title: Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion.
abstract: OBJECTIVE
  Our objective was to formulate practice guidelines for the treatment and prevention of pediatric obesity.
  
  
  CONCLUSIONS
  We recommend defining overweight as body mass index (BMI) in at least the 85th percentile but < the 95th percentile and obesity as BMI in at least the 95th percentile against routine endocrine studies unless the height velocity is attenuated or inappropriate for the family background or stage of puberty; referring patients to a geneticist if there is evidence of a genetic syndrome; evaluating for obesity-associated comorbidities in children with BMI in at least the 85th percentile; and prescribing and supporting intensive lifestyle (dietary, physical activity, and behavioral) modification as the prerequisite for any treatment. We suggest that pharmacotherapy (in combination with lifestyle modification) be considered in: 1) obese children only after failure of a formal program of intensive lifestyle modification; and 2) overweight children only if severe comorbidities persist despite intensive lifestyle modification, particularly in children with a strong family history of type 2 diabetes or premature cardiovascular disease. Pharmacotherapy should be provided only by clinicians who are experienced in the use of antiobesity agents and aware of the potential for adverse reactions. We suggest bariatric surgery for adolescents with BMI above 50 kg/m(2), or BMI above 40 kg/m(2) with severe comorbidities in whom lifestyle modifications and/or pharmacotherapy have failed. Candidates for surgery and their families must be psychologically stable and capable of adhering to lifestyle modifications. Access to experienced surgeons and sophisticated multidisciplinary teams who assess the benefits and risks of surgery is obligatory. We emphasize the prevention of obesity by recommending breast-feeding of infants for at least 6 months and advocating that schools provide for 60 min of moderate to vigorous daily exercise in all grades. We suggest that clinicians educate children and parents through anticipatory guidance about healthy dietary and activity habits, and we advocate for restricting the availability of unhealthy food choices in schools, policies to ban advertising unhealthy food choices to children, and community redesign to maximize opportunities for safe walking and bike riding to school, athletic activities, and neighborhood shopping.
authors.affiliation: George Washington University School of Medicine, Washington, D.C. 20037, USA.
authors.forename: Gilbert P
authors.initials: GP
authors.lastname: August
authors.forename: Sonia
authors.initials: S
authors.lastname: Caprio
authors.forename: Ilene
authors.initials: I
authors.lastname: Fennoy
authors.forename: Michael
authors.initials: M
authors.lastname: Freemark
authors.forename: Francine R
authors.initials: FR
authors.lastname: Kaufman
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lustig
authors.forename: Janet H
authors.initials: JH
authors.lastname: Silverstein
authors.forename: Phyllis W
authors.initials: PW
authors.lastname: Speiser
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Styne
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D050110:Bariatric Surgery; D015992:Body Mass Index; D004032:Diet; D019317:Evidence-Based Medicine; D008019:Life Style; D009043:Motor Activity; D009765:Obesity / Q000175:diagnosis / Q000517:prevention & control; D011248:Pregnancy Complications / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy / Q000517:prevention & control; D012944:Social Support
