Challenge

More than a few healthcare professionals have a real pediatric concern for the health and wellness of America’s youth. During the past three decades, there has been an increase in the prevalence of chronic conditions such as asthma and behavior/learning problems, (e.g., attention-deficit/hyperactivity disorder), among children and adolescents. Just in the period from 1994 to 2006, chronic health conditions among U.S. children and adolescents doubled (Van Cleave et al., 2010). An increase in the prevalence of any chronic health condition among America’s youth merits attention. However, obesity among children and adolescents is of special concern because it is such a threat to their health and wellness. Obese children and adolescents are being diagnosed with adult diseases and conditions such as insulin resistance, metabolic syndrome, high cholesterol, high blood pressure, early heart disease, type 2 diabetes and elevated C-reactive protein levels (Skinner, et al., 2010). Further, obesity exacerbates other chronic illnesses and makes their treatment more difficult. In a real sense, the obesity epidemic among American youth is an unprecedented health crisis and challenge. Prevalence of Obesity among Children and Adolescents An estimated 12.5 million (16.9%) of children and adolescents aged 12-19 years are obese, with the prevalence of obesity being higher among adolescents (18.4% for 12-19 year olds) than among preschool-aged children (12.1% for 2-5 year olds & 18% for 6-11 year olds) (Ogden et al., 2012). In terms of rate of prevalence, from 1976-1980 to 2007-2008, obesity among preschool children aged 2-5 increased from 5.0% to 10.4% and among children aged 6-11 obesity rose from 6.5% to 19.6%. During the same period, obesity among adolescents aged 12-19 more than tripled, rising from 5.0% to 18.1% (Ogden & Carroll, 2010). Gender Of the nearly 12.5 million (17%) of U.S. children and adolescents who are obese, the prevalence of obesity is higher among boys than girls. Approximately seven million boys (18.6%) and more than five million girls (15.0%) girls are obese (Ogden et al., 2012). From 1988-1994 to 2007-2008 obesity prevalence among boys aged 12-19 increased from 11.3% to 19.3% and among girls it increased from 9.7% to 16.8% (Ogden & Carroll, 2010). Race/Ethnicity The increase in obesity for boys and girls aged 12-19 cuts across racial/ethnic boundaries. However, race/ethnicity makes a difference in the prevalence of obesity among American adolescents (Ogden & Carroll, 2010). Racial/ethnic differences for boys. From 1988-1994 to 2007-2008 obesity prevalence among boys aged 12-19 increased racially/ethnically as follows: 11.6% – 16.7% (non-Hispanic white boys) 10.7% – 19.8% (non-Hispanic black boys) 14.1% – 26.8% (Mexican-American boys) (Ogden & Carroll, 2010) Racial/ethnic differences for girls. From 1988-1994 to 2007-2008 obesity prevalence among girls aged 12-19 increased racially/ethnically as follows: 8.9% -14.5% (non-Hispanic white girls) 16.3% – 29.2% (non-Hispanic black girls) 13.4% – 17.4% (Mexican-American girls) (Ogden & Carroll, 2010). Prevention of Childhood Obesity “Prevention is better than cure” (Desiderius Erasmus), is a principle which represents the single best way to start, sustain and succeed at slowing the inexorable increase in obesity among children and adolescents. http://journals.fotki.com/fumicochadwick54/blog/entry/wbftgqgtdrwks/

 Prevention vs. Treatment Compared to prevention, the treatment of obesity is more challenging for all concerned from the obese child, to health care professionals, organizations and institutions (governmental and private), to communities and society at large. Existing evidence shows that while challenging, prevention is a more effective, long-term option in halting the rising increase in the prevalence of obesity among children and adolescents. One challenging feature of obesity is that once it exists it is tough to treat or otherwise get obese children to lose weight and keep it off. Hence, most experts agree that the prevention of obesity should begin as early in life as possible, starting with efforts to maintain nutritional status during pregnancy to protect the health of the fetus and mother (e.g., see Aranceta et al., 2009). Healthy Children and Youth Treating obese children will not turn the tide of the obesity epidemic. Hence, healthy children and youth are the primary target of obesity prevention. Preventing obesity in healthy children and youth has a greater likelihood of long-term success and incurs less cost in the long-run (see Institute of Medicine, 2005). Action Plan for Obesity Prevention In 2001, the Institute of Medicine Committee on Prevention of Obesity in Children and Youth (IOMC) developed a prevention-focused action plan to address the prevalence and prevention of obesity (Institute of Medicine, 2005). http://www.imfaceplate.com/kyleleonreviewscamm/for-cellulite-removal-as-a-tasty-snack

 The IOMC’s report, Preventing Childhood Obesity: Health in the Balance is a useful evidenced-based approach to the prevention of childhood obesity (see Institute of Medicine, 2005). Population-, Evidence- and Evaluation-Based Approach Based on the best available evidence, the IOMC identified “a primary prevention, population-based approach to be the most viable long-term strategy for reducing obesity and its chronic disease burdens” (Institute of Medicine, 2005, p.107). It also recommended an evaluation of any intervention or change to prevent obesity among children and youth in the United States. Maintaining Energy Balance “Maintaining energy balance at a healthy weight while protecting overall health, growth and development, and nutritional status” (Institute of Medicine, 2005, p.3) is central to the IOMC’s action plan for obesity prevention. The balance is between energy/calories consumed and energy expended to support healthy growth and development, metabolism, thermogenesis and physical activity. Balancing this equation is easier said than done. There is a constellation of interdependent factors (e.g., genetic, biological, psychological, sociological and environmental), including nutrition and physical activity, which can affect energy balance one way or another. http://www.bubblews.com/news/1825140-for-cellulite-removal-as-a-tasty-snack