Childhood Obesity -- The Shape of Things to Come

Optimal Weight for Life Program in the Division of Endocrinology, Children's Hospital Boston, USA.
New England Journal of Medicine (Impact Factor: 55.87). 01/2008; 357(23):2325-7. DOI: 10.1056/NEJMp0706538
Source: PubMed

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    • "Among the major public health problems in childhood and adolescence, excess body weight has received great attention in recent decades. This is due to the high prevalence of excess body weight observed in several countries and its negative health consequences (Ebbeling et al., 2002; Ludwig, 2007; Sikorski et al., 2012). To develop actions to improve this situation, studies have tried to identify the main determinants of excess weight in specific pediatric populations (Assunção et al., 2012). "
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    ABSTRACT: The aim of this study was to analyze the association between risk behaviors and adiposity indicators in adolescents and to discuss some methodological aspects related to this relationship. We evaluated 1,321 adolescents (55.2% female) aged 10-16 years. Relative body fat (%fat) by measurement of triceps and subscapular skinfold thickness and waist circumference (WC) were used as total and central adiposity indicators, respectively. Physical inactivity, time spent in front of the TV, the consumption of soda and/or chocolate, alcohol, and tobacco smoking were analyzed as risk behaviors. Information about the socioeconomic status (categorized into three levels) and nutritional status of the mother (overweight or normal weight) were used as adjustment factors in the analyses of prevalence ratio (PR) of the outcomes and their associated 95% confidence intervals (95% CI). The chi-square test and Poisson regression were used for statistical analyses. Low associations were found between risk behaviors and adiposity indicators. Tobacco smoking was the most positively correlated behavior with adiposity in girls (%fat: PR = 1.61; 95% CI = 1.04-2.47; WC: PR = 1.90; 95% CI = 1.17-3.08) and in adolescents whose mothers were normal weight (%fat: PR = 2.31; 95% CI = 1.33-4.03; WC: PR: 2.31; CI: 1.19-4.46). Additionally, as an important methodological issue, we highlighted the assessment of risk behaviors in adolescents as crucial to producing more robust evidence on the subject. Of the investigated behaviors, we concluded that tobacco smoking is the behavior most associated with adiposity indicators. © The Author(s) 2015.
    Journal of Child Health Care 08/2015; 1(10). DOI:10.1177/1367493515598642 · 0.88 Impact Factor
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    • "Childhood obesity is contributing significantly to adult obesity, diabetes as well as non-communicable diseases (Black et al., 2013). Hence, it is imperative to detect the problem at an early stage to plan and implement efficient and effective intervention strategies (Ludwig, 2007). However, this over-consciousness of issue at times results in requiring a slightly obese child to lose mass (weight) on the basis of current obesity profile. "
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    ABSTRACT: This paper proposes an objective criterion for shedding off or putting on mass (weight) in marginally obese children. With increasing awareness of childhood obesity among community-health workers, pediatricians, nutritionists, teachers and parents, efforts are made to reduce mass based on the current obesity profile of a child. However, this approach fails to take into account the fact that a child, by the very nature of age group under study, is gaining height at the same time trying to manage mass through a combination of diet, exercise and lifestyle adjustment (optimization approach). Optimal mass was defined in 2011 by the author as the mass corresponding to percentile of height. Hence, a child should momentarily achieve optimal mass when mass-percentile trajectory crosses height-percentile trajectory. However, for the purpose of maintaining optimal mass, not only, the values, but also, the slopes of height-and mass-percentile trajectories must match (dynamical-system approach). This paper follows height and mass trajectories of a girl in the age range 5.88-9.44 years and illustrates the need for gaining mass instead of reducing, although she was marginally obese at her last checkup. To help achieve the goal of optimal-mass management, month-wise targets to attain specific heights and masses (on specific dates of a given month) as well as lifestyle adjustment, diet and exercise plans are provided.
    International Journal of Biology and Biotechnology 07/2015; 12(3):381-391.
    • "The estimated direct medical costs associated with obesity in the United States have been calculated at $26 billion per year (Cawley and Meyerhoefer 2012). It is also anticipated that obesity-related illness and associated costs will increase substantially into the future (Health at a Glance 2007: OECD Indicators 2007; Ludwig 2007). At an individual level, obese people are estimated to "

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