Bagchi Global Perspectives on Childhood Obesity

Current Status, Consequences and Prevention
1. Auflage 2010
ISBN: 978-0-08-096172-9
Verlag: Elsevier Science & Techn.
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 536 Seiten

Understanding the complex factors contributing to the growing childhood obesity epidemic is vital not only for the improved health of the world's future generations, but for the healthcare system. The impact of childhood obesity reaches beyond the individual family and into the public arenas of social systems and government policy and programs. Global Perspectives on Childhood Obesity explores these with an approach that considers the current state of childhood obesity around the world as well as future projections, the most highly cited factors contributing to childhood obesity, what it means for the future both for children and society, and suggestions for steps to address and potentially prevent childhood obesity. - This book will cover the multi-faceted factors contributing to the rapidly growing childhood obesity epidemic - The underlying causes and current status of rapidly growing obesity epidemic in children in the global scenario will be discussed - The strategies for childhood obesity prevention and treatment such as physical activity and exercise, personalized nutrition plans and school and community involvement will be presented

Autoren/Hrsg.

Bagchi, Debasis

Inhaltsverzeichnis

1;Front Cover;1
2;Global Perspectives on Childhood Obesity;4
3;Copyright;5
4;Table of Contents;6
5;Contributors;8
6;Preface;12
7;Dedication;14
8;Section IEpidemiology and Prevalence;16
8.1;Chapter1 Pediatric Obesity;18
8.1.1;Prevention;18
8.1.2;Screening;19
8.1.3;Identification;19
8.1.4;Assessment;20
8.1.5;Treatment;23
8.1.6;Advocacy;24
8.1.7;Conclusion;27
8.1.8;References;27
8.2;Chapter2 Salient Features on Child Obesity from the Viewpoint of a Nutritionist;28
8.2.1;Genetic and Family Aspects;28
8.2.2;Importance of Cognitive Restraint in Children;29
8.2.3;Obesity and Eating Disorders;31
8.2.4;Physical Activity;32
8.2.5;Strategies;32
8.2.6;Conclusion;33
8.2.7;References;33
8.3;Chapter3 Developmental Trajectories of Weight Status in Childhood and Adolescence;36
8.3.1;Developmental Trajectories of Weight Status in Childhood and Adolescence;36
8.3.2;Tracking of Weight Status in Childhood and Adolescence;36
8.3.3;Normative Growth Curve Methods;38
8.3.4;Non-Normative Growth Curve Methods;39
8.3.5;Conclusion;43
8.3.6;References;44
8.4;Chapter4 The Measurement and Epidemiology of Child Obesity;46
8.4.1;Introduction;46
8.4.2;BMI and Body Fatness;47
8.4.3;Classification Systems for High Levels of BMI and Body Fatness;50
8.4.4;Ability of a High bmi to Identify Children who have Excess Body Fatness;53
8.4.5;Conclusion;54
8.4.6;References;55
8.5;Chapter5 Good-Enough Parenting, Self-Regulation, and the Management of Weight-Related Problems;58
8.5.1;Introduction;58
8.5.2;Weight-Related Problems and Self-Regulation;59
8.5.3;Self-Regulation;60
8.5.4;Coping and Competence;62
8.5.5;Parenting, coping, and self-regulation;63
8.5.6;Effective Communication and Prosocial Coping;64
8.5.7;Parenting Style;65
8.5.8;Conclusion and Future Directions for Parent Practices;67
8.5.9;References;68
8.6;Chapter6 Nursing Perspective on Childhood Obesity;72
8.6.1;Introduction;72
8.6.2;Impact of Childhood Obesity;74
8.6.3;Nurse’s Identification of At-risk Children;75
8.6.4;Nurse’s Role in Prevention and Treatment Implementation;77
8.6.5;Treatment Options;78
8.6.6;Barriers to Successful Treatment;81
8.6.7;Conclusion;83
8.6.8;References;83
8.7;Chapter7 Contemporary Racial/Ethnic and Socioeconomic Patterns in U.S. Childhood Obesity;86
8.7.1;Introduction;86
8.7.2;Data and Methods;87
8.7.3;Results;91
