The Epidemic of

Childhood Obesity in
the United States:
Michelle D. Kelly
Old Before Their
Time
 References

• Discrimination and Health pp.36-75. Kreiger, N., in Social Epidemiology,

2008. Berkman, L., and Kawachi, I., Eds.
• Gene-Diet Interactions in Childhood Obesity. Papoutsakis, C. and
Dedoussis, D. World Health Organization, Geneva, Switzerland, 2006.
• The integrative role of the CNS fuel sensing mechanisms in energy balance
and glucose regulation. Sandoval, D., Cota, D., and Seely RJ. Annu Rev
Physiol. 2008; 70:513-35.
• Management approaches for pediatric obesity. Miller, J. & Silverstein, J.
Nature Clinical Practice Endocrinology & Metabolism 2007. 3, 810-81
• Mechanisms linking obesity to insulin resistance and type 2 diabetes.
Kahn, S., Hull, R., and Utzschneider, K. Nature. 2006, vol 444, 840-845
• The Association of Television and Video Viewing with Fast Food Intake by
Preschool-Age Children. Taveras, E., Sandora, T., Shih, M., Ross-Degnan,
D., Goldman, D., and Gillman, M. Obesity (2006) 14, 2034–2041.
• Childhood and Adolesecent Obesity: Prevalence and Significance. Styne,
D.
The Pediatric Clinics of North America, 2001. Available online 15 July
2005.
• Treatment of impaired glucose tolerance in childhood. Caprio, S. Nature
Clinical Practice Endocrinology & Metabolism (2008) 4, 320-321.
 Emerging literature
• epidemic of childhood obesity relatively
new phenomena

• # childhood onset cases of DM type 2

increase

• environment & genetics blamed

• US: 9 million overweight children

of which 4.5 million are obese
all are likely to become overweight adults
 Cause and effect in Childhood
Obesity: Solution for a
National Epidemic.

Wieting, J. 2008.
Journal
American Osteopath
Association;
108(10) 544-552.

Increased risk of preventable and

chronic health issues
Obesity is diabetes in the making

Born in the USA- year 2000

1 in 3
30% of boys
40% of girls
 (Styne, 2005)

Children predicted to have shorter life

spans than their parents
 Race & societal factors
Risk of overweight
Native American 39%
African American 24%
Hispanic 24%
Urban
access to grocery store
safe play space
(Kreiger, 2008)
 stigma

Isolation
Depression
Poor self esteem

(Taveras,
Lower quality of life Sandora, Shih,
Ross-Degnan,
Goldman, &
Gillman, 2006)
 physical inactivity
Nintendo…..

PE
Walking
Playing
Sports
 mass media

5 minutes of TV =
One food commercial

5 h /day = 40,000/yr
 Advocacy
Regulate
Helmets
Car seats
 Assessment 2007
• Annual BMI
• Dietary patterns
• Level of (in)activity
• FH
• obesity, DM, CVD,
• early mortality heart disease or stroke
• Physical exam
Expert Committee on the Assessment,
Prevention & Treatment of Child &
Adolescent Overweight and Obesity, 2009
Practice
Recommendation:
Screen for Pediatric Obesity

• Pulse

• Blood pressure

• Fasting lipid profile

• overwt w/o risk factors

• Overwt with risk factors

• AST-ALT
• Fasting glucose (Miller &
• Obese - BUN, creatinine Silverstein,
2008)