title: Childhood obesity: Determinants, evaluation, and prevention.
abstract: Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child's food environment at home and parental obesity are strong determinants. Urban poor in developed countries and urban rich in developing countries are both at risk. In developing countries, a number of beliefs passed down over generations are other important determinants. Evaluation includes assessing the child's lifestyle, excluding weight-promoting medication history; poor linear growth needs endocrine evaluation; genetic syndromes should be considered if there are clinical pointers. Overweight children should be evaluated for hypertension, dyslipidemia, T2DM, and NAFLD. Therapeutic lifestyle changes targeting food habits and physical activity through parental participation and social support are the cornerstones of preventing childhood obesity. Active travel and play by making the built environment more accessible, ban on 'junk' food advertising, and effective health education through active participation of clinicians, school systems, and the media will go a long way in reversing anticipated trends in childhood obesity.
authors.affiliation: Institute of Child Health, Kolkata, India.
authors.forename: Moutusi
authors.initials: M
authors.lastname: Raychaudhuri
authors.forename: Debmalya
authors.initials: D
authors.lastname: Sanyal
keywords: Childhood obesity; determinants; evaluation; prevention
references.citation: J Clin Endocrinol Metab. 2008 Dec;93(12):4576-99
references.pmid: 18782869
references.citation: Diabetes Care. 2000 Mar;23(3):381-9
references.pmid: 10868870
references.citation: Obes Rev. 2010 Oct;11(10):695-708
references.pmid: 20331509
references.citation: Pediatrics. 2011 Dec;128 Suppl 5:S213-56
references.pmid: 22084329
references.citation: N Engl J Med. 1997 Sep 25;337(13):869-73
references.pmid: 9302300
references.citation: Int J Obes Relat Metab Disord. 1999 Nov;23 Suppl 8:S1-107
references.pmid: 10641588
references.citation: Asia Pac J Clin Nutr. 2008;17 Suppl 1:172-5
references.pmid: 18296330
references.citation: Lancet. 2002 Aug 10;360(9331):473-82
references.pmid: 12241736
references.citation: Am J Hum Biol. 2004 May-Jun;16(3):346-53
references.pmid: 15101059
references.citation: Pediatr Clin North Am. 2011 Dec;58(6):1333-54, ix
references.pmid: 22093854