A new consensus statement by Shaping America’s Health and The
Obesity Society takes into account the influence of race, ethnicity and culture
on childhood obesity.
The consensus statement was published in Diabetes Care.
“Although childhood obesity is increasing in all ethnic and racial
groups, its prevalence is higher in nonwhite populations. The reasons for the
differences in prevelence of obesity among groups are complex, likely involving
genetics, physiology, culture, socioeconomic status, environment and
interactions among these variables as well as others not fully
recognized,” the consensus panel wrote.
A seven-member panel of experts in pediatric endocrinology, nutrition,
cardiology, gastroenterology, anthropology and epidemiology focused on five
- What are the prevalence, severity and consequences of childhood
obesity across race/ethnicity in the United States?
- How might socioeconomic factors influence racial/ethnic differences
in childhood obesity?
- What are the biological and cultural factors associated with
racial/ethnic differences in childhood obesity?
- What are the implications of race/ethnicity on the prevention of
- What are the implications of race/ethnicity on the treatment of
“Hopefully this statement will make a difference in viewing obesity
as a serious problem for children and adolescents,” panel member Sonia
Caprio, MD, professor of pediatric endocrinology, Yale University School of
Medicine, told Endocrine Today.
The consensus statement recommends that health care professionals
routinely discuss obesity and its risks with children and families, especially
children at higher risk, such as non-Hispanic blacks and Mexican-Americans,
and they should be culturally sensitive.
Efforts should take into account the socioeconomic status and education
level of the child and family. The panel recommended using prevention efforts
that fall within the framework of the socioeconomic model, which views children
in the context of their family, culture and community.
“Socioeconomic position and social class permeate every aspect of
life and have a cumulative effect on health status throughout the life cycle.
Controlling for socioeconomic status variables, however, is very difficult
because many, if not most, of these variables are unobserved,” the panel
Emphasis should be placed on early treatment and mutually agreed-upon
treatment goals. The statement recommends awareness of specific racial, ethnic
and sex differences in perception of obesity that may influence goals, such as
body image, religious views and realities of time and money. Although
comprehensive lifestyle modification is recommended for white middle-class
children, further study is needed to determine the benefits of these
interventions in nonwhite children.
The panel also suggested that health care professionals play an active
role in advocating local and national policies and a healthy environment for
children. This includes promoting physical activity and healthy food choices,
providing children with safe places to play in poor and minority neighborhoods
and restricting youth-targeted unhealthy food advertising.
“Understanding the influence of these variables on the patterns of
eating and physical activity that lead to obesity will be critical to
developing public policies and effective clinical interventions to prevent and
treat childhood obesity,” the panel wrote. – by Katie
Diabetes Care. 2008;31:2211-2221.
This is a critically important paper at a time when obesity in children
is becoming a national epidemic. Until society gets involved, we are not going
to solve the problem of childhood obesity. This is a call to arms to involve
the medical community and the community at large to counter this epidemic by
introduction of didactic lectures on the importance of nutrition and
participation by schools in education; healthy lunch options; avoidance of fast
foods available in vending machines; and introduction of minimally required
exercise programs. Just like cigarette smoking, when society decided that there
should be laws to limit smoking in public areas, that is when the rate of
smoking went down, and rates of cancer and blood pressure are going down. This
is a landmark paper addressing a fundamental health problem of the 21st
– Mark A. Sperling, MD
Endocrine Today Editorial Board member