chemical_list: D019440:Anti-Obesity Agents
references.citation: J Pediatr. 2007 Jan;150(1):12-17.e2
references.pmid: 17188605
references.citation: Pediatrics. 2006 Nov;118(5):e1303-10
references.pmid: 17079531
references.citation: Pediatrics. 2001 Apr;107(4):E55
references.pmid: 11335776
references.citation: Int J Obes Relat Metab Disord. 1999 Dec;23(12):1314-9
references.pmid: 10643690
references.citation: Pediatrics. 2006 Nov;118(5):e1516-22
references.pmid: 17015494
references.citation: MMWR Morb Mortal Wkly Rep. 2005 Sep 30;54(38):949-52
references.pmid: 16195692
references.citation: Eur J Appl Physiol. 2000 Jan;81(1-2):132-9
references.pmid: 10552278
references.citation: Arch Pediatr Adolesc Med. 2008 Jan;162(1):29-33
references.pmid: 18180409
references.citation: J Pediatr. 2005 Apr;146(4):482-8
references.pmid: 15812450
references.citation: J Clin Endocrinol Metab. 2003 Jun;88(6):2586-92
references.pmid: 12788859
references.citation: Am J Clin Nutr. 2001 Nov;74(5):579-84
references.pmid: 11684524
references.citation: JAMA. 2005 Apr 20;293(15):1861-7
references.pmid: 15840860
references.citation: Obes Surg. 2002 Apr;12 Suppl 1:12S-16S
references.pmid: 11969102
references.citation: Int J Obes Relat Metab Disord. 2001 Mar;25(3):325-31
references.pmid: 11319628
references.citation: Pediatrics. 2004 Aug;114(2):e198-205
references.pmid: 15286257
references.citation: Pediatrics. 2006 Jun;117(6):2047-54
references.pmid: 16740847
references.citation: Pediatrics. 2005 Sep;116(3):e389-92
references.pmid: 16140683
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S254-88
references.pmid: 18055654
references.citation: J Clin Endocrinol Metab. 2005 Mar;90(3):1460-5
references.pmid: 15613431
references.citation: Am J Clin Nutr. 1998 Apr;67(4):748S-756S
references.pmid: 9537624
references.citation: Am J Physiol Endocrinol Metab. 2005 Mar;288(3):E617-24
references.pmid: 15536205
references.citation: Pediatr Clin North Am. 2001 Aug;48(4):1041-53
references.pmid: 11494637
references.citation: Am J Clin Nutr. 1999 Jul;70(1):123S-5S
references.pmid: 10419414
references.citation: J Pediatr. 2001 Apr;138(4):474-80
references.pmid: 11295708
references.citation: Obesity (Silver Spring). 2006 Apr;14(4):710-6
references.pmid: 16741274
references.citation: Pediatrics. 2007 Jul;120(1):e112-9
references.pmid: 17606538
references.citation: J Pediatr Surg. 2006 Jan;41(1):137-43; discussion 137-43
references.pmid: 16410123
references.citation: Am J Public Health. 1999 Oct;89(10):1529-35
references.pmid: 10511835
references.citation: Lancet. 2006 Jul 22;368(9532):299-304
references.pmid: 16860699
references.citation: N Engl J Med. 2005 May 19;352(20):2100-9
references.pmid: 15901863
references.citation: J Pediatr. 2002 Mar;140(3):340-7
references.pmid: 11953733
references.citation: Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
references.pmid: 15286277
references.citation: J Clin Endocrinol Metab. 2004 Oct;89(10):4821-6
references.pmid: 15472169
references.citation: Arch Dis Child. 2008 Apr;93(4):341-5
references.pmid: 18089632
references.citation: Prev Med. 2006 Sep;43(3):212-7
references.pmid: 16712912
references.citation: Am J Psychiatry. 2002 Apr;159(4):655-7
references.pmid: 11925306
references.citation: Curr Gastroenterol Rep. 2002 Jun;4(3):244-50
references.pmid: 12010626
references.citation: J Pediatr. 2006 Feb;148(2):183-7
references.pmid: 16492426
