OBESITY IN CHILDHOOD AND ADOLESCENTS: 24 TABLES 8
Obesityin Childhood and Adolescents: 24 tables
Obesityin Childhood and Adolescents: 24 tables Book Review
Theimportance of child growth and development cannot be gainsaid as faras his or her wellbeing in the future is concerned. Indeed, it iswell recognized that the speed by which a child grows and developsboth psychologically and physically has a bearing on his or hercapacity to be independent in the future, as well as contribute tothe wellbeing of others. Unfortunately, it is not always the casethat the development of a child is smooth. Indeed, there existsnumerous ailments and hiccups that have the capacity to derail or atleast have a negative effect of the child. Needless to say, volumesof literature have been written exploring the varied aspects ofchildhood development, as well as some of the issues that wouldaffect it. This is the case for the book “Obesity in Childhood andAdolescents: 24 tables”, which primarily explores the differentelements of obesity including its causes, reasons for its increase inthe contemporary human society and even some of the ways that it canbe eliminated.
Writtenby Kiess et al (2004), the book aims at enhancing the knowledge andcomprehension of physicians regarding obesity in childhood andadolescence, not to mention furthering the public awarenesspertaining to the health burden, as well as the economic dimensionpertaining to obesity at young ages. Indeed, quite a number of itschapters offer insight into the fundamental comprehension of thefactors that contribute to or even avert the possibility for thedevelopment of obesity and overweight among the young people.Further, the book offers tools that clinicians can use in themanagement of care to the child, as well as adolescent who hasobesity or weight problems. This information is presented alongsideinformation derived from the latest research and scientific studiespertaining to obesity’s molecular biology.
Thisbook is based on the observation of the rising cases of obesity andoverweight among young people in a large number of societies. Theauthors acknowledge that the level of fatness in an adolescent oreven a child at which there is an acute morbidity increase or evenlater on in life varies across different individuals. Nevertheless,research has shown that overall obesity and overweight wouldsignificantly increase the vulnerability of an individual tosubsequent morbidity. Of particular note is the difficulty andcontroversy that plagues the diagnosis and definition of obesity inadolescents and children (Kiess,2004).This is especially considering that the magnitude of body fat massamong adolescents and children is subject to the age, developmentalstage, gender and even ethnic background of an individual. Some ofthe aspects that may be helpful in evaluating the fat deposition inthe upper body are the waist-to-hip ratio and waist circumference.Unfortunately, these techniques cannot be used in measuring thevisceral intra-abdominal fat accumulation. Other tools that may beuseful in scientific studies include DEXA, hydrodensitometry andbioimpedance among other direct body fat content measurements.Nevertheless, the most common technique used in adults is the bodymass index (BMI), which involves the division of weight in kilogramby the square of height in meters. It is noted that the calculationof BMI is extremely easy, not to mention the fact that it issufficiently correlated with the direct fatness measures (Kiess,2004).There have been propositions in the recent times that the cut-offpoints of BMI in adults (25 and 30 kg/m2) should be connected to theBMI percentiles in adolescents and children so as to allow forcut-off points at lower age (Kiess,2004).In essence, there have been publications for gender and age-specificBMI values for individuals between the ages of 2 and 18 correspondingwith the BMI values for 25 and 30 kg/m2 at the age of 18 years. Inthis regard, the rates of obesity for BMI 30kg/m2 in the UnitedStates adult population are projected to be 30% and 40% those of 2015and 2025 respectively.
Inaddition, the authors acknowledge the increasing rates of childhoodobesity to the point of reaching epidemic proportions in almost everyother industrialized country across the globe. It is noteworthy thatage-adjusted prevalence for the epidemic could be as high as 20% oreven 30% in varied populations (Kiess,2004).There is data, for instance, derived from 2630 children in 1999,which showed that there was a huge increase of children with theailment between the age of 6 and 15 years. Indeed, it is noted thatthe overweight frequency was between 22% at 6 years of age to around31 percent at 15 years, while the frequency of obesity was between10% at 6 years of age and 17% at 15 years (Kiess,2004).
