Nutritional aspects of obesity in infancy and childhood
1981
The etiological complexity of obesity makes prevention and treatment difficult. In children, diagnosis is complicated by extreme variations of body composition. Comparison of triceps and subscapular skinfold thicknesses to age/sex standards is a fairly reliable adiposity indicator in children. Child obesity prevalence rates vary from 6-13%, depending on age, sex, and various demographic factors. Obesity in adulthood seems to be more strongly correlated to occurrences of obesity in late childhood and adolescence than in prenatal states or infancy; both genetic and environmental factors are significant. New data suggest a constant turnover of adipocyte precursors that become mature fat-filled cells through overfeeding, which can be reduced in volume but probably not in number. Adipose organ geometry seems most sensitive before age 2 and again during the adolescent growth spurt. Child obesity treatment should be based on a nutritious diet supporting lean tissue growth while holding adipose mass constant. Child obesity prevention efforts should be tempered by the following considerations: no single measure is safe and effective in all cases; use of low-fat milk may increase risk of excess renal solute loads; optimal nutrition in infancy should be encouraged; regular exercise habits should be encouraged; and short-term intervention may be ineffective for those destined by nature or nurture to become obese. (cj)
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