Obesity, physical inactivity, and their consequences are rapidly increasing problems in the United States among individuals of all ages. The antecedents of these problems begin in childhood and adolescence. This issue of the ARCHIVES is devoted to better understanding the epidemiology of obesity and physical inactivity, examining the effectiveness of interventions to reverse the course of these problems during the pediatric years, and investigating the consequences of failing to intervene.
Prior studies have shown an inconsistent relationship between child overweight and inadequate household resources to purchase food. The protective effect of food assistance programs such as food stamps and school breakfast and lunch programs is unknown. Using data from the 1997 Panel Study of Income Dynamics, Jones and colleagues found that girls from food insecure households were 68% less likely to be overweight if they were participating in all 3 programs compared with girls from food insecure households not participating in these programs. There appeared to be no protective effect in boys.
A school-based healthy-weight program has been developed in Cambridge, Mass, consisting of body mass index surveillance, health report cards, and school nurse follow-up. In this study of 1396 ethnically diverse students from 4 urban elementary schools, parents were given either personalized weight and fitness report cards or general information only. Among overweight students, intervention parents were more likely to be aware of their child's weight status, to seek medical help, and to plan dieting and physical activities for their child. This intervention may represent an inexpensive way to increase parental motivation to address their children's weight and physical inactivity.
Teasing about weight has long been a common occurrence in schools. This study examined the psychological consequences of such teasing in 4745 middle school and high school students. Nearly one third of girls and 25% of boys were teased about their weight by their peers; 29% of girls and 16% of boys reported being teased by family members. Adolescents teased by family members were twice as likely to have suicidal ideation and attempt suicide compared with those not teased. Teasing was associated with low self-esteem, low body satisfaction, and high depressive symptoms, even after adjusting for body mass index. This study indicates the important consequences of being teased about weight, especially if the teasing is done by family members.
The incidence of type 2 diabetes mellitus increases markedly for obese children after puberty. This randomized controlled trial examined the effect of a reduced–glycemic load diet on body mass index (BMI) and body fat mass compared with a conventional low-fat diet. One year after the intervention began, obese adolescents receiving the low–glycemic load diet had decreased their BMI and body fat mass, whereas those given the conventional diet had an increased BMI and body fat mass. Insulin resistance decreased less in the low–glycemic load group. This study indicates that an ad libitum reduced–glycemic load diet may be a promising alternative in obese adolescents.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2003;157(8):717. doi:10.1001/archpedi.157.8.717