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The U.S. continues to lead the way,
with as many as 37% of its children
and adolescents carrying around
too much fat. But other countries
are rapidly catching up. According
to statistics presented recently
at the European Congress on Obesity
in Helsinki, Finland, more than
20% of European youngsters between
the ages of 5 and 17 are either
overweight or obese. Children in
North Africa and the Middle East
aren't far behind. Across Asia too,
childhood obesity is on the rise,
and the trend has been documented
even in urbanized areas of sub-Saharan
Africa.
"These figures should set alarm
bells ringing in ministries of health
across the developed and developing
world," says Tim Lobstein,
co-editor of a forthcoming report
to the World Health Organization
on childhood obesity. And with good
reason: people who are obese as
children have a high risk of becoming
obese adults — meaning they
will have a much higher risk of
contracting heart disease, hypertension,
diabetes and cancer. The surge of
obesity among children, in short,
presages a global explosion of illnesses
that will drain economies, create
enormous suffering and cause millions
of premature deaths. "This
is a true health-care crisis,"
says Robert Lustig, a pediatric
endocrinologist at the University
of California.
Fully 9% of obese children and adolescents
already suffer from a condition
known as metabolic syndrome. Among
the most worrisome symptoms are
changes in blood chemistry that
can trigger future health problems.
A substantial fraction of overweight
kids, for example, have elevated
levels of LDL cholesterol, putting
them at risk for atherosclerosis.
Many also have elevated blood-sugar
levels, a precursor of Type 2 diabetes.
Around the world, the prevalence
of Type 2 diabetes, formerly known
as adult-onset diabetes, is soaring
in the under-18 crowd. As a result,
complications like nerve and eye
damage, which typically take years
to develop, are appearing among
people in their 20s.
Why do children become obese? One
important factor is insulin, which
enables the body to store extra
calories as fat. Physical exercise
helps control insulin levels, while
certain foods elicit its massive
release. For example, ingesting
fat alone doesn't prompt a big surge
in insulin, but fat combined with
starches and sugar does. A child
who sits in front of the TV for
hours on end, eating potato chips
and doughnuts, is an ideal fat-storage
machine.
Genetics can make a difference as
well. Those who are most susceptible
to gaining weight on high-fat, carbohydrate-rich
diets are those who are primed to
produce high levels of circulating
insulin in the first place. Among
them are the inhabitants of the
South Pacific island of Nauru, who
— thanks to a surfeit of cheap,
calorie-dense foods, along with
a shift away from jobs requiring
physical activity — have the
unwelcome distinction of being some
of the fattest, most diabetes-prone
people on the planet.
Alas, the Nauruan experience, while
extreme, is not unique. Asia, for
instance, lags behind the U.S. and
Europe in its obesity statistics,
but Thailand, Malaysia, Japan and
the Philippines have all reported
troubling increases in recent years.
In China, where a one-child-per-family
policy has created millions of spoiled
and overfed children (a phenomenon
known as little-emperor syndrome),
the rise in childhood obesity is
particularly alarming. Up to 10%
of China's 290 million children
are believed to be overweight or
obese, and that percentage is expected
to double a decade from now.
Encouragingly, changing a family's
lifestyle in healthy ways does not
appear to be all that difficult.
Parental involvement is critical
since so much of modern life —
streets without sidewalks, housing
developments without parks, schools
without exercise programs —
conspires with TV, computer games,
soda machines and fast-food restaurants,
to make it hard for children on
their own to avoid gaining weight.
That adults are finally becoming
aware of the problem and are willing
to do something about it is extremely
positive. But unless they do so
in much greater numbers, the steady
increase in life expectancy that
has marked the 20th century may
reverse itself in the 21st, and
far too many members of the next
generation could end up dying before
their parents.
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