Is Childhood Obesity Related to Dietary Intakes and Eating Behaviors?

05/06/07 Childhood obesity is a serious problem for increasing numbers of children around the world. According to the International Obesity Task Force, 1 of 10 schoolaged children worldwide is overweight or obese, a number totaling 155 million; of these, 2-3% (30-45 million) are obese. Prevalence is highest in the Americas and Europe, followed by the Near/Middle East, with smaller but growing numbers in the Asia-Pacific and Sub-Saharan regions of the world.

In the United States, which provides the data for much of this report, prevalence continues to rise. The most recent nationally representative data indicate that 33.6% of individuals aged 2-19 years were overweight and 17-1% were at risk for overweight in 2003- 2004, compared to 28.2% and 13.9% in 1999-2000, respectively. In this age group, the prevalence of overweight or at risk for overweight was highest among Mexican Americans (56.2%), followed by Non-Hispanic blacks (55.1%) and Non-Hispanic whites (49.8%), and a higher percentage of males were overweight (18.2%) compared to females (16.0%).

Obesity poses a significant public health threat to children for reasons that affect both their current and future health. Obese children suffer from a broad range of physical and psychosocial health consequences and are more likely to become obese adolescents and adults. Cardiovascular risk factors which arise as sequelae to childhood obesity also appear to persist into adulthood. Obese adults, in turn, are at increased risk of insulin resistance, hypertension, hypertriglyceridemia, dyslipidemia, cardiovascular diseases, non-insulin dependent diabetes, gallstones, cholecystitis, respiratory dysfunction, certain cancers, and overall mortality.

Dramatic increases in obesity over the past several decades suggest the predominance of influential environmental factors over genetic factors. While a host of factors work in tandem at the population level to favor increased food intake and decreased physical activity, obesity at the individual level ultimately results from an imbalance between energy intake and energy expenditure. Several review articles have examined the connection between diet and obesity among children to a limited degree." The purpose of this article is to comprehensively review studies that have examined the relation between diet and childhood obesity. In the paper, "children" are broadly defined as individuals aged 2-19 years and "diet" includes multiple aspects of dietary intake and eating behavior. This paper focuses on observational data that have examined the dietary etiology of obesity, rather than dietary treatment of obesity, and clinical studies are also included where possible. The main goal of this paper is to review the evidence and highlight methodological considerations, as well as to identify research gaps and future directions.

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