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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

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2018 Impact Factor: 1.847

Front. Med.    2018, Vol. 12 Issue (6) : 658-666    https://doi.org/10.1007/s11684-018-0640-1
REVIEW
Epidemic obesity in children and adolescents: risk factors and prevention
Eun Young Lee1, Kun-Ho Yoon1,2()
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
2. Institute of Catholic Ubiquitous Health Care, The Catholic University of Korea, Seoul 06591, Korea
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Abstract

The prevalence of obesity among children and adolescents (aged 2–18 years) has increased rapidly, with more than 100 million affected in 2015. Moreover, the epidemic of obesity in this population has been an important public health problem in developed and developing countries for the following reasons. Childhood and adolescent obesity tracks adulthood obesity and has been implicated in many chronic diseases, including type 2 diabetes, hypertension, and cardiovascular disease. Furthermore, childhood and adolescent obesity is linked to adulthood mortality and premature death. Although an imbalance between caloric intake and physical activity is a principal cause of childhood and adolescent obesity, environmental factors are exclusively important for development of obesity among children and adolescents. In addition to genetic and biological factors, socioenvironmental factors, including family, school, community, and national policies, can play a crucial role. The complexity of risk factors for developing obesity among children and adolescents leads to difficulty in treatment for this population. Many interventional trials for childhood and adolescent obesity have been proven ineffective. Therefore, early identification and prevention is the key to control the global epidemic of obesity. Given that the proportion of overweight children and adolescents is far greater than that of obesity, an effective prevention strategy is to focus on overweight youth, who are at high risk for developing obesity. Multifaceted, comprehensive strategies involving behavioral, psychological, and environmental risk factors must also be developed to prevent obesity among children and adolescents.

Keywords obesity      children      adolescents      epidemiology      risk factor      prevention     
Corresponding Author(s): Kun-Ho Yoon   
Just Accepted Date: 14 August 2018   Online First Date: 09 October 2018    Issue Date: 03 December 2018
 Cite this article:   
Eun Young Lee,Kun-Ho Yoon. Epidemic obesity in children and adolescents: risk factors and prevention[J]. Front. Med., 2018, 12(6): 658-666.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-018-0640-1
https://academic.hep.com.cn/fmd/EN/Y2018/V12/I6/658
Psychosocial Poor self-esteem, anxiety, depression, eating disorders, social isolation, lower educational attainment
Neurological Idiopathic intracranial hypertension (Pseudotumor cerebri)
Endocrine Insulin resistance, type 2 diabetes, precocious puberty, polycystic ovary syndrome (girls), hypogonadism (boys)
Cardiovascular Dyslipidemia, hypertension, left ventricular hypertrophy, coagulopathy, chronic inflammation, endothelial dysfunction
Pulmonary Obstructive sleep apnea, asthma, exercise intolerance
Gastrointestinal Gastresophageal reflux, nonalcoholic fatty liver disease, steatohepatitis, gallstones, constipation
Renal Glomerulosclerosis
Dermatologic Acanthosis nigricans, intertrigo, hidradenitis suppurativa, furunculosis, stretch marks
Musculoskeletal Slipped capital femoral epiphysis, Blount’s disease, forearm fracture, back pain, flat feet
Long-term risks Carotid artery atherosclerosis, colorectal carcinoma, ischemic heart disease, stroke, short life span, premature death
Tab.1  Complications of childhood and adolescent obesity
Diet Avoid consumption of calorie-dense, nutrient-poor foods
Encourage consumption of whole fruits vs. fruit juice
Eat breakfast daily
Avoid skipping meals
Physical activity Encourage at least 20 (optimally 50) minutes of vigorous physical activity at least 5 days per week
Balance technology-related screen time
Psychological Goal setting
Contingent rewards
Problem solving
Environmental Foster healthy sleep patterns
Encourage breastfeeding of infants
Involve the entire family rather than only the individual
Assess family function and address family stressors
Incorporate school- and community-based engagement
Apply a tax on unhealthy foods (e.g., fast foods, soft drinks, confectionery, and snacks)
Label food with calories, ingredients, and nutrients
Tab.2  Comprehensive approach for childhood and adolescent obesity
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