There is also evidence that the relative availability and price of different food products affect food consumption,14 and that the built environment, such as quality of local parks, affects the level of physical activities in a community.15 These findings not only emphasize the impact of environmental factors on the obesity epidemic but also indicate that policies affecting the availability of high-caloric-density food, the cost of fruits and vegetables, and the built environment may contribute to the obesity epidemic.
News stories consistently mentioned individual behavioral changes most often as a solution to the problem of childhood obesity. Television news was more likely than other news sources to focus on behavior change as a solution, whereas newspapers were more likely to identify system-level solutions such as changes that would affect neighborhoods, schools, and the food and beverage industry.
In Massachusetts, percentage of overweight/obese by community varied from 9.6% to 42.8%. As household income dropped, percentage of overweight/obese children rose. In Michigan sixth graders, as household income goes down, frequency of fried food consumption per day doubles from 0.23 to 0.54, and daily TV/video time triples from 0.55 to 2.00 hours, whereas vegetable consumption and moderate/vigorous exercise go down.
The prevalence of overweight/obese children rises in communities with lower household income. Children residing in lower income communities exhibit poorer dietary and physical activity behaviors, which affect obesity.
Lack of willpower was ranked near the bottom in both surveys. Physical activity was the second ranked causative mechanism in both surveys. Carbohydrate craving was near the bottom and repeated dieting decreased in importance over 4 years. Depression did not change in rank. Emotional problems were far less likely to be an important cause of obesity.
Being overweight, or obese, can not only have negative health impacts, but can cause emotional and psychological stress, "Childhood overweight also is associated with social and psychological problems, such as discrimination and poor self-esteem".
The nutritional quality of food consumed away from home is considerably poorer than that of foods consumed in the home, providing more total fat, saturated fat, cholesterol and sodium, and less fiber and calcium per unit energy. In addition, Americans are deriving an increasing proportion of their daily energy intake from foods prepared away from home.
With the rising prevalence of overweight and obesity in children, noninsulin-dependent diabetes mellitus (type 2 diabetes) is increasingly a pediatrician's problem. In one report (13), 4% of new diagnoses of diabetes before 1992 were classified as type 2 diabetes. In 1994, 16% of new diabetics were classified as type 2, a 4-fold increase. In the Cincinnati area between 1982 and 1994, there was a 10-fold increase in type 2 diabetes in children and the African American population was more severely affected than the white population (13).
Elevated blood pressure, dyslipidemia, and a higher prevalence of factors associated with insulin resistance and type 2 diabetes appear as frequent comorbidities in the overweight and obese pediatric population. In some populations, type 2 diabetes is now the dominant form of diabetes in children and adolescents. Disturbingly, obesity in childhood, particularly in adolescence, is a key predictor for obesity in adulthood.
The time to become obese and the amount of daily extra calories taken share an exponential relationship. (ii) The body weight gain from holiday season overeating can last up to 2 years if no extra physical activity is taken. (iii) Compared to normal weight individuals, obese individuals have a much higher energy-to-fat conversion rate (56% vs. 35%). (iv) Exercising is about 26% more effective in aiding fat reduction than dieting. (v) Changes in fat mass and fat-free mass share a competitive relationship in both long and short-term weight gain/loss.