Book description

 Obesity is an important pediatric public health problem associated with risk of complications in childhood and increased morbidity and mortality throughout adult life. Obesity is now linked to more deaths than underweight. In 2014, according to the World Health Organization (WHO), more than 1.9 billion persons ≥20 yr old were overweight or obese. In the United States, 37% of adults are obese, and 35% are overweight. In children the prevalence of obesity increased 300% over approximately 40 yr. According to the National Health and Nutrition Examination Survey (NHANES), 2013–2014, 34% of children 2-19 yr old were overweight or obese, with 17% in the obese range. Risk for obesity in children 2-19 yr old varies significantly by race/ethnicity, with >20% for minority children compared with 15% for white children. Across all racial groups, higher maternal education confers protection against childhood obesity. The first 1000 days, the period from conception to age 2 yr, are increasingly recognized as a modifiable period related to risk for childhood obesity. Parental obesity correlates with a higher risk for obesity in the children. Prenatal factors, including high preconceptual weight, gestational weight gain, high birthweight, and maternal smoking, are associated with increased risk for later obesity. Paradoxically, intrauterine growth restriction with early infant catch-up growth is associated with the development of central adiposity and adult-onset cardiovascular (CV) risk. Breastfeeding is modestly protective for obesity based on dose and duration. Infants with high levels of negative reactivity (temperament) are more at risk for obesity than those with better self-regulation.