PHYSICAL-ACTIVITY, GENETIC, AND NUTRITIONAL CONSIDERATIONS IN CHILDHOOD WEIGHT MANAGEMENT

Juvenile obesity is a serious, increasingly prevalent problem in techn ologically developed societies. Almost one-quarter of U.S. children ar e now obese, a dramatic increase of over 20% in the past decade. It is intriguing that the increase in prevalence has been occurring while o verall fat consumption has been declining. Body mass and composition a re influenced by genetic factors, but the actual heritability of juven ile obesity is not known. A low physical activity (PA) is characterist ic of obese children and adolescents, and it may be one cause of juven ile obesity. There is little evidence, however, that overall energy ex penditure is low among the obese. There is a strong association betwee n the prevalence of obesity and the extent of TV viewing. Enhanced PA can reduce body fat and blood pressure and improve lipoprotein profile in obese individuals. Its effect on body composition, however, is slo wer than with low-calorie diets. The three main dietary approaches are : protein sparing modified fast, balanced hypocaloric diets, and compr ehensive behavioral lifestyle programs. To achieve long-standing contr ol of overweight, one should combine changes in eating and activity pa tterns, using behavior modification techniques. However, the onus is a lso on society to reduce incentives for a sedentary lifestyle and over -consumption of food. To address the key issues related to childhood w eight management, the American College of Sports Medicine convened a S cientific Roundtable in Indianapolis.