Obesity has emerged as the most pressing nutritional problem facing the developed world. This trend has occurred over a relatively short period of time; in the United States, it appears to have begun in the last quarter of the 20th century. The epidemic in children followed shortly thereafter. The most recent data from national surveys in the United States suggest that almost two-thirds of the adult population are overweight, and almost one third is In children, current estimates put the prevalence of overweight at 15%, a threefold increase over the past 30 years.

 

Although this epidemic has spared no subgroup of the population and has been documented in individuals of all ages and racial/ethnic and socioeconomic subgroups, the problem is greatest in minority populations and among persons living in poverty. The World Health Organization defines obesity as a condition of abnormal or excess accumulation of adipose tissue (body fat) to an extent that an individual’s health may be impaired. Because the precise measurement of adipose tissue requires invasive laboratory measures, in the population context, a simpler measure on which to base an obesity definition is required.

 

Although imperfect, the Body Mass Index (BMI), defined as weight in kilograms divided by height in meters squared, has been adopted by consensus in the United States by the National Institutes of Health and the Centers; for Disease Control and Prevention (CDC) and internationally by WHO (2000). Consensus definitions of overweight and obesity have been set at 25 (overweight) and 30 (obesity), with severity classes of obesity defined as follows: overweight, 25.0 to 29.9; Class I obesity, 30.0 to 34.9; Class II obesity, 35.0 to 39.9; and Class III obesity, 40.0+. The WHO (2000) terminology differs slightly, but the cutoff points are the same.

In growing children, in whom weight and height are both changing (and at different rates), the definition of obesity is inherently more complicated. Although no universally agreed on standard exists for assessing overweight and obesity in children and adolescents, there is a growing consensus that BMI should be adopted as an indirect measure of adiposity for children and adolescents, as well Because BMI varies substantially by age and gender during childhood and adolescence, the specific BMI cutoffs used to classify obesity must be gender- and age-specific and must be referenced against a standard. . In the United States, the standard used is the CDC Revised Growth Reference Internationally, several standards), including one based on a pooled international sample are also in use.

 

 

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