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A common policy response to the rise in obesity prevalence is to undertake interventions in childhood, but it is an open question whether this is more effective than reducing the risk of becoming obese during adulthood. In this paper, we model the effect on health outcomes of (i) reducing the prevalence of obesity when entering adulthood; (ii) reducing the risk of becoming obese throughout adult life; and (iii) combinations of both approaches. We found that, while all approaches reduce the prevalence of chronic diseases and improve life expectancy, a given percentage reduction in obesity prevalence achieved during childhood had a smaller effect than the same percentage reduction in the risk of becoming obese applied throughout adulthood. A small increase in the probability of becoming obese during adulthood offsets a substantial reduction in prevalence of overweight/obesity achieved during childhood, with the gains from a 50% reduction in child obesity prevalence offset by a 10% increase in the probability of becoming obese in adulthood. We conclude that both policy approaches can improve the health profile throughout the life course of a cohort, but they are not equivalent, and a large reduction in child obesity prevalence may be reversed by a small increase in the risk of becoming overweight or obese in adulthood.

The prevalence of childhood overweight and obesity has risen substantially worldwide in less than one generation. In the USA, the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country's children are overweight or obese. Some low-income and middle-income countries have reported similar or more rapid rises in child obesity, despite continuing high levels of undernutrition. Nutrition policies to tackle child obesity need to promote healthy growth and household nutrition security and protect children from inducements to be inactive or to overconsume foods of poor nutritional quality. The promotion of energy-rich and nutrient-poor products will encourage rapid weight gain in early childhood and exacerbate risk factors for chronic disease in all children, especially those showing poor linear growth. Whereas much public health effort has been expended to restrict the adverse marketing of breastmilk substitutes, similar effort now needs to be expanded and strengthened to protect older children from increasingly sophisticated marketing of sedentary activities and energy-dense, nutrient-poor foods and beverages. To meet this challenge, the governance of food supply and food markets should be improved and commercial activities subordinated to protect and promote children's health.

Objectives. Obesity in childhood is associated with the presence of risk factors for later disease and with the early development of these diseases. This paper aims to estimate the numbers of children with obesity-related disease risk factors and co-morbidities in the European Union (EU). Methods. A search of the scientific literature identified prevalence rates relating variously to impaired glucose tolerance, hyperinsulinaemia, type 2 diabetes, several cardiovascular risk factors, non-alcoholic fatty liver disease, and the metabolic disease syndrome among obese children. Using the lowest likely prevalence rates for each disease indicator, estimates were made of the expected numbers of obese children within the EU likely to be showing the specified indicator. Results. On the most conservative estimate, over 20 000 obese children in the EU have type 2 diabetes, while over 400 000 have impaired glucose tolerance. Over a million obese children are likely to show a range of indicators for cardiovascular dise...

Surveys have shown the prevalence of overweight among school age children to be as high as 35% in parts of Europe, and several countries have reported prevalence rates increasing year-on-year. The purpose of the present paper is to review the rate of change in prevalence of overweight and obesity among children in the European region.A search of published and unpublished surveys was undertaken to find pairs of surveys that could indicate rates of change of prevalence within comparable population groups using comparable measures. Data from 45 pairs of surveys from 11 countries were analysed.Annual increases in prevalence of overweight (including obesity) rose from typically below 0.5 percentage points in the 1980s, to over 1.0 percentage points in the late 1990s. For obesity alone, the annual increase in prevalence was typically below 0.1 percentage points in the 1980s and typically 0.3 percentage points in the late 1990s.The prevalence of overweight and obesity among children is rising in the European region, and the annualised rates of increase are themselves increasing. Unless action is taken to counteract these trends, by the year 2010 the European Union can expect to see the numbers of overweight and obese children rising by approximately 1.3 million children per year, of which the numbers of obese children will be rising by over 0.3 million per year.

Aims. To establish the prevalence of child overweight and obesity in the USA using IOTF-recommended definitions. Methods. Original data from the NHANES surveys for 1999–2000 and 2003–2004 were analysed using the IOTF cut-offs and prevalence levels calculated using sample weightings provided. Results. In 1999–2000, overweight (including obesity) was affecting 29% of school-age children. By 2003–2004 this figure had risen above 35%. Obesity alone was affecting 10% of school children in the 1999–2000, and over 13% in 2003–2004. Conclusion. The United States is experiencing levels of child overweight and obesity that are among the highest recorded in any country in the world.