Childhood obesity

At a symposium on childhood obesity, William Dietz (Centers for Disease Control, Atlanta, Georgia) gave an overview of obesity and the consequences of childhood obesity in the U.S. The prevalence of obesity showed a progressive increase in this country from 1991 to 1999, with a concordant increase in diabetes (1). Next to tobacco use, low levels of physical activity and poor dietary habits are the major factors in the U.S. leading to increases in mortality (2). Dietz reviewed epidemiological data for children from the 1960s through 1990s, which suggested that obesity has particularly increased during the past decade in both the U.S. and other countries. Complications of overweight occurring during childhood include its effects on growth, psychosocial difficulties, hyperlipidemia, hepatic steatosis, and abnormal glucose metabolism, as well as persistence into adulthood, leading to a myriad of further complications.

Over the past 20 years, fast food consumption has increased to account for >40% of income spent on food, with 25% of daily calorie intake among children being from snacks. Dietz noted that schools look to food as a “revenue generator,” which leads to more fast food and soda being consumed. Annual per capita consumption of soft drinks increased from 27 gallons in 1972 to 44 gallons in 1992. Supermarkets “may have the same impact on people as a buffet,” by exposing purchasers to a variety of foods, increasing weight gain. Another potential driver of obesity is portion size, which has shown a particular increase among older children.

In the Netherlands 30% of all trips are made by bicycle, whereas in the U.S. 1% are made …