references.citation: Int J Obes (Lond). 2006 Feb;30(2):331-41
references.pmid: 16158082
references.citation: Int J Sports Med. 1996 Jan;17(1):1-6
references.pmid: 8775568
references.citation: Int J Obes Relat Metab Disord. 2004 Nov;28(11):1399-410
references.pmid: 15486569
references.citation: Obes Res. 2005 Feb;13(2):274-82
references.pmid: 15800284
references.citation: Pediatrics. 2005 Apr;115(4):e443-9
references.pmid: 15805347
references.citation: Am J Clin Nutr. 1999 Jul;70(1):137S-144S
references.pmid: 10393161
references.citation: JAMA. 1999 Oct 27;282(16):1561-7
references.pmid: 10546696
references.citation: Am J Prev Med. 2007 Jul;33(1):34-40
references.pmid: 17572309
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S193-228
references.pmid: 18055652
references.citation: Prev Med. 2005 Jun;40(6):769-78
references.pmid: 15850878
references.citation: Am J Clin Nutr. 2003 Feb;77(2):379-84
references.pmid: 12540397
references.citation: J Clin Invest. 2002 Oct;110(8):1093-103
references.pmid: 12393845
references.citation: J Clin Hypertens (Greenwich). 2001 Nov-Dec;3(6):362-7
references.pmid: 11723358
references.citation: BMJ. 2004 May 22;328(7450):1237
references.pmid: 15107313
references.citation: J Pediatr. 2005 Apr;146(4):559-64
references.pmid: 15812467
references.citation: Med Sci Sports Exerc. 1996 Jan;28(1):19-23
references.pmid: 8775350
references.citation: Vital Health Stat 11. 2002 May;(246):1-190
references.pmid: 12043359
references.citation: Pediatrics. 2006 Oct;118(4):1510-8
references.pmid: 17015542
references.citation: Arch Dis Child. 2003 Sep;88(9):748-52
references.pmid: 12937090
references.citation: Pediatrics. 2007 Sep;120(3):576-83
references.pmid: 17766531
references.citation: J Sch Health. 1982 Nov;52(9):529-34
references.pmid: 6925099
references.citation: Ann Intern Med. 2003 Dec 2;139(11):930-2
references.pmid: 14644896
references.citation: J Pediatr. 2006 Jun;148(6):788-792
references.pmid: 16769388
references.citation: Diabetes Care. 2006 Nov;29(11):2427-32
references.pmid: 17065679
references.citation: Pediatrics. 2004 Jul;114(1):217-23
references.pmid: 15231931
references.citation: Obes Res. 2001 Oct;9(10):599-604
references.pmid: 11595776
references.citation: J Pediatr. 1999 Aug;135(2 Pt 1):162-8
references.pmid: 10431109
references.citation: Am J Clin Nutr. 1992 Mar;55(3):645-51
references.pmid: 1550038
references.citation: J Clin Endocrinol Metab. 2008 Mar;93(3):666-73
references.pmid: 18171699
references.citation: Public Health Nutr. 2000 Mar;3(1):31-8
references.pmid: 10786721
references.citation: Pediatrics. 2006 Sep;118(3):e594-601
references.pmid: 16950951
references.citation: Int J Dermatol. 2007 Nov;46(11):1155-9
references.pmid: 17988334
references.citation: Int J Obes Relat Metab Disord. 2000 Nov;24(11):1453-8
references.pmid: 11126342
references.citation: Endocrinol Metab Clin North Am. 2003 Dec;32(4):787-804, viii
references.pmid: 14711062
references.citation: JAMA. 2001 May 16;285(19):2453-60
references.pmid: 11368697
references.citation: Endocrinology. 1999 Aug;140(8):3790-6
references.pmid: 10433240
references.citation: N Engl J Med. 1999 Sep 16;341(12):879-84
references.pmid: 10486419
references.citation: JAMA. 2004 Jun 16;291(23):2847-50
references.pmid: 15199035
references.citation: Pediatrics. 2003 Aug;112(2):424-30
references.pmid: 12897303
references.citation: JAMA. 2007 Oct 10;298(14):1661-73
references.pmid: 17925518
references.citation: J Pediatr. 2001 Apr;138(4):481-5
references.pmid: 11295709
