[SportMed] MEDICAL CONDITIONS OBESITY : PHYSICAL EXERCISE AND FITNESS : PREVENTION: Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity

 

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MEDICAL CONDITIONS OBESITY :

PHYSICAL EXERCISE AND FITNESS :

PREVENTION:

Active Healthy Living: Prevention of Childhood Obesity
Through Increased Physical Activity

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Active Healthy Living: Prevention of Childhood Obesity
Through Increased Physical Activity

A Statement Of Reaffirmation For This Policy Was Published At 125(2):e444
Revised 105(5):1156

Pediatrics

May 2006, VOLUME 117 / ISSUE 5

American Academy of Pediatrics

http://pediatrics.aappublications.org/content/117/5/1834

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Abstract

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The current epidemic of inactivity and the associated epidemic of obesity are being driven by multiple factors (societal, technologic, industrial, commercial, financial) and must be addressed likewise on several fronts. Foremost among these are the expansion of school physical education, dissuading children from pursuing sedentary activities, providing suitable role models for physical activity, and making activity-promoting changes in the environment. This statement outlines ways that pediatric health care providers and public health officials can encourage, monitor, and advocate for increased physical activity for children and teenagers.

healthy livingphysical activityobesityoverweightadvocacychildrenyouth

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INTRODUCTION

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In 1997, the World Health Organization declared obesity a global epidemic with major health implications.1 According to the 19992000 National Health and Nutrition Examination Survey (www.cdc.gov/nchs/nhanes.htm), the prevalence of overweight or obesity in children and youth in the United States is over 15%, a value that has tripled since the 1960s.2 The health implications of this epidemic are profound. Insulin resistance, type 2 diabetes mellitus, hypertension, obstructive sleep apnea, nonalcoholic steatohepatitis, poor self-esteem, and a lower health-related quality of life are among the comorbidities seen more commonly in affected children and youth than in their unaffected counterparts.37 In addition, up to 80% of obese youth continue this trend into adulthood.8,9 Adult obesity is associated with higher rates of hypertension, dyslipidemia, and insulin resistance, which are risk factors for coronary artery disease, the leading cause of death in North America.10

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Assessment of Overweight

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Ideally, methods of measuring body fat should be accurate, inexpensive, and easy to use; have small measurement error; and be well documented with published reference values. Direct measures of body composition, such as underwater weighing, magnetic resonance imaging, computed axial tomography, and dual-energy radiograph absorptiometry, provide an estimate of total body fat mass. These techniques, however, are used mainly in tertiary care centers for research purposes. Anthropometric measures of relative fatness may be inexpensive and easy to use but rely on the skill of the measurer, and their relative accuracy must be validated against a gold-standard measure of adiposity. Such indirect methods of estimating body composition include measuring weight and weight for height, body mass index (BMI), waist circumference, skinfold thickness, and ponderal index.11 Of these, perhaps the most convenient is BMI, which can be calculated according to the following formulas (www.cdc.gov/growthcharts):

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BMI varies with age and gender. It typically increases during the first months of life, decreases after the first year, and increases again around 6 years of age.11 A specific BMI value, therefore, should be evaluated against age- and gender-specific reference values. In the United States, such reference charts based on early 1970s survey data of children 2 to 20 years of age are readily available for clinical use.12 Children and youth with a BMI greater than the 95th percentile are classified as overweight or obese, and those between the 85th and 95th percentiles are designated at risk of overweight.13 Although BMI tends to underestimate overweight in tall individuals and overestimate overweight in short individuals and those with high lean body mass (ie, athletes), it generally correlates well with more precise measures of adiposity in individuals with BMI in the 95th percentile or greater.14

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Addtional Topics Discussed in This Article

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Factors Contributing to Obesity

Youth at Risk of Decreased Physical Activity

Physical Activity in Schools

Management of the Obese Child

Health Benefits of Physical Activity

Prevention of Overweight in Children and Youth

Increasing Physical Activity Levels in Children and Youth

Age-Appropriate Recommendations for Physical Activity

Office-Based Physical Activity Assessment

CONCLUSIONS

RECOMMENDATIONS

ADVOCACY

PROMOTING A HEALTHY LIFESTYLE

REFERENCES

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The complete article may be read at the URL above.

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Sincerely,
David Dillard
Temple University
(215) 204 – 4584
jwne@temple.edu
http://workface.com/e/daviddillard

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[SportMed] MEDICAL CONDITIONS OBESITY : PHYSICAL EXERCISE AND FITNESS : PREVENTION: Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity

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