An increase in body mass index (BMI) and percentage ideal body weight are good predictors of morbidity, some researchers suggest that visceral obesity represents a variant that is more closely related to excess morbidity. Daniels states that obesity-problems and diseases "once thought applicable only to adults are now being seen in children and with increasing frequency. Examples include high blood pressure, early symptoms of hardening of the arteries, type 2 diabetes, nonalcoholic fatty liver disease, polycystic ovary disorder, and disordered breathing during sleep" (Daniels 2006, 47). Following Wadden and Stunkard (9) blood volume is increased in obesity in proportion to the increased body mass. Because blood volume increases with obesity proportionally more than does cardiac output, even simple obesity is a volume expanded state. Even in simple obesity, cardiac stroke volume and pulse rate are increased in line with the hypervolaemic conditions mentioned above. Obese patients with co-morbidities have cardiac dilation and hypertrophy demonstrable by echocardiography (Hills 82). ECG diagnosis of hypertrophy is more problematic because of the effect of thickening of the chest wall. Some studies suggest left ventricular mass index is proportional to BMI, others that it is more closely related to percentage of body weight over ideal weight. However, as the strain on the heart persists both impaired systolic function and diastolic function typically develop (Glanz and Sallis 2006). Obesity can impact on lung function, with excess central fat deposition producing a restrictive pulmonary abnormality and increased work of breathing. As a result, respiratory complaints are common in subjects with obesity and conditions such as asthma are often overdiagnosed in obese patients. Obesity is also linked to breathing disorders during sleep, such as sleep apnoea and nocturnal hypoventilation (Wadden and Stunkard 92).
Fast food, unhealthy behavior patterns and lack of physical activity lead to increased obesity in children. As the most important, "the industry markets heavily to children with the goal of fostering a fast-food habit that will persist into adulthood" (Murphy, 2000). As with adults, it is critical that children who are overweight or obese at minimum achieve the recommendations of physical activity for health for their age. Two consensus conferences held during the last decade have addressed the activity needs of young people. Achieving standard recommendations has been even more difficult with children than with adults (Hulls 43). The main problem is that children can show deterioration in their health due to low activity levels, because there has been insufficient time, and therefore there are no strong epidemiological endpoints on which to establish relationships (Daniels 2006). As well as reinforcing physical activity behaviors, reducing access to sedentary life style can increase activity levels in obese children. There is a close link between sedentary living (such as the amount of time spent watching television) and obesity, than physically active pursuits and obesity (Karen et al 2005).
Helping children make permanent, healthy changes to their eating