the same BMI values. Obese children have a greater chance of becoming obese adults than children of normal weight. Children of obese parents have an even greater likelihood of becoming obese. An obese preschooler with normal weight parents has approximately a 25 percent chance of becoming an obese adult; however, the same child with an obese parent has greater than a 60 percent chance of becoming an obese adult (Whitaker et al., 1997). Moreover, an obese 2- to 5-year-old is more than four times as likely to become an obese adult when compared to a child who is below the 50th percentile of the CDC BMI charts3 (Freedman et al., 2005).

Although childhood-onset obesity accounts for only a quarter of adult obesity cases, obesity that is present before a child is 8 years of age, and persists into adulthood, is associated with severe obesity—a BMI greater than 40 kg/m2—in adulthood as compared with a BMI of 35 kg/m2 for adult-onset obesity (Freedman et al., 2001). Between 1990 and 2000, severe obesity, which is associated with more serious health complications, more than doubled, increasing from 0.78 percent to 2.2 percent in U.S. adults (Freedman et al., 2002). Additionally, concerns about childhood-onset obesity are supported by documented associations between childhood obesity and increased cardiovascular disease risk and mortality in adulthood (Li et al., 2004; Srinivasan et al., 2002). The most promising way to prevent future adult obesity is to promote an environment conducive to healthy eating among children and youth (Taylor et al., 2005).

Obesity is not the only diet-related problem children and youth face. In addition to the consumption of excess calories and added sugars, the consumption of sodium, saturated fats, and trans fats are well above recommended levels and the consumption of vegetables, fruits, whole grains, and calcium are well below recommended levels. American children and youth are therefore at increased risk for developing conditions such as heart disease, stroke, certain cancers, type 2 diabetes, and osteoporosis later in life. As discussed in Chapter 2, the most current data indicate that the overall nutrient intakes of children and adolescents4 depart substantially from recommended patterns and reflect a pattern that puts young people’s health at risk (Box 1-1).


The CDC BMI charts are mathematically smoothed curves of the pooled growth parameters of children and adolescents sampled in cross-sectional national health surveys conducted from 1963 to 1994. The current CDC guidelines for healthy weight in children and youth are in the range of the 5th to the 85th percetiles.


See discussion later in this chapter for age categories and related terms used throughout this report.

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