Childhood obesity is one of the most critical public health problems today and threatens to reverse the last half century’s gains in reducing cardiovascular (CVD) disease and death.'Our nation needs immediate action to prevent excess weight gain in all our children and to treat children and adolescents who are already overweight or at risk of developing obesity",told an expert of pediatrics and environmental health .

Results of several studies shown that abdominal obesity, in particular, has increased dramatically in U.S. kids and teens, especially in older teens. For kids and teens who are overweight, getting more physical activity and eating more vegetables, fruits, low-fat dairy products, and lean proteins may help reduce excess weight gain.Poor nutrition and physical inactivity together are the second leading cause of premature and preventable death ? after tobacco.

Obese children under three years of age without obese parents are at low risk for obesity in adulthood, but among older children, obesity is an increasingly important predictor of adult obesity, regardless of whether the parents are obese. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age.

20.3% of Florida high school students reported eating 5 or more servings of fruits or vegetables each day during the past 7 days. 65.5 % of high school students reported watching TV for 2 or more hours on an average school day (pediatricians recommend no more than 1 to 2 hours per day) 32.8 % of high school students reported playing video games or using the computer for fun on an average school day.

One study in the Annals of Internal Medicine reports that teenage girls who are obese run a three-fold greater risk of premature death in middle age.

According to one survey, 10.3% of teenage girls and 6.9% of boys with chronic illness, such as diabetes or asthma, had an eating disorder. Some recent research suggests an endocrinological link between obesity, diabetes, and eating disorders.Binge eating (without purging) is most common in type 2 diabetes and, in fact, the obesity it causes may even trigger this diabetes in some people.

Body Mass Index (BMI) is a measure of body fatness. It is calculated by dividing a person’s weight in kilogrammes by their height in metres squared.Obese children are likely to suffer from sleep apnea a breathing disorder that causes a brief interruption of breathing during sleep.

• Below the 5th percentile for their age are considered underweight.
• Equal to or above the 85th percentile for their age are at risk for being overweight.
• Equal to or above the 95th percentile for their age are considered overweight. A child who has continuously been in the 85th, 90th, or 95th percentile range is probably growing normally (homeostasis) for his or her body type. A child who has a large upward change in BMI percentile, even if not considered overweight, should be evaluated to determine the cause.

BMI Percent is the weight indicator used for children and teens. It is an indicator that compares calculated BMI to all other children of the same age and sex. For example, a child whose BMI is at the 50th percentile means that 50 percent of children of the same age and sex have a lower BMI. A child is at risk for overweight if his or her BMI is between the 85th and 95th percentile and is overweight if his or her BMI is greater than or equal to the 95th percentile.

A new analysis of a major study of childhood nutrition shows that early sexually-maturing girls are more likely than other girls to be obese, while in boys early developers are less likely to be obese than other males."This suggests that sexual maturity might have different biological influences on growth in weight and height in boys and girls," expert said. "During the growth process in boys, more energy may be devoted toward height than to the development of fat tissue, while early-maturing girls are more likely to store extra energy intake as fat tissue."

Study found that major race/ethnicity groups differ when it comes to the top three health concerns for children as well. While white adults list smoking, drug abuse and alcohol abuse at their top three concerns, black adults rate teen pregnancy, smoking and drug abuse, and Hispanic adults rank smoking, drug abuse and childhood obesity as the three major health problems for children.

For healthy children with normal blood pressure, prevention of obesity is thought to be the most important approach to maintain normal left ventricular mass. However, for children with established left ventricular hypertrophy.Researchers are urging more frequent blood pressure testing and weight assessment and, in some cases, an echocardiogram in teenagers. Both studies found that thickening of the heart walls -- called left ventricular hypertrophy -- is common in teens who have high blood pressure and obesity.

Preventive measure:

Obesity is also an issue fraught with emotion and a potential for stigmatization, making it extremely difficult to discuss with patients. Significant behavior change is required to prevent obesity and diabetes, both for patients and teens.Access food nutrition, goal-setting, physical activity, and encouraging a healthy lifestyle.

Teens who are most physically active and consume the most calories are the leanest, researchers said.The take-home message would be to encourage your child to do as much vigorous physical activity as possible, including at least one hour of moderate to vigorous physical activity on a daily basis.This allows your child to eat more calories, which encourages more healthy eating habits while remaining in energy balance.Make sure your kid gets outside during daylight hours. You could make it a policy in your family that unless the weather is bad, your children play outdoors after school. This encourages physical activity, and rules out the inactive pursuits of TV and other media.

The higher the concentration of poverty within a community, the fewer the supermarkets.One study found that children who lived in metropolitan areas where fruits and vegetables were relatively expensive gained significantly more weight than children who lived where fruits and vegetables were cheaper.

Television ads, the internet, games, and strategic product placement strongly influence children to prefer and request high-calorie, low-nutrient foods and beverages. over 80 percent of food products aimed at children are of poor nutritional quality.

Recommendations for prevention of overweight and obesity during childhood and adolescence include:

• The best way to have a healthy weight is prevention. Be sure your family has healthy habits from the beginning, and prevent yourself and your children from becoming overweight. It is much easier to maintain a healthy weight than it is to lose weight. So whole family effort is most impotent.
• Gradually work to change family eating habits and activity levels rather than focusing on a child's weight.
• Be a role model. Parents who eat healthy foods and participate in physical activity set an example so that a child is more likely to do the same.
• Encourage physical activity. Children should have 60 minutes of moderate physical activity most days of the week. More than 60 minutes of activity may promote weight loss and subsequent maintenance. But that doesn't mean 60 solid minutes at a stretch. Shorter, repeated bursts of activity during the day can help burn calories, too.
• Reduce "screen" time in front of the television and computer to less than two hours daily.
• Encourage children to eat when hungry and to eat slowly.
• Encourage your teen to scale back and stop eating when he or she is full.Encourage your teen also to replace even one bag of chips a day with a healthier grab-and-go option from home:
• Frozen grapes
• Oranges, strawberries or other fresh fruit
• Sliced red, orange or yellow peppers
• Cherry tomatoes
• Baby carrots
• Low-fat yogurt or pudding
• Pretzels
• Graham crackers
• String cheese
• Mealtimes should be family times! Create a relaxed atmosphere around mealtime. Eat slowly and enjoy your food. Eat together as a family, and don’t watch TV during meals
• Avoid using food as a reward or withholding food as a punishment.
• Keep the refrigerator stocked with fat-free or low-fat milk, fresh fruit, and vegetables instead of soft drinks and snacks high in sugar and fat.
• Use rewards when your child meets their weekly goals. Rewards could be special time with you doing an activity your child enjoys or a special toy.
• Have your child keep a record of their food intake and exercise. This will allow them to be more self-aware of their behavior. Then look at the record together, one-on-one, and go over it. Give them positive feedback
• Serve at least five servings of fruits and vegetables daily.
• Encourage children to drink water rather than beverages with added sugar, such as soft drinks, sports drinks, and fruit juice drinks.
• Weight and body image can be delicate issues — especially for teenage girls. When it comes to teen weight loss, remind your teen that there's no single ideal and no perfect body. The right weight for one person might not be the right weight for another.Rather than talking about "fat" and "thin," encourage your teen to focus on practicing the behaviors that promote a healthy weight.
• BMI is used to screen for overweight, at risk of overweight, or underweight. However, BMI is not a diagnostic tool. For example, a child may have a high BMI for age and sex, but to determine if excess fat is a problem, a health care provider would need to perform further assessments. These assessments might include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.