Pediatric Annals

editorial 

The Overweight Epidemic

Stanford T Shulman, MD

Abstract

Large-scale communal and societal issues must be addressed before effective prevention of overweight can be achieved.

Abstract

Large-scale communal and societal issues must be addressed before effective prevention of overweight can be achieved.

The statistics are frightening, and they clearly document that we've become an overweight society. The evidence that children, young children at that, are central to this epidemic of overweight is irrefutable. The 68kg, 7-year-old boy with chronic osteomyelitis I saw recently in our outpatient clinic is only the latest in a series of truly large children who have passed my way. I am sure all pediatricians encounter such children.

The concept of the "adipose rebound," I must admit, was new to me as I read through the articles for this issue of Pediatric Annals, devoted to the overweight child. This rebound refers to the period from about ages 4 to 6 when all children add adipose cells that then persist essentially for life. The younger and heavier children are at the period of adipose rebound, the more likely they are to become overweight adults.

Dr. Kathy Kaufer Christoffel serves as guest editor of this issue of Pediatric Annals, and she has assembled a fine set of articles related to this critically important topic. She and the authors of the included articles highlight several factors that explain at least part of the increase in overweight children and adolescents in our society. The factors of sedentary lifestyle, hours spent (inactively) in front of the television or computer or video monitor, the role of junk food, and others are all of great importance.

Dr. Christoffel is right on target, however, when she emphasizes the big picture communal and societal issues that are operative and that must be addressed before effective prevention on a large scale can be achieved. The parallels to those efforts by pediatricians and our allies to promote child passenger safety, including public education, appropriate legislation, and child carseat distribution, are really striking because access to healthy foods, non-motorized transportation, and safe recreational venues would be required to prevent overweight effectively within society. Considerable work will need to be done to make progress in this regard, especially as this problem affects underserved minority populations.

This month's stamps do not mention overweight or obesity specifically but relate to proper nutrition for children and monitoring of growth parameters in childhood. The Bangladeshi and Indian stamps each shows a child against the background of a growth chart. The blue stamp from Benin in Africa portrays a baby and many fruits and vegetables and was issued in honor of an International Conference on Nutrition. The colorful Solomon Islands stamp also highlights healthy fruits and vegetables. The 2001 Mexican stamp cleverly portrays a partly eaten apple as a world map and states "World Hunger Day, Fighting Hunger to Combat Poverty."

10.3928/0090-4481-20040101-03

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