Childhood and adolescent overweight and obesity are an epidemic problem in the United States. Studies show that approximately one third of youth are overweight or obese, representing a tripling since the 1960s and 1970s. The average male and female adult in the United States has gained 25 lbs and 24 lbs, respectively, since 1962. The body mass index of the average adult has increased from 25 to 28. Among youth, the average body mass index has increased from 21.3 to 24.1 since 1963. This increase in bodyweight among adults and youth is partially due to the decreased levels of physical activity. The economic and health consequences of this epidemic are enormous. Type 2 diabetes mellitus, a disease that was rare among youth 20 to 30 years ago, now represents as many as 45% of all cases of diabetes among youth. Cardiovascular risk factors are worsened in overweight and obese youth, and early evidence of atherosclerosis manifested by endothelial dysfunction and increased coronary artery calcium is present in a high percentage of overweight youth. Numerous psychosocial problems also are increased among overweight and obese youth. However, there are numerous examples in the scientific literature of successful approaches to the prevention and management of overweight and obesity in youth. This article summarizes statistics concerning the prevalence of overweight, obesity, and physical inactivity among youth; discusses the numerous physical and psychosocial consequences of overweight and obesity among youth; and presents information regarding interventions that have been demonstrated to be effective in preventing childhood and adolescent overweight and obesity.
Ogden CL, Carrol MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999-2004 . JAMA.2006;295:1549-1555.
2.
Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in among US adults, 1999-2000. JAMA.288;288:1723-1727.
3.
Lissau I., Overpeck MD, Ruan WJ, et al. Body mass index and overweight in 13 European countries, Israel, and the United States. Arch Pediatric Adolesc Med.2004;158:27-33.
4.
Ogden CL, Fryar CD, Carroll MD, et al. Mean body weight, height, and body mass index, United States 1960—2002. Advance Data. 2004;347:1-18.
5.
Olshansky SJ , Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. New Engl J Med.2005;352:1138-1145.
6.
Tsai WS, Inge TH, Burd RSBariatric surgery in adolescents. Arch Pediatr Adolesc Med.2007;11:217-221.
7.
National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health.Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS). NIH News. Available at: http://nih.gov/news/pr/apr2007/niddk-16.htm . Accessed September 7, 2007.
8.
Finkelstein EA , Fiebelkorn IC, Wang G.National medical spending attributable to overweight and obesity: how much and who's paying. Health Affairs.2003;W3:219-226.
9.
Flegal KM, Graubard BI, Williamson DF, et al. Excess deaths associated with underweight, overweight, and obesity . JAMA.2005;293:1861-1867.
10.
Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA.2004;291:1238-1245.
11.
Centers for Disease Control and Prevention.Youth Risk Behavior Surveillance System. Available at: http://www.cdc.gov/HealthyYouth/yrbs/index.htm. Accessed September 7, 2007.
12.
Kimm SY, Glynn NW, Kriska AM, et al. Decline in physical activity in black girls and white girls during adolescence. N Engl J Med.2002;347:709-715.
13.
Duke J., Huhman M., Heitzler C.Physical activity levels among children aged 9-13 years in the United States, 2002. Morb Mortal Wkly Rep.2003;290:1308-1309.
14.
Reilly JJ, Jackson DM, Montgomery C., et al. Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. Lancet. 2004;363:211-212.
15.
Pate RR, Pfeiffer KA, Stewart G.Physical activity among children attending pre-schools. Pediatrics . 2004;114:1258-1263.
16.
Finn K., Johannsen N., Specker B.Factors associated with physical activity in preschool children. J Pediatr.2002;140:81-85.
17.
National Association for Sport and Physical Education.Active Start: A Statement of Physical Activity Guidelines for Children Birth to Five Years. Reston, Va : National Association for Sport and Physical Education Publications; 2002.
18.
Martin SL, Lee SM, Lowry R.National prevalence and correlates of walking and bicycling to school . Am J Prev Med.2007;33:98-105.
19.
Martin S., Carlson S.Barriers to children walking to and from school. Morb Mortal Wkly Rep. 2004;54:949-952.
20.
The Thunderhead Alliance.New report links decline in bicycling and walking to nation's obesity epidemic . Available at: http://www.thunderheadalliance.org/doc/Benchmarking%20Press%20Release%208.28.07.doc. Accessed September 9, 2007.
21.
