Читать книгу Clinical Obesity in Adults and Children - Группа авторов - Страница 34

Today, one in five children (18.5%) in the United States have obesity, which is more than three times the prevalence observed in 1978 (5%) [30]. However, data from NHANES suggest that the overall prevalence has plateaued in recent years (after 2004) among US children aged 2–19 years [31]. The plateau is occurring at high levels of obesity, particularly among Hispanic and black children: in 2016, 26% of Hispanic, 22% of black, and 14% of white children had obesity [31]. With regards to age groups, obesity in 2‐ to 5‐year‐olds has been decreasing since 2004 (though NHANES data showed a spike from 2014 to 2016), has plateaued in 6‐ to 11‐year‐old, and continues to increase in 12‐ to 19‐year‐old (a 3 percentage point increase between 2004 and 2016) [31].

Childhood obesity is a strong predictor of adult obesity [32–35]. Some have posited that in the United States, obesity patterns are established by age 11 [31]. Once children are on a trajectory of obesity, it is difficult to change. Two‐year‐olds with severe obesity only have a 1 in 5 chance of not having obesity at age 35, and 5‐year‐olds with severe obesity only have a 1 in 10 chance of not having obesity at age 35 [35]. US adolescents (12–21 years) with obesity are 16 times more likely to develop severe obesity (BMI ≥40 kg/m²) as young adults (18–33 years) than adolescents who are overweight or have a healthy body weight [36]. Given current levels and trends in childhood obesity in the United States, more than 57% of today’s children and adolescents are predicted to have obesity at age 35 [35].

In other parts of the world, greater progress has been made in halting the rise of childhood obesity. In Switzerland, the prevalence of obesity among children aged 6–12 years has plateaued in recent years at much lower levels than the United States: 5.3% in 2017–2018 [37]. Similarly, in 2008, it was shown that the prevalence of obesity among 2‐ to 18‐year‐old in Australia had plateaued at 5–6% [38]. In fact, a handful of European countries have even reported declines in childhood obesity. In Italy, the prevalence of obesity among 8‐ to 9‐year‐old declined significantly from 12.0% in 2008 to 9.3% in 2016 [39]. Declining trends were observed across sociodemographic groups, though not statistically significant among children with low education or foreign mothers [39]. Similarly, from 2000 to 2007, the prevalence of obesity among 7‐ to 9‐year‐old children in France declined from 3.8 to 2.8% (though not statistically significant) [40].

The opposite is seen in other parts of the world, particularly rapidly developing economies, where childhood obesity is increasing. For example, in China, the prevalence of childhood obesity increased from 5.3% in 1995 to 20.5% in 2014 and showed no sign of stabilizing [41]. In Colombia, the prevalence of combined overweight and obesity among 5‐ to 9‐year‐olds increased from 14.3% in 2005 to 18.9% in 2010, and among 10‐ to 17‐year‐olds, these numbers are 13.7 to 16.7%, respectively [42]. Thus, trends in the United States, Australia, and many European countries suggest that childhood obesity can be prevented at the population level. Still, similar efforts are needed in other parts of the world where the prevalence of childhood obesity continues to increase.