Despite the lack of agreement over childhood obesity classification, there is ample evidence to illustrate the scale of the problem across the world.
Using the existing WHO standards, the 1998 World Health Report indicated that about 22 mil-
OBESITY AS A GLOBAL PROBLEM Table 1.9 Prevalence of overweight" in 6- to 8-year-old children
USA China Russia South Africa Brazil
"Defined as BMI higher than the US reference NHES 85th percentile. Source: Popkin et al. (35).
lion children under 5 years are overweight across the world (2). This was based on weight-for-height data from 79 developing countries and a number of industrialized countries. Once the new growth reference is available a more realistic estimate should be possible.
Another comparison performed using the US NHES criteria also revealed the alarmingly high levels of overweight that exist in older children in both developed and developing countries. In some countries, up to a quarter of the school age child population is already overweight (Table 1.9).
Trend data suggest that the childhood obesity problem is increasing rapidly in many parts of the world. In the US, the percentage of young people aged 5-14 who are overweight has more than doubled in the past 30 years. Prevalence has risen from 15% in 1973-1974 to 32% in 1992-1994. Meanwhile, in England, triceps skinfold measurement increased by almost 8% in 7-year-old English boys and by 7% in 7-year-old girls between 1972 and 1994. In Scotland over the same period, triceps skinfold measurement increased by nearly 10% in 7-year-old boys and by 11% in 7-year-old girls. Weight for height index followed a similar pattern.
Childhood obesity is also increasing in Asia. In Thailand, the prevalence of obesity in 6- to 12-year-old children rose from 12.2% in 1991 to 15.6% in 1993. In Izumiohtsu city in Japan, the percentage of obese children aged 6-14 years doubled from 5 to 10% between 1974 and 1993.
Data from developing countries in Latin America show that urban residency, high SES and higher maternal education are associated with greater risk of overweight in children and that obesity is more common in girls than in boys. In developed countries an opposite association between SES and obesity is often found, with children from poorer educated parents with lower occupations more likely to be overweight.
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