Healthy Living

Saturday, September 6, 2008

Is childhood obesity finally at a plateau?

The latest data from the National Health and Nutrition Examination Survey reported this week in JAMA suggest that, after a steep rise for decades, the rate of childhood obesity in the U.S. has plateaued. If this is true, it is welcome news and perhaps testimony to the fact that national awareness of epidemic childhood obesity is translating slowly but surely into meaningful action.

But let's not be hasty. There are several potential problems with the report.

First, the problem we have seen over recent years is not just more people becoming obese, but people becoming more obese. This appears to be true of children and adults alike. The greater the degree of overweight in children, as in adults, the greater the risk of associated disease, such as diabetes. So even if and when the number of people succumbing to obesity stops rising, the epidemic can continue to worsen if degrees of obesity continue to worsen.

Second, we are seeing obesity occur at ever younger ages. And a recent report out of Boston suggested rising rates of obesity in infants, in the first year of life.

Third, everything is relative, including obesity. Childhood obesity is defined as being at or above the 95th percentile for age and sex adjusted body mass index. The current report is based on growth curves established for the population in the year 2000. Older reports were based on older growth curves. As children get heavier, the 95th percentile moves up with their average weight. So it's possible to report a stable percentage of children above a particular cut-point for obesity, but overlook the fact that the cut-point itself is moving higher. This appears to be the case in the new study, but I am checking with the investigators to be sure and will report back what I hear.

I don't want to look past a cup half-full and see it as half-empty. But I don't want to be too Pollyanna about this purported plateau either. It may be real and meaningful, and that's good news. It may be neither. Either way, the mission of protecting our children from obesity and its consequences will require our dedicated efforts for the foreseeable future.


More Ways to Stay Healthy
Lower Blood Sugar in 30 Days With Prevention's New Diabetes Diet
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