Childhood obesity in developing countries
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Childhood obesity in developing countries Louis CK Low Hong Kong, China
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Author Affiliations: Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, China (Low LCK) Corresponding Author: Louis CK Low, MBChB, FRCPCH, FHKAM (Paed), Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China (Tel: (852) 2255-4090; Fax: (852) 2855-1523; Email: [email protected]. hk) doi:10.1007/s12519-010-0217-9 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2010. All rights reserved.
risk of cardiac events in adulthood.[2,3,7] Every organ system can be affected by childhood obesity and comorbidities include hypertension, non-alcoholic liver disease, insulin resistance, dyslipidemia, pulmonary disorders and psychological problems.[2,7] The clinical approach of identifying children at risk and treating them should be complemented by a public health approach of preventing unhealthy weight gain in the population. In the definition of overweight and obesity, some developed countries use their own national body mass index (BMI) standard. The WHO has adopted the updated BMI reference based on the modified United States NHANES I data collected in 1971-1974 (available at http://www.cdc.gov/growthcharts) while other countries use the BMI cutoff ranges for overweight and obesity with age based on the International Obesity Task Force (IOTF) international growth reference constructed from six representative population growth studies (Brazil, Great Britain, Netherlands, Singapore, Hong Kong and United States).[8] The Scientific Advisory Committee on Nutrition in the United Kingdom recommends using the 2006 WHO Child Growth Standard between 2 weeks and 2 years and to use the 1990 UK Growth reference for older children. The United States recommends the use of Center for Disease Control (CDC) derived normative percentiles (85th-94th percentile as overweight, and >95th percentile as obese). The experts in China recommended the use of the 2005 Working Group on Obesity in China (WGOC) BMI Reference for screening for overweight and obesity in Chinese children.[6] In recent years, waist circumference >90th percentile of the age, sex and ethnic specific reference has been advocated for defining central obesity.[9] For developing countries, each country should evaluate carefully to acertain the most appropriate growth reference for use in the assessment of growth disorders in their population. A recent study found that the difference in the prevalence of overweight in Asian children using the CDC and IOTF cutoffs was small (
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