The Current State of Childhood Obesity
By Meghan Vivo

Childhood obesity has been on the U.S. government's radar since the 1970s. And yet the epidemic continues to pick up speed with every year that passes. Right now, one-third of American children and adolescents are either obese or at risk of becoming obese. What has happened since 1970? For one, fast food consumption has increased fivefold among children. Also, only 20 to 25 percent of high school students eat five or more servings of fruits and vegetables per day. And outdoor playtime gradually has been replaced by television, video games, and the Internet.

According to the Centers for Disease Control and Prevention (CDC), over the past three decades the childhood obesity rate has more than doubled for preschool children aged 2-5 years and adolescents aged 12-19 years, and it has more than tripled for children aged 6-11 years. And kids don't grow out of the problem. Overweight adolescents have a 70 percent chance of becoming overweight or obese adults. The obesity epidemic takes an even greater toll on minorities who often have limited access to health care.

Today's kids are eating too much and exercising too little, and the impact on their health is devastating. The extra pounds often start kids on the path to health problems that were once confined to adults. In one study, approximately 60 percent of obese children aged 5 to 10 years had at least one cardiovascular disease risk factor, such as elevated total cholesterol, triglycerides, insulin, or blood pressure, and 25 percent had two or more risk factors. By the 1990s, type 2 diabetes accounted for 8 to 45 percent of all new pediatric cases of diabetes, compared to fewer than 4 percent before the 1990s. It's hard to imagine a world where a heart attack is a common occurrence among 20- and 30-year-olds, but this may soon be our reality.

Childhood obesity isn't just an American problem. Although the highest prevalence rates have been observed mainly in developed countries, kids in developing countries are getting fatter as well. For instance, the World Health Organization reports that Iran has one of the highest rates of childhood obesity. In Saudi Arabia, one in every six children aged 6 to 18 years old is obese. In both developed and developing countries, obesity is becoming the number-one health threat to children.

Progress in Schools
Schools nationwide are becoming more aware of the childhood obesity epidemic. The good news is many states and school districts are making efforts to limit portion sizes and improve the nutritional quality of foods and beverages available in schools. The CDC's School Health Policies and Programs Study 2006 shows that some progress is being made. For example, the number of schools offering deep-fried potatoes dropped more than 20 percent from 2000, and more and more schools are using healthier food preparations, such as trimming fat from meat and using part-skim or low-fat cheese.

The bad news is that despite government recommendations, only four states (Alabama, Louisiana, Maine, and New Mexico) prohibit vending machines in schools and only one state (New York) bans all forms of advertising for candy, soft drinks, and fast food. As for physical education, a national study reports that only 8 percent of elementary schools, 6.4 percent of middle/junior high schools, and 5.8 percent of senior high schools provide daily physical education or its equivalent. Only 11.8 percent of states require recess for elementary students.

Given these trends, the CDC's lofty goals, published in Healthy People 2010, to reduce the prevalence of childhood obesity to 5 percent of the population will not be achieved.

Future Projections
If we stay on our current path, by 2010 it is projected that an estimated 20 percent of children and adolescents in the United States will be obese, and nearly half will be overweight, according to a report published by the International Journal of Pediatric Obesity.

Other countries will experience similar increases. By 2010, experts predict that there will be 26 million overweight and obese youngsters in the European Union nations, an estimated 20,000 of whom will have type 2 diabetes. In the Middle East, the number of obese children is expected to rise to 11.5 percent, while the Asian average could triple from 1.5 to 5.3 percent.

In response to these alarming statistics, a number of governmental programs and local initiatives have cropped up across the country. In 2002, the CDC initiated its VERB campaign to encourage 9- to 13-year-olds to take part in physical activities like bike riding or skateboarding. After spending almost $60 million in one year, the program reportedly spurred a 30 percent increase in exercise among the teens it reached. In 2006, the program was cancelled due to Bush administration budget cuts.

Other promising federal programs like the Agriculture Department's school snack program, which reached only 14 states, and the CDC's anti-obesity initiative, which reached only 28 states, have fallen short of expectations. However, some states have achieved moderate success with programs to build new sidewalks and bike paths as well as community gardens.

In spite of these efforts, forecasts for our children's health look bleak. Based on current obesity rates among teens, researchers at the University of California, San Francisco have estimated that the prevalence of coronary heart disease will jump as much as 16 percent by 2035, with more than 100,000 additional cases of the disease attributable to the rise in childhood obesity. When today's teenagers reach 35-50 years of age, deaths due to coronary heart disease will be even higher, up as much as 19 percent.

For the first time in U.S. history, experts are predicting that this generation of children could live shorter lives than their parents. Currently, the average American will live 77.6 years. In the next 50 years, obesity may reduce life expectancy by four to nine months, according to projections published in the New England Journal of Medicine. Even more grim, researchers speculate that if the current epidemic continues at this rate, life expectancy could drop by two to five years in the coming decades. For the majority of people who assumed that U.S. life expectancy would just continue to rise with the addition of new health discoveries and technological advances, this research makes it clear that something needs to be done.

Obese children carry the scars of weight-related physical and emotional problems well into adulthood. But the situation isn't hopeless. Efforts to get parents, schools, city planners, and the government on board to fight the battle against childhood obesity are underway, and public awareness continues to rise. Small changes in fast food marketing, school lunches and physical education classes, and parental monitoring are just the first steps in getting American children back on track.

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