Cook S., Weitzman M., Auinger P., et al. Prevalence of a metabolic syndrome phe notype in adolescents: findings from the third National Health and Nutrition Examination Survey. Arch Pediatr Adolesc Med.2003;157:821-827.
22.
Pinhas-Hamiel O., Dolan LM, Daniels SR, et al. Increased incidence of non-insulin-dependent diabetes among adolescents. J Pediatr.1996 ;128:608-615.
23.
Dietz WHOverweight in childhood and adolescence. N Engl J Med.2004;350:855-857.
24.
The Writing Group for the SEARCH for Diabetes in Youth Study Group.Incidence of diabetes in youth in the United States. JAMA.2007;297:2716-2724.
25.
Lauer RM, Clarke WRChildhood risk factors for high adult blood pressure: the Muscatine Study . Pediatrics. 1989;84:633-641.
26.
Freedman DS , Khan LK, Dietz WH, et al. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Study. Pediatrics. 2001;108:712-718.
27.
Munter P., He J., Cutler JA, et al. Trends in blood pressure among children and adolescents. JAMA.2004;291:2107-2113.
28.
Berenson GS , Srinivasan SR, Bao W., et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa Heart Study. N Engl J Med.1998;338:1650-1656.
29.
Mahoney LT, Burns TL, Stanford W., et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol.1996;27:277-284.
30.
McGill HC Jr, McMahan CA, Malcom GT, et al. Relation of glycohemoglobin and adiposity to atherosclerosis in youth: Pathobiological Determinants of Atherosclerosis in Youth (PDAY). Arterioscler Thromb Vasc Biol. 1995;15:431-440.
31.
van Dam RN, Willet WC, Manson JE, et al. The relationship between overweight in adolescents and premature death in women. Ann Intern Med.2006;154:91-97.
32.
Field AE, Cook NR, Gillman MWWeight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res.2005;13:163-169.
33.
Reaven PD, Trausstadottir T., Brennan J., et al. Cardiovascular risk factors associated with insulin resistance in children persist into late adolescence. Diabetes Care. 2005;28:148-150.
34.
Goodman E., Dolan LM, Morrison JA, et al. Factor analysis of clustered cardiovascular risk in adolescence: obesity is the predominant correlate of risk among youth. Circulation. 2005;111:1970-1977.
35.
Lawlor DA, Leon DAAssociation of body mass index and obesity measured in early childhood with risk of coronary heart disease and stroke in middle age. Circulation.2005;111:1891-1896.
36.
Stettler N., Stallings VA, Troxel AB, et al. Weight gain in first week of life and overweight in adulthood . Circulation. 2005;111:1897-1903.
37.
Klein DJ, Aronson-Friedman L., Harlan WR, et al. Obesity and the development of insulin resistance and impaired fasting glucose in black and white adolescent girls. Diabetes Care. 2004;27:378-383.
38.
Jeffreys M. , Davey-Smith G., Martin RM, et al. Childhood body mass index and later cancer risk: a 50-year follow-up of the Boyd Orr Study . Int J Cancer. 2004;112:348-351.
39.
Xiangrong L. , Shengxu L., Ulusoy E., et al. Childhood adiposity as a predictor of cardiac mass in adulthood: the Bogalusa Heart Study. Circulation . 2004;110:3488-3492.
40.
Pavkov ME, Bennett PH, Knowler WC, et al. Effect of youth-onset type 2 diabetes mellitus on incidence of end-stage renal disease and mortality in young and middle-aged Pima Indians . JAMA.2006;296:421-426.
41.
Juonala M., Jarvisalo MJ, Maki-Torkko N., et al. Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation. 2005;112:1486-1493.
42.
Sinaiko AR, Steinberger J., Moran A., et al. Relation of body mass index and insulin resistance to cardiovascular risk factors, inflammatory factors, and oxidative stress during adolescence . Circulation. 2005;111:1985-1991.
43.
Snitker S., Le KY, Hager E., et al. Association of physical activity and body composition with insulin sensitivity in a community sample of adolescents. Arch Pediatr Adolesc Med.2007;161:667-683.
Pine DS, Goldstein RB, Wolk S., et al. The association between childhood depression and adult body mass index. Pediatrics. 2001;107:1049-1056.
46.
Crosnoe R.Gender, obesity, and education. Sociol Educ.2007;80:241-260.