references.citation: Circulation. 2006 Sep 5;114(10):1056-62
references.pmid: 16940191
references.citation: Am J Clin Nutr. 2003 Nov;78(5):1030-8
references.pmid: 14594792
references.citation: Am J Prev Med. 2003 Apr;24(3):209-17
references.pmid: 12657338
references.citation: J Adolesc Health. 1997 Jan;20(1):27-37
references.pmid: 9007656
references.citation: Obes Res. 1999 Mar;7(2):189-98
references.pmid: 10102256
references.citation: N Engl J Med. 1997 Sep 25;337(13):869-73
references.pmid: 9302300
references.citation: Am J Clin Nutr. 2002 Sep;76(3):497-8
references.pmid: 12197989
references.citation: Horm Res. 1998;49(1):17-21
references.pmid: 9438780
references.citation: Curr Diab Rep. 2001 Aug;1(1):19-27
references.pmid: 12762953
references.citation: J Clin Endocrinol Metab. 2007 Feb;92(2):517-22
references.pmid: 17105842
references.citation: Diabetes Care. 2007 Feb;30(2):395-402
references.pmid: 17259519
references.citation: Pediatrics. 2004 Mar;113(3 Pt 1):475-82
references.pmid: 14993537
references.citation: Pediatrics. 2006 Jun;117(6):2065-73
references.pmid: 16740849
references.citation: J Am Diet Assoc. 2005 Mar;105(3):364-70
references.pmid: 15746823
references.citation: Am J Clin Nutr. 2005 Jul;82(1 Suppl):265S-273S
references.pmid: 16002835
references.citation: J Pediatr. 2004 Jan;144(1):47-55
references.pmid: 14722518
references.citation: JAMA. 2006 Apr 5;295(13):1549-55
references.pmid: 16595758
references.citation: Prev Med. 2003 Mar;36(3):309-19
references.pmid: 12634022
references.citation: JAMA. 2005 Jun 15;293(23):2873-83
references.pmid: 15956632
references.citation: Diabetes Care. 2006 Jul;29(7):1689-92; discussion 1693-6
references.pmid: 16801603
references.citation: Am J Clin Nutr. 2006 Jan;83(1):3-4
references.pmid: 16400041
references.citation: Diabetes Care. 1999 Feb;22(2):345-54
references.pmid: 10333956
references.citation: Am J Public Health. 1997 Aug;87(8):1328-34
references.pmid: 9279269
references.citation: Obes Res. 2003 Feb;11(2):170-5
references.pmid: 12582210
references.citation: Pediatrics. 2004 Aug;114(2):e154-9
references.pmid: 15286251
references.citation: J Am Diet Assoc. 1990 Feb;90(2):214-20
references.pmid: 2303658
references.citation: N Engl J Med. 2004 Jun 3;350(23):2362-74
references.pmid: 15175438
references.citation: N Engl J Med. 1998 Jun 4;338(23):1650-6
references.pmid: 9614255
references.citation: Kidney Int. 2001 Apr;59(4):1498-509
references.pmid: 11260414
references.citation: J Pediatr. 2006 Feb;148(2):188-94
references.pmid: 16492427
references.citation: J Pediatr. 2006 Feb;148(2):195-200
references.pmid: 16492428
references.citation: Int J Obes (Lond). 2006 Apr;30(4):579-89
references.pmid: 16570086
references.citation: Am J Respir Crit Care Med. 2002 May 1;165(9):1217-39
references.pmid: 11991871
references.citation: Circulation. 2006 Sep 12;114(11):1214-24
references.pmid: 16908770
references.citation: J Clin Endocrinol Metab. 2004 Feb;89(2):520-4
references.pmid: 14764756
references.citation: Can Med Assoc J. 1983 Mar 1;128(5):525-30
references.pmid: 6337692
references.citation: Am J Med Sci. 1995 Dec;310 Suppl 1:S91-100
references.pmid: 7503133
references.citation: Am J Epidemiol. 2005 Sep 1;162(5):397-403
references.pmid: 16076830
references.citation: Epidemiology. 2005 Mar;16(2):247-53
references.pmid: 15703541
references.citation: Rev Endocr Metab Disord. 2001 Oct;2(4):371-83
references.pmid: 11725724
references.citation: JAMA. 2003 Apr 9;289(14):1805-12
references.pmid: 12684359
references.citation: Circulation. 2007 Apr 24;115(16):2089-90
