Obesity in children: special considerations

Identifying Obesity in Children

The same BMI standards used for adults along with anthropometry (measurement of fat by skin fold thickness) may be used to identify overweight adolescents, although there are other considerations in this population. Ethnic variations, timing of growth spurts, and higher normal fat levels around puberty can cause disparities in these measurements.

Causes and Risk Factors for Obesity in Children

Factors Surrounding Birth. The following are some studies reporting certain factors surrounding birth that are associated in a child's weight:

• Some studies report an association between low birth weight and a risk for later obesity and diabetes. A 2000 UK study proposed that some infants who have a low birth weight due to conditions that restrain growth in the womb (such as having thin mothers who smoke) may undergo a natural catch-up growth between infancy and two years old. This rapid growth, in turn, may increase the risk for later obesity.
• In a study of African American children, having an overweight pregnant mother increased the risk for later weight gain, but low birth weight did not.
• Some studies have found that prolonged and exclusive breast-feeding may offer some protection against childhood obesity.

Socioeconomic and Cultural Factors. Children are particularly vulnerable to the temptations proffered by the media-minded culture, such as food advertisements and sedentary video games. And, neither the media nor even the educational system has strong well-financed programs that encourage healthy alternatives including exercise and healthy foods. The following are some specific problems created by the culture:

• Sugar is a significant problem. (The role of high fat diets on obesity in children is less clear.) Soda, other sweetened beverages, and fruit juice in fact may be singled out as major contributors to childhood obesity. One 2001 study reported that drinking soda regularly increases a child's risk for obesity by 60%. And the average American adolescent consumes 15 to 20 extra teaspoons a day just from soda and sugary drinks. (Juice, while better than soda, is still filled with sugar.)
• Less physical exercise is playing a significant role in obesity in children. One study has found that the annual distance walked by children has fallen by nearly 30% since 1972, partially because more parents are driving their children to school out of fear of abduction, molestation, and traffic accidents.
• Excessive television watching plays a critical role in obesity in children, particularly in girls and minority children. In one 2001 study obesity rates were lowest in children who watched television one hour or less a day and highest in those who watched four or more hours.