Clinical Obesity in Adults and Children. Группа авторов

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2 Causes of Obesity

       Emily Oken1,2 and Susan E. Ozanne3

      1 Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA

      2 Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA

      3 University of Cambridge Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Wellcome‐MRC Institute of Metabolic Science, Cambridge, UK

      The global obesity epidemic has spared no segment of the population, even children. In the United States, prevalence of all categories of obesity among children has continued to increase over the past decade, including in the youngest children aged 2–5 years [1]. Globally, between 1980 and 2015 the prevalence of obesity increased from 3.9 to 7.2% in boys and from 3.7 to 6.4% in girls aged 2–4 years [2]. Multiple streams of evidence suggest that exposures occurring in early life, including prenatally and even preconceptionally, contribute to these obesity trends. In this chapter, we provide a brief overview of obesity assessment in children, review evidence from human and animal studies regarding early life exposures that likely influence body weight development, discuss potential mechanisms, and finally review implications for clinical and public health practice.

      In both clinical practice and public health surveillance, children’s weight status is routinely assessed according to body mass index (BMI), calculated as weight in kilograms divided by height (or recumbent length in children under age 2 years) in meters squared, and categorized compared with a reference population of the same age and sex. The World Health Organization Child Growth Standard, which provides standards for weight, length, and BMI‐for‐age and sex for children from birth to age 18 years, is used as the reference in most settings [3,4]. With this tool, obesity is defined as BMI above the 97.7th percentile. In the United States, many continue to calculate BMI percentiles from growth charts developed by the Centers for Disease Control and Prevention (CDC), which provide reference data based on US‐specific, population‐based norms for children 2 years and older [5]. Within the CDC reference, obesity is defined as BMI at or above the 95th percentile for age and sex, and overweight as a BMI between the 85th and 95th percentiles. While the two different references yield slightly different thresholds and thus slightly different obesity prevalence values within a population, they are equally predictive of obesity and adverse

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