Passage 2 A Public Health Problem of Childhood Obesity
肥胖癥對(duì)人的終生影響 《時(shí)代周刊》
[00:03]Lifelong Effects of Childhood Obesity
[00:07]A public health problem of childhood obesity
[00:11]Children usually dream of their future profession. Doctor, firefighter,
[00:17]astronaut. These are the things kids want to be when they grow up.
[00:22]Obese 35-year-old with type 2 diabetes and heart disease? Not exactly.
[00:29]But according to two studies published recently
[00:32]in the New England Journal of Medicine (NEJM),
[00:36]that's where our children are headed, unless monumental and immediate
[00:41]changes are made in the effort to curb childhood obesity.
[00:46]"This is a public health problem, and public health problems require policies
[00:52]that actually reinforce positive choices,"
[00:55]says Dr. Kirsten Bibbins-Domingo of the University of California,
[01:00]San Francisco, a principal author of one of the NEJM studies.
[01:06]"We know that healthy nutritious foods and physical activity
[01:11]are really the keys to preventing excessive weight gain in childhood.
[01:16]We need a joint effort at the federal,
[01:19]state and local level across government and industry to ensure
[01:25]that those things are available to our children."
[01:30]Diseases and deaths out of childhood obesity
[01:34]Those efforts are already overdue,
[01:37]according to the findings of Bibbins-Domingo's report.
[01:41]Estimating from childhood obesity rates from 2000,
[01:46]she and her colleagues at San Francisco General Hospital
[01:50]and Columbia University, infer that by 2020,
[01:55]as many as 44% of American women and 37% of men, at age 35,
[02:03]will be obese obese and, therefore, ill. By 2020, "we found,
[02:10]not unexpectedly, that the prevalence of heart disease
[02:14]will rise by as much as 16%, and heart disease deaths by
[02:20]as much as 19% between the ages of 35 and 50 years," says Bibbins-Domingo.
[02:28]Estimating conservatively,
[02:30]that figure translates to about 100,000 additional heart disease deaths
[02:36]among 35-to-50-year-olds solely due to obesity. Realistically,
[02:43]says Bibbins-Domingo, the number is probably closer to 300,000.
[02:49]The second, larger study in the NEJM came to similar conclusions.
[02:56]By comparing the childhood medical records
[02:59]and adulthood hospital records of 276,835 Danish citizens born
[03:07]between 1930 and 1976, researchers found a distinct correlation
[03:14]between higher childhood body mass index (BMI)
[03:19]the ratio between height and weight that is the standard for defining obesity
[03:24]and a greater risk of future heart disease and heart disease-related death.
[03:31]According to the authors,
[03:32]it is the first study to conclusively link excess weight in childhood
[03:38]and health problems later on. What's more,
[03:41]the data showed that the correlation is linear and progressive:
[03:46]as kids' BMI increased, their risk of adult heart disease rose alongside it.
[03:54]"We anticipated finding a threshold, or a cut point
[03:58]at which the risk dramatically increased or remained stable,
[04:03]so when it worked out to be such a proportional increase
[04:07]we were very surprised," says co-author Dr. Jennifer Baker,
[04:12]of the Center for Health and Society at the Institute of Preventive Medicine
[04:17]in Copenhagen. "The association we found is very straightforward,
[04:23]the higher a child's BMI in childhood from the ages of 7 to 13,
[04:29]the greater the risk of heart disease in adulthood.
[04:33]They increase in proportion to each other."
[04:37]Risk increase with weight and age
[04:41]The risk increased not only with weight, but also with age.
[04:46]At seven, a girl of average height and weight (about 4 feet, 52 pounds.)
[04:53]had a 4.6 % chance of developing heart disease in adulthood;
[04:59]the risk for that same girl, 10 pounds heavier, jumped to 4.8%. At age 13,
[05:06]a healthy girl (5 feet and 2 inches, 101 pounds.)
[05:12]had a 4.6% chance of developing heart disease as an adult,
[05:17]but at a higher BMI - the equivalent of adding about 28 pounds
[05:23]her risk of heart disease spiked to 5.7%.
[05:28]That amounts to an overall 24% higher risk of developing the disease.
[05:35]In boys, the study found, the risks were even greater. At age seven,
[05:42]a healthy boy (about 4 feet, 52 pounds) had an 11.7% chance of later
[05:50]developing heart disease; with 8.6 pounds of additional padding,
[05:55]that risk jumped to 12.9%. And at age 13, heavy boys
[06:01]those with 24.7 pounds of extra weight showed a whopping 33% increased
[06:10]risk of developed heart disease over their slimmer peers.
[06:15]By the U.S. standards - where some nine million children
[06:20]are overweight the children included in the Danish paper
[06:23]would have barely made the cutoff for "overweight.
[06:27]" Merely being chubby it seems let alone obese can be a serious health risk.
[06:33]"Our study shows that even a few excess pounds or kilograms of weight
[06:39]can damage future health," Baker says.
[06:43]Baker did not have access to her subjects' adult weights,
[06:48]so she could not confirm whether their heart-disease risk was influenced
[06:52]by adult obesity, but her study did show that those risks
[06:58]weren't nearly as high in kids who started out heavy at age 7,
[07:03]but lost the weight by 13.
[07:06]"If we could intervene in that period to help these children attain
[07:10]and maintain an appropriate weight for their age,
[07:15]we really could significantly reduce the risk of heart disease in the future,"
[07:21]says Baker.
[07:23]Early prevention
[07:25]It's better, experts say, to prevent that risk from ever climbing
[07:30]and keep children fit from the beginning.
[07:33]"If you're trying to prevent this problem,
[07:35]then you want to establish good food habits early.
[07:40]You want to keep children away from the food industry messages
[07:44]to eat unhealthy food. It could be that earlier years
[07:49]will be the best time to begin that education," says Dr. Kelly Brownell,
[07:55]director of the Rudd Center for Food Policy and Obesity at Yale.
[08:01]As with most health problems, the key is prevention,
[08:06]and the effort cannot be left up to the individual
[08:10]parents ought to be the first to take responsibility.
[08:14]Dismissing childhood obesity as baby fat or relying on a kid's will power
[08:20]is simply not a solution, says Baker.
[08:23]"We cannot consider it just to be a superficial problem.
[08:27]It's a health risk problem," she says. "We can no longer sit back and wait,
[08:33]and think a child may grow out of it."