Oneof the most interesting assertions made by the authors regards thetendency for obese children to become even more overweight over time.According to a Bogalusa heart study well detailed in the book, 22percent of children who were surveyed in 1990 incorporated a BMIhigher than the 85thpercentile that had been studied in similar surveys carried out in1980 (Kiess,2004).It is noteworthy that children who had a BMI below the 50thpercentile did not show any change, while those whose BMI was abovethe 50thpercentile showed an immense increase in the BMI.
Inaddition, the book seeks to answer the question regarding the causesof this epidemic particularly in the developed or industrializedcountries. The authors note that the ailment epidemic is an interplaybetween genetics and the environment within which an individual livesor even socioeconomic factors. The role of genetics in causingobesity has been largely explained by the discovery of leptin, the obgene product, as well as the enhanced comprehension of the role thatneuropeptides like the orexins, melanocyte concentrating hormone,neuropeptide Y and proopiomelanocorticotropin (Kiess,2004).Indeed, studies show that about 50 percent of the risk of becomingobesity is actually inherited from parents to their offspring. Whilethis is the case, it is acknowledged that the development of a largeproportion of body fatness in the early stages of development can beattributed to exogenous or environmental factors. The exogenousfactors would include the excessive utilization of advanced mediaparticularly viewing television, excessive consumption of diets richin fats, as well as the deficiency of physical activity (alsoreferred to as sedentary life style) would contribute heavily to therisk of becoming obese especially during adolescence and childhood.This assertion is supported by cross-sectional studies done onnational samples in the country which showed that there exists aconsiderable statistical correlation between obesity and viewing oftelevision among adolescents and children (Kiess,2004).It is noted that adolescents and children aged between 8 and 18 yearsold spend about 4.5 hours per day on average watching videotapes andtelevision, as well as playing video games. Of particular note is thefact that the demographic groups that have the highest level ofvulnerability for becoming obese are Latinos and African Americans,as well as children who come from low-income families. These groupshave been recognized as having the tendency to spend even more timewatching television compared to other children in the country.
Onthe same note, the authors examine the role of social economicfactors in the development of obesity and overweight amongadolescents and children. It is noted that teenagers brought up inlow-income families had a significantly higher disposition forbecoming overweight compared to their counterparts from high incomefamilies. Of particular note is the assertion that diet and nutritionduring infancy influences body fatness and rate of growth even afterinfancy.
Nevertheless,whether obesity emanates from excess intake of energy or decline inexpenditure of energy or physical activity still remains unclear.Indeed, a large number of authors insinuate that intrauterine growthretardation would predispose an individual to the development of theproblem later on in life. On the same note, there are still questionsregarding the evidence that fat patterning emanates from variationsin early postnatal and fetal nutrition. This is especiallyconsidering the fact that there exists numerous disorders that maypresent with obesity at the formative years of an individual.
Theauthors also underline the importance of the public and physiciansalike recognizing the impact that obesity has on individual lives andhealth economics. Indeed, obesity among youngsters is a fundamentalburden for the country considering that as much as about $70 billionis used in the United States every year on lost income and medicalexpenses resulting from obesity complications. Further, researchshows that another $30 billion may be spent on programs, products anddiet foods that are aimed at helping individuals lose weight. Theprospective financial costs for obesity that has started at an earlyage is quite high although profits and sales for the treatmentindustry is also rising (Kiess,2004).This underlines the fundamental nature of the epidemic in thehealthcare planning systems. Underlining the connection betweenobesity and child development is the fact that such individuals havediminished prospects of living healthy lives and developing in ahealthy manner. Indeed, their social lives and emotional being wouldbe negatively affected considering the stigmatization with which theyhave to grapple.
Thisbook presents a pretty comprehensive examination of the variedaspects of obesity particularly among adolescents and children.Indeed, the authors explore the limitations and difficulties thatplague the definition of the condition among children and adolescentsconsidering that earlier books primarily lean on the adultpopulations. In essence, this book fills a gap in research that hasalways been ignored. Nevertheless, it would be imperative that theauthors explore the efficacy of the varied strategies of eliminatingthe condition among adults and determine their applicability onchildren and adolescents. Further, exploring the possibility ofeliminating it among individuals who were genetically predisposed tothe condition would be imperative. This, however, does not underminethe fact that the book would be quite useful in explaining one of themost prevalent ailments among children and adolescents.
Kiess,W. (2004). Obesityin childhood and adolescence: 24 tables.Basel:Karger.