references.pmid: 17452616
references.citation: J Clin Endocrinol Metab. 2002 Apr;87(4):1581-5
references.pmid: 11932286
references.citation: Am J Clin Nutr. 2002 Sep;76(3):653-8
references.pmid: 12198014
references.citation: JAMA. 2007 Oct 10;298(14):1695-6
references.pmid: 17925525
references.citation: J Am Diet Assoc. 2001 Jul;101(7):798-802
references.pmid: 11478479
references.citation: Prev Med. 1998 Nov-Dec;27(6):879-90
references.pmid: 9922071
references.citation: Arch Intern Med. 2006 Feb 13;166(3):285-93
references.pmid: 16476868
references.citation: JAMA. 1996 Mar 13;275(10):768-76
references.pmid: 8598593
references.citation: Endocr Rev. 2000 Dec;21(6):671-96
references.pmid: 11133068
references.citation: Int J Obes (Lond). 2006 Jan;30(1):23-30
references.pmid: 16344845
references.citation: J Adolesc Health. 1996 Jan;18(1):27-34
references.pmid: 8750425
references.citation: Health Psychol. 2007 Sep;26(5):521-32
references.pmid: 17845100
references.citation: Obes Res. 2002 Aug;10(8):838-40
references.pmid: 12181394
references.citation: Am J Clin Nutr. 1994 Jul;60(1):15-22
references.pmid: 8017331
references.citation: Percept Mot Skills. 1999 Aug;89(1):245-8
references.pmid: 10544425
references.citation: J Nutr Educ Behav. 2002 May-Jun;34(3):140-50
references.pmid: 12047838
references.citation: Endocrinol Metab Clin North Am. 1996 Sep;25(3):649-63
references.pmid: 8879991
references.citation: Arch Pediatr Adolesc Med. 2005 Aug;159(8):740-4
references.pmid: 16061781
references.citation: Med Sci Sports Exerc. 1999 Jan;31(1):143-8
references.pmid: 9927022
references.citation: Can J Public Health. 1995 Jan-Feb;86(1):62-5
references.pmid: 7728720
references.citation: Circulation. 2007 Apr 24;115(16):2111-8
references.pmid: 17420343
references.citation: Obes Res. 1996 May;4(3):229-43
references.pmid: 8732957
references.citation: Ann Epidemiol. 2002 Feb;12(2):131-40
references.pmid: 11880221
references.citation: Pediatrics. 2006 Oct;118(4):1388-93
references.pmid: 17015527
references.citation: Arch Pediatr Adolesc Med. 2006 Jan;160(1):25-31
references.pmid: 16389207
references.citation: Pediatrics. 2002 Nov;110(5):903-10
references.pmid: 12415028
references.citation: Ann Intern Med. 2005 Apr 5;142(7):547-59
references.pmid: 15809466
references.citation: Pediatrics. 2006 Mar;117(3):673-80
references.pmid: 16510646
references.citation: J Pediatr. 2004 Oct;145(4):439-44
references.pmid: 15480363
references.citation: J Clin Endocrinol Metab. 2008 Dec;93(12):4600-5
references.pmid: 18782881
references.citation: J Hum Lact. 2003 Feb;19(1):9-18
references.pmid: 12587638
references.citation: J Pediatr. 1980 Feb;96(2):187-93
references.pmid: 7351577
references.citation: J Pediatr Gastroenterol Nutr. 2006 Jan;42(1):66-70
references.pmid: 16385256
references.citation: J Pediatr. 2007 Jan;150(1):3-5
references.pmid: 17188602
references.citation: JAMA. 2003 Dec 17;290(23):3092-100
references.pmid: 14679272
references.citation: J Clin Endocrinol Metab. 2004 Mar;89(3):1096-101
references.pmid: 15001593
references.citation: J Pediatr. 2006 Feb;148(2):152-4
references.pmid: 16492420
references.citation: J Clin Endocrinol Metab. 2004 Feb;89(2):525-33
references.pmid: 14764757
references.citation: Int J Obes (Lond). 2005 Sep;29 Suppl 2:S40-5
references.pmid: 16385751
references.citation: JAMA. 2005 Oct 19;294(15):1918-24
references.pmid: 16234498
references.citation: Gastroenterology. 2001 Feb;120(3):669-81
references.pmid: 11179243