47.
Herbst A., Bachran R., Kapellan T., et al. Effects of regular physical activity on control of glycemia in pediatric patients with type 1 DM. Arch Pediatr Adolesc Med.2006;160:573-577.
48.
Ferreira I., Twisk JWR, van Mechelen W., et al. Development of fatness, fitness, and lifestyle from adolescence to the age of 36 years. Arch Intern Med.2005 ;165:142-148.
49.
Eisenmann JC , Wickel EE, Welk GJ, et al. Relationship between adolescent fitness and fatness and cardiovascular disease risk factors in adulthood: the Aerobics Center Longitudinal Study (ACLS). Am Heart J.2005;149:46-53.
50.
Nassis GP, Psarra G., Sidossis LSCentral and total obesity are lower in overweight and obese children with a high cardiorespiratory fitness and this may reduce the hazards of obesity in children. Euro J Clin Nutr.2005;59:137-141.
51.
Parker Ed , Schmitz KH, Jacobs DR, et al. Regular physical activity in young adults is associated with a 15% reduction in the development of hypertension over a 15 year period. Am J Public Health.2007;97:703-709.
52.
Carnethon MR , Loria CA, Hill JO, et al. Risk factors for the metabolic syndrome: the Coronary Risk Development in Young Adults (CARDIA) study, 1985-2001. Diabetes Care.2004;27:2707-2715.
53.
Savoye M., Shaw M., Dziura J., et al. Effects of a weight management program on body composition and metabolic parameters in overweight children. JAMA.2007;297:2697-2704.
54.
Austin SB, Kim J., Wiecha J., et al. Weight-control behaviors in early adolescent girls: school-based overweight preventive intervention lowers incidence of disordered. Arch Pediatr Adolesc Med.2007;161:865-869.
55.
Watts K., Beye P., Siafarikas A., et al. Effects of exercise training on vascular function in obese children . J Pediatr.2004;144:620-627.
56.
Watts K., Beye P., Siafarikas A., et al. Exercise training normalizes vascular dysfunction and improves central adiposity in obese adolescents. J Am Coll Cardiol.2004;43:1823-1829.
57.
Ribeiro MM, Silva AG, Santos NS, et al. Diet and exercise training restore blood pressure and vasodilatory responses during physiological maneuvers in obese children. Circulation. 2005;111:1915-1923.
58.
Gutin B., Barbeau P., Owens S., et al. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. Am J Clin Nutr.2002;75:818-826.
59.
Shaibi GQ, Cruz ML, Ball GD, et al. Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Med Sci Sports Exer. 2006;38:1208-1215.
60.
Klijn PHC , van der Baan-Slootweg OH, van Stel HFAerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test. BMC Pediatr.2007;7:17.
61.
Faigenbaum AD, McFarland JE, Johnson L., et al. Preliminary evaluation of an after-school resistance training program for improving physical fitness in middle school-age boys. Percept Mot Skills. 2007;104:407-415.
62.
Faigenbaum AD, Kraemer WJ, Cahill B., et al. Youth resistance training: position statement paper and literature review. Strength Conditioning J.1996;12:62-75.
63.
Goldfield GS , Mallory R., Parker T., et al. Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children . J Pediatr Psychol. 2007;32:783-793.
64.
Franks A., Kelder SH, Dino GASchool-based programs: lessons learned from CATCH, Planet Health, and Not-On-Tobacco. PrevChronic Dis. 2007;4: A33-A40.
65.
Committee on Nutrition.Prevention of pediatric overweight and obesity. Pediatrics . 2003;112:424-430.
66.
Institute of Medicine.Preventing childhood obesity: health in the balance. Available at: http://books.nap.edu/catalog/11015.html. Accessed September 15, 2007.
67.
Pate RR, Davis MG, Robinson TNPromoting physical activity in children and youth: a leadership role for schools . Circulation. 2006;114:1214-1224.
68.
Weiss MRMotivating kids in physical activity. President's Council on Physical Fitness and Sports. ResDigest. 2000;3(11):1-8.
69.
Corbin CB, Pangrazi RPPhysical Activity for Children: A Statement of Guidelines for Children Ages 5-12. 2nd ed. Reston, VA : National Association for Sports and Physical Education ; 2004. Available at: http://www.aahperd.org/naspe/template.cfm?template=ns_children.html.
