Prevention of Childhood Obesity

The World Health Organization has been working with triglycerides, and low HDL was 12.7%, 5.2%, 5.1%, 5.0%, and its member states to reduce childhood obesity by imple-10.2%, respectively (11). The accumulation of risk factors menting the “Global Strategy on Diet, Physical Activity, is also rather prevalent, and 10% of adolescents fulfill the and Health” (1). The number of overweight and obese criteria for metabolic syndrome (12). children worldwide has been estimated at over 155 and Overweight and obesity in childhood and adolescence 45 million, respectively (2, 3). In other words, 1 out of ev-increase the risk of coronary heart disease (CHD) in ery 8 children in the world has excess weight. The early adulthood (13, 14), and the prevalence of CHD has been consequences of obesity in children and adolescents are predicated to increase 5%–16% by 2035. Therefore, accord- hyperlipidemia, insulin resistance, and hypertension in ing to Ludwig’s hypothesis, we have passed phase 1 (in- the pediatric age group (4). Furthermore, in recent years, creased prevalence of pediatric obesity) and phase 2 (in- an increasing number of complications, including type creased complications such as type 2 diabetes, fatty liver, 2 diabetes, fatty liver, and orthopedic, respiratory, and etc.) of the obesity epidemic, and we are entering phase sleep disorders have been reported (5, 6). This trend of in-3, which projects a rise in adult CHD in those suffering creasing pediatric obesity is seen not only in developed from excess weight and obesity during childhood (15). It countries, but also in developing countries (7). An alarm-has been predicted that this process may shorten life ex- ing prevalence of childhood and adolescent obesity has pectancy in the United States by 2–5 years by midcentury; been reported in Middle Eastern countries (8). For ex-equal to all cancers combined (16). Are people waiting ample, in Iran, the Tehran Lipid and Glucose Study (TLGS) to see phase 4 of Ludwig’s hypothesis, an acceleration of and other investigations have reported a disturbing rise obesity through transgenerational mechanisms in the in the rate of excess weight in the pediatric age group late 21st century, including irreversible biologic changes (9, 10). In 9% of boys and 7% of girls, 2 or more non-com-in hormonal pathways, fat cells, and the brain that in- municable disease risk factors were seen, and the preva-crease hunger and adversely affect metabolism, and af- lence of hypertension, obesity, high cholesterol, elevated fection of offspring through prenatal programming?