viernes, 16 de octubre de 2009

Childhood Obesity

Morbid or extreme obesity is no longer a disease seen only in adults. Extreme obesity is increasingly affecting children as well. A single BMI measure does not accurately define obesity in children and adolescents since height increases during the pre-teenage and into the mid-teenage years. Instead, BMI is indexed to age and presented as a percentile to determine obesity in children and adolescents. A BMI for age ≥ 95th percentile indicates obesity in pediatric populations while a BMI for age ≥ 99th percentile is deemed “extreme” or morbid obesity; this percentile curve tracks toward BMI values of 35-40 kg/m2 in young adulthood. Four percent of all children and adolescents are considered extremely obese when using this definition, which is interesting, as extreme obesity similarly prevalent in adults. More striking is the fact that nearly 60% of the extremely obese children in the United States have two cardiovascular risk factors. When these same children reach their 30s, their BMI will often average around 43 kg/m2. Bottom line, extreme childhood obesity is directly linked to health problems during childhood and leads to extreme obesity in adulthood.
How did this happen?
Simple answer: Energy in (consumed/ingested) must equal energy out. The more thorough answer however, is far more interesting. During periods of famine our early ancestors depended on formidable physiologic processes to inhibit weight loss. Storing excess fat is one of these protective mechanisms utilized when food was scarce. Now that food production processes have been developed, most industrialized countries do not have the same food scarcity problems our ancestors once had. These same manufacturing processes that have increased food shelf life and increased the amount of food available to us, also remove healthy nutrients such as fiber and leave the tasty salts, sugars, and fats in place. To summarize, with less physical activity required in everyday life due to technological advances and food shortages no longer an an issue, energy imbalances accumulate day after day.

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