Childhood Obesity - Prevention Programs

The epidemic of obesity in American Indian communities and the need for childhood obesity-prevention programs

Mary Story, Marguerite Evans, Richard R Fabsitz, Theresa E Clay, Bonnie Holy Rock and Brenda Broussard

American Indians of all ages and both sexes have a high prevalence of obesity. The high prevalence of diabetes mellitus in American Indians shows the adverse effects that obesity has in these communities. Obesity has become a major health problem in American Indians only in the past 1–2 generations and is believed to be associated with the relative abundance of high-fat foods and the rapid change from active to sedentary lifestyles. Intervention studies are urgently needed in American Indian communities to develop and test effective strategies for weight reduction. The poor success rate of adult obesity treatment programs in the general population points to the need to develop prevention approaches aimed toward children. Because eating and physical activity practices are formed early in life and may be carried into adulthood, prevention programs that encourage increased physical activity and healthful eating habits targeted toward young people need to be developed and tested. To be most effective, interventions must be developed with full participation of the American Indian communities.

American Journal of Clinical Nutrition, Vol. 69, No. 4, 747S-754S, April 1999

Copy right 1999 American Society of Clinical Nutrition

What is overweight and obesity?

Overweight and obesity are defined as ''abnormal or excessive fat accumulation that presents a risk to health''.

Measuring overweight and obesity

It is difficult to develop one simple index for the measurement of overweight and obesity in children and adolescents because their bodies undergo a number of physiological changes as they grow. Depending on the age, different methods to measure a body's healthy weight are available:

For children aged 0-5 years

The WHO Child Growth Standards, launched in April 2006, include measures for overweight and obesity for infants and young children up to age 5.

• For individuals aged 5-19 years

WHO developed the Growth Reference Data for 5-19 years. It is a reconstruction of the 1977 National Center for Health Statistics (NCHS)/WHO reference and uses the original NCHS data set supplemented with data from the WHO child growth standards sample for young children up to age 5.

• For Adults

The most commonly used measure for overweight and obesity is the Body Mass Index (BMI) - a simple index to classify overweight and obesity in adult populations and individuals. It is defined as the weight in kilograms divided by the square of the height in meters (kg/m2).

The BMI is the same for both sexes and for all ages of adults. However, it should be considered as a rough guide because it may not correspond to the same body fat percentage in different individuals. This BMI-chart is not yet usable for children.