references.citation: J Pediatr Endocrinol Metab. 2004 Mar;17(3):307-19
references.pmid: 15112907
references.citation: Metabolism. 2001 Dec;50(12):1457-61
references.pmid: 11735093
references.citation: Obes Res. 2001 Mar;9(3):179-87
references.pmid: 11323443
references.citation: Int J Obes Relat Metab Disord. 2001 Apr;25(4):550-8
references.pmid: 11319661
references.citation: JAMA. 2001 May 16;285(19):2461-7
references.pmid: 11368698
references.citation: BMJ. 2004 Jun 19;328(7454):1490
references.pmid: 15205295
references.citation: Ann Intern Med. 2007 Jul 3;147(1):41-50
references.pmid: 17606960
references.citation: J Am Diet Assoc. 1996 Dec;96(12):1245-50, 1253; quiz 1251-2
references.pmid: 8948385
references.citation: J Biol Chem. 1991 Jan 15;266(2):837-43
references.pmid: 1702440
references.citation: J Nutr. 2000 Jul;130(7):1734-42
references.pmid: 10867044
references.citation: JAMA. 2004 Apr 28;291(16):2013-6
references.pmid: 15113821
references.citation: Pediatrics. 2005 Jul;116(1):e125-44
references.pmid: 15995013
references.citation: Nature. 1997 Jun 26;387(6636):903-8
references.pmid: 9202122
references.citation: Pediatrics. 2001 Aug;108(2):347-53
references.pmid: 11483799
references.citation: Pediatr Ann. 2006 Apr;35(4):290-4, 297-9
references.pmid: 16637558
references.citation: Am J Clin Nutr. 2005 Feb;81(2):409-15
references.pmid: 15699228
references.citation: Am J Public Health. 2002 Feb;92(2):246-9
references.pmid: 11818300
references.citation: Diabetes Care. 2004 Aug;27(8):2067-73
references.pmid: 15277443
references.citation: Am J Public Health. 2003 Sep;93(9):1431-4
references.pmid: 12948957
references.citation: N Engl J Med. 2007 Dec 6;357(23):2329-37
references.pmid: 18057335
references.citation: Arch Pediatr Adolesc Med. 1999 Apr;153(4):409-18
references.pmid: 10201726
references.citation: Science. 2006 Apr 14;312(5771):279-83
references.pmid: 16614226
references.citation: Eur J Obstet Gynecol Reprod Biol. 2005 Dec 1;123(2):204-11
references.pmid: 16316811
references.citation: J Am Diet Assoc. 2001 Jan;101(1):42-6
references.pmid: 11209583
references.citation: Diabetes. 2006 Feb;55(2):551-8
references.pmid: 16443794
references.citation: Ann Pharmacother. 2007 Sep;41(9):1445-55
references.pmid: 17652127
references.citation: J Am Diet Assoc. 1990 Sep;90(9):1247-52, 1255
references.pmid: 2398216
references.citation: J Clin Endocrinol Metab. 2007 Nov;92(11):4282-5
references.pmid: 17698912
references.citation: J Pediatr Gastroenterol Nutr. 1997 Nov;25(5):554-5
references.pmid: 9360213
references.citation: J Clin Endocrinol Metab. 2005 Mar;90(3):1871-87
references.pmid: 15598688
references.citation: J Clin Endocrinol Metab. 2007 Feb;92(2):430-6
references.pmid: 17118995
references.citation: J Am Diet Assoc. 2006 Jun;106(6):925-45
references.pmid: 16812927
references.citation: N Engl J Med. 2002 Feb 7;346(6):393-403
references.pmid: 11832527
references.citation: J Nutr. 2005 Apr;135(4):879-81
references.pmid: 15795451
references.citation: J Pediatr. 2001 Apr;138(4):493-8
references.pmid: 11295711
references.citation: J Dev Behav Pediatr. 1990 Oct;11(5):234-9
references.pmid: 2258441
references.citation: J Pediatr. 1985 Sep;107(3):317-29
references.pmid: 3875704
references.citation: Am J Pathol. 1998 Oct;153(4):1023-33
references.pmid: 9777934
references.citation: Clin Psychol Rev. 2007 Mar;27(2):240-9
references.pmid: 17070638
references.citation: Lancet. 2007 Jun 23;369(9579):2059-61
references.pmid: 17586288
references.citation: Ann Intern Med. 2005 Apr 5;142(7):525-31
