Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Are Our Children Too Fat?
The Answer is Yes. Should They Stay That Way? The Answer is No.
Working and playing in the outdoors rely on a certain degree of physical fitness and overall state of health. Current medical knowledge supports the concept of ideal body weight, at which a person is neither too fat nor too thin. When we consider Western civilization, we picture the former. In the absence of hardship, such as poverty or famine, we eat what we like and fall off ideal body weight to the high side. Obesity is a national U.S. epidemic, and it can be argued that it is a worldwide problem.
We have long relied on inference and intuition to make the association between childhood obesity and cardiovascular (predominately heart) disease in adulthood. Recent analysis shows we need no longer ponder the association – it is real and frightening. Markus Juonala, MD and colleagues recently addressed this issue in an article in the New England Journal of Medicine entitled “Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors” (2011;365:1876-85). The premise was to observe that obesity in childhood is associated with increased cardiovascular risk, but it is not known whether or not this risk is diminished or eliminated in persons who are overweight or obese as children if they are not obese as adults.
Using a follow-up period of 23 years, body mass index (BMI) was determined for 6328 persons. The overall analysis indicated that persons who were overweight or obese during childhood but were nonobese as adults had risks of outcomes (type 2 diabetes, high blood pressure, “bad” lipid profiles of elevated low-density lipoprotein cholesterol/reduced high-density lipoprotein cholesterol/elevated trigycerides, and carotid artery atherosclerosis) similar to those of persons who had a normal BMI consistently from childhood to adulthood. The takeaway is that there is a “point of return,” such that a person who is obese in childhood can improve their cardiovascular future by losing weight and getting back down to a recommended BMI.
So, what should we do? Obesity in childhood is predictive of obesity in adulthood, so it seems to be a good idea to keep one’s children from becoming obese, to encourage proper eating habits at an early age, and to make the appropriate interventions for overweight children to be able to lose weight while they are still children. We would be doing them a huge favor, perhaps letting them become healthier and allowing them to live longer.
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