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      Childhood and Adolescent Obesity in the United States: A Public Health Concern

      review-article
      , PhD 1 , , MBBS, MPH 2 , , MD, PhD 3 , , MD 3 , , MD 3
      Global Pediatric Health
      SAGE Publications
      obesity, childhood, adolescents, United States, body mass index, BMI

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          Abstract

          Childhood and adolescent obesity have reached epidemic levels in the United States. Currently, about 17% of US children are presenting with obesity. Obesity can affect all aspects of the children including their psychological as well as cardiovascular health; also, their overall physical health is affected. The association between obesity and other conditions makes it a public health concern for children and adolescents. Due to the increase in the prevalence of obesity among children, a variety of research studies have been conducted to discover what associations and risk factors increase the probability that a child will present with obesity. While a complete picture of all the risk factors associated with obesity remains elusive, the combination of diet, exercise, physiological factors, and psychological factors is important in the control and prevention of childhood obesity; thus, all researchers agree that prevention is the key strategy for controlling the current problem. Primary prevention methods are aimed at educating the child and family, as well as encouraging appropriate diet and exercise from a young age through adulthood, while secondary prevention is targeted at lessening the effect of childhood obesity to prevent the child from continuing the unhealthy habits and obesity into adulthood. A combination of both primary and secondary prevention is necessary to achieve the best results. This review article highlights the health implications including physiological and psychological factors comorbidities, as well as the epidemiology, risk factors, prevention, and control of childhood and adolescent obesity in the United States.

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          Most cited references41

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          Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association.

          Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing. Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behavior-based treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks.
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            Why Have Americans Become More Obese?

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              Perinatal risk factors for childhood obesity and metabolic dysregulation.

              Childhood obesity has increased significantly in recent decades. The objective was to examine the perinatal risk factors related to childhood obesity. In a prospective study, 89 women with normal glucose tolerance (NGT) or gestational diabetes mellitus (GDM) and their offspring were evaluated at birth and at 8.8 +/- 1.8 y. At birth, obstetrical data, parental anthropometric measures, and neonatal body composition were assessed; at follow-up, diet and activity were assessed and laboratory studies were conducted. Weight was classified by using weight for age and sex, and body composition was measured by using dual-energy X-ray absorptiometry. In childhood, data were analyzed as tertiles and prediction models were developed by using logistic and stepwise regression. No significant differences in Centers for Disease Control and Prevention weight percentiles, body composition, and most metabolic measures were observed between children of mothers with NGT and GDM at follow-up. Children in the upper tertile for weight had greater energy intake (P = 0.02), skinfold thickness (P = 0.0001), and leptin concentrations (P 30 (odds ratio: 3.75; 95% CI: 1.39, 10.10; P = 0.009) and for percentage body fat was maternal pregravid BMI >30 (odds ratio: 5.45; 95% CI: 1.62, 18.41; P = 0.006). Maternal pregravid BMI, independent of maternal glucose status or birth weight, was the strongest predictor of childhood obesity.
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                Author and article information

                Journal
                Glob Pediatr Health
                Glob Pediatr Health
                GPH
                spgph
                Global Pediatric Health
                SAGE Publications (Sage CA: Los Angeles, CA )
                2333-794X
                1 December 2019
                2019
                : 6
                : 2333794X19891305
                Affiliations
                [1 ]Federal Ministry of Health, Abuja, Nigeria
                [2 ]Essex County College, Newark, NJ, USA
                [3 ]Saint James School of Medicine, Anguilla, British West Indies
                Author notes
                [*]Adekunle Sanyaolu, Federal Ministry of Health, Federal Capital Territory, Abuja, Nigeria. Email: sanyakunle@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0002-6265-665X
                Article
                10.1177_2333794X19891305
                10.1177/2333794X19891305
                6887808
                31832491
                555245fc-eb7f-41b1-8b0f-fd9fa66c1048
                © The Author(s) 2019

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 12 February 2019
                : 12 October 2019
                : 6 November 2019
                Categories
                Review Article
                Custom metadata
                January-December 2019

                obesity,childhood,adolescents,united states,body mass index,bmi
                obesity, childhood, adolescents, united states, body mass index, bmi

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