references.pmid: 15809464
references.citation: JAMA. 2007 Jun 27;297(24):2697-704
references.pmid: 17595270
references.citation: J Clin Endocrinol Metab. 2008 Dec;93(12):4606-15
references.pmid: 18782880
references.citation: Pediatrics. 1998 Sep;102(3):E29
references.pmid: 9724677
references.citation: Obes Res. 1995 Nov;3 Suppl 4:553S-559S
references.pmid: 8697058
references.citation: BMJ. 1999 Jul 17;319(7203):147-50
references.pmid: 10406746
references.citation: Arch Pediatr Adolesc Med. 2003 Aug;157(8):821-7
references.pmid: 12912790
references.citation: J Pediatr. 2006 Jan;148(1):3-4
references.pmid: 16423587
references.citation: Diabetes. 1996 Feb;45(2):242-56
references.pmid: 8549870
references.citation: J Adolesc Health. 2002 Aug;31(2):125-32
references.pmid: 12127382
references.citation: Pediatrics. 2005 May;115(5):1367-77
references.pmid: 15867049
references.citation: Diabetologia. 1985 Jul;28(7):412-9
references.pmid: 3899825
references.citation: J Med Genet. 2007 May;44(5):306-13
references.pmid: 17182655
references.citation: Best Pract Res Clin Endocrinol Metab. 2005 Sep;19(3):327-41
references.pmid: 16150378
references.citation: Obes Rev. 2005 Feb;6(1):67-85
references.pmid: 15655039
references.citation: Pediatrics. 2001 Feb;107(2):423-6
references.pmid: 11158483
references.citation: Ann N Y Acad Sci. 2008;1135:265-79
references.pmid: 18574233
references.citation: N Engl J Med. 2002 Mar 14;346(11):802-10
references.pmid: 11893791
references.citation: J Pediatr. 1998 May;132(5):840-8
references.pmid: 9602197
references.citation: Ann Intern Med. 2000 Jul 18;133(2):92-103
references.pmid: 10896648
references.citation: Prev Med. 2001 Mar;32(3):245-54
references.pmid: 11277682
references.citation: Lancet. 1998 Jul 18;352(9123):160-1
references.pmid: 9683198
references.citation: J Pediatr Endocrinol Metab. 2005 Aug;18(8):761-8
references.pmid: 16200842
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S164-92
references.pmid: 18055651
references.citation: Clin Endocrinol (Oxf). 2003 Jul;59(1):82-8
references.pmid: 12807508
references.citation: Am J Public Health. 1994 May;84(5):807-13
references.pmid: 8179053
references.citation: J Pediatr. 2007 Jun;150(6):618-22, 622.e1-5
references.pmid: 17517246
references.citation: BMC Pediatr. 2004 Mar 12;4:6
references.pmid: 15113440
references.citation: Am J Health Promot. 1995 Nov-Dec;10(2):85-8
references.pmid: 10160050
references.citation: Pediatrics. 1998 Mar;101(3):E5
references.pmid: 9481024
references.citation: J Pediatr. 2004 Dec;145(6):744-9
references.pmid: 15580194
references.citation: J Child Neurol. 2000;15 Suppl 1:S22-6
references.pmid: 11218053
references.citation: Obes Res. 2004 Feb;12(2):275-83
references.pmid: 14981220
references.citation: Am J Clin Nutr. 1999 Jul;70(1):157S-162S
references.pmid: 10393164
references.citation: Proc Natl Acad Sci U S A. 2006 Mar 7;103(10):3502-9
references.pmid: 16537441
references.citation: Pediatrics. 2007 Dec;120 Suppl 4:S229-53
references.pmid: 18055653
references.citation: Arch Pediatr Adolesc Med. 2006 Sep;160(9):906-22
references.pmid: 16953014
references.citation: Am J Public Health. 2001 Apr;91(4):618-20
references.pmid: 11291375
references.citation: Pediatr Clin North Am. 2001 Aug;48(4):969-80
references.pmid: 11494646
references.citation: Chest. 2006 Jan;129(1):174-81
references.pmid: 16424429
references.citation: J Pediatr. 2006 Jan;148(1):16-22
references.pmid: 16423592
references.citation: J Pediatr. 2006 Jan;148(1):23-9
references.pmid: 16423593