Childhood Obesity

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In March 2004 a group of 65 physicians and other health professionals representing nine countries on four continents convened in Israel to discuss the widespread public health crisis in childhood obesity. Their aim was to explore the available evidence and develop a consensus on the way forward.

The process was rigorous, although time and resources did not permit the development of formal evidence-based guidelines. In the months before meeting, participants were allocated to seven groups covering prevalence, causes, risks, prevention, diagnosis, treatment, and psychology. Through electronic communication each group selected the key issues for their area, searched the literature, and developed a draft document. Over the 3-d meeting, these papers were debated and finalized by each group before presenting to the full group for further discussion and agreement.

In developing a consensus statement, this international group has presented the evidence, developed recommendations, and provided a platform aimed toward future corrective action and ongoing debate in the international community.

Why is obesity so prevalent?

Man has evolved under conditions of stress in which it was advantageous to be able to store fat . It is this genetic propensity to store fat in response to insulin, paired with our lifestyles with too much sedentary activity and processed energy-dense foods, that has contributed to the problem of overweight. Numerous genetic markers have been linked with obesity and its metabolic consequences , yet identifiable hormonal, syndrome, or molecular genetic abnormalities can presently account for less than 5% of obese individuals. This is discussed in greater detail in Causes.

An Endocrinologist's Guide to the Clock

It has long been known that organisms exhibit a multiplicity of physiological and behavioral rhythms that recur every 24 h. This in turn gave rise to speculation over the existence of a biological clock able to “tell the time” from the ambient day/night cycle. In the 1950s, the term “circadian” was coined to denote these daily cycles, and clock theory was consolidated (1). Experimental data and mathematical modeling proposed that an oscillator generates a characteristic sine-wave output with a regular cycle length, or period, responsible for repeating 24-h rhythms. Crucially, the clock is endogenous, not reactive. It does not merely passively respond to environmental changes but sustains free-running cycles that persist even when organisms are housed in constant darkness in deprivation of external time cues. Such time cues are called Zeitgebers, and by a process of phase-shifting they may reset or entrain the clock to a new environmental rhythm. The master Zeitgeber is light. The out...

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