8.7.4;Conclusion;96
8.7.5;References;99
8.8;Chapter8 Prediabetes among Obese Youth;102
8.8.1;Introduction;102
8.8.2;Definitions;102
8.8.3;Epidemiology of Diabetes and Prediabetes;103
8.8.4;Whom to Screen?;105
8.8.5;Progression of Prediabetes;105
8.8.6;Treatment of Prediabetes;106
8.8.7;Lifestyle;106
8.8.8;Pharmacotherapy in Prediabetes;106
8.8.9;Conclusion;107
8.8.10;References;107
8.9;Chapter9 Prediabetes and Type 2 Diabetes;110
8.9.1;Introduction;110
8.9.2;Global T2DM Prevalence Reports;110
8.9.3;Additional T2DM Reports from Centers And Unique Populations;111
8.9.4;Prediabetes Prevalence in Youth;111
8.9.5;Center-Based Studies and Unique Populations;112
8.9.6;Longitudinal Studies in Adults;113
8.9.7;Longitudinal Studies in Youth;113
8.9.8;American Diabetes Association (ADA) Guidelines for Screening;114
8.9.9;Risk Factors Identified for Pediatric T2DM;114
8.9.10;Presentation;116
8.9.11;Screening for T2DM in Primary Care;116
8.9.12;Complications of T2DM;116
8.9.13;Follow-Up for Youth With T2DM;116
8.9.14;Prevention;116
8.9.15;Conclusions and Suggested Approaches to Screening;117
8.9.16;Identified Risk Factors for T2DM;117
8.9.17;Which Tests to Use?;117
8.9.18;How Often to Test?;118
8.9.19;Conclusion;118
8.9.20;References;118
8.10;Chapter10 Prevalence of the Metabolic Syndrome in U.S. Youth;122
8.10.1;Introduction;122
8.10.2;Estimating The Population-Based Prevalence of Metabolic Syndrome in Children and Adolescents;123
8.10.3;Nhanes III Prevalence Estimates;123
8.10.4;Later Nhanes Prevalence Estimates;124
8.10.5;Other Regional-Based Sample Estimates;126
8.10.6;Ethnicity and The Prevalence of Metabolic Syndrome;127
8.10.7;Pathophysiology and Secular Trends;127
8.10.8;Future Projections;128
8.10.9;Conclusion;128
8.10.10;References;129
9;Section IIPathophysiology;132
9.1;Chapter11 Emerging Pathways to Child Obesity Starts from the Mother’s Womb;134
9.1.1;Introduction;134
9.1.2;Background on Factors of Child Obesity;134
9.1.3;Involvement of Genetics in Child Obesity;135
9.1.4;Factors Involved During Fetal Life (Nutritional);135
9.1.5;Factors Involved During Fetal Life (Non-Nutritional);136
9.1.6;Hidden Chemicals That Trigger Obesity During Pregnancy;137
9.1.7;Prevention of Child Obesity Before Birth;137
9.1.8;Change The Attitude, Change The Trend;138
9.1.9;Conclusion;139
9.1.10;References;139
9.2;Chapter 12 The Social, Cultural and Familial Contexts Contributing to Childhood Obesity;142
9.2.1;Introduction;142
9.2.2;Cultures and Childhood;142
9.2.3;Cultured Bodies in the Global Context;144
9.2.4;The Importance of Childhood and Class;145
9.2.5;Energy in and Energy Out: Food Consumption and Physical Activity;145
9.2.6;Culinary Cultures and Food Consumption Practices;145
9.2.7;The Culture of Physical Activities;146
9.2.8;National Sociocultural Trends Influencing Body Weight;147
9.2.9;Familial Contexts of Childhood Obesity;148
9.2.10;Running and Juggling: Time Pressure, Convenience, and Child-Centered Parenting;148
9.2.11;Conclusion: Intervening in Sociocultural and Familial Contexts of Childhood Obesity;150
9.2.12;References;151
9.3;Chapter 13 Cardiovascular Risk Clustering in Obese Children;154
9.3.1;Pathophysiology of the Insulin Resistance Syndrome in Childhood;154
9.3.2;Defining the Insulin Resistance Syndrome in Children;158
9.3.3;Clinical Relevance;158
9.3.4;Conclusion;158
9.3.5;References;159
9.4;Chapter 14 A Link between Maternal and Childhood Obesity;162
9.4.1;Background;162
9.4.2;Obesity and the Family;162
9.4.3;The Genetic Basis of Childhood Obesity;163
9.4.4;The Role of the Prenatal Environment;164
9.4.5;Maternal Obesity and the Family Environment;167
9.4.6;The Link Between Maternal and Child Obesity: Public Health Implications;168
9.4.7;References;169
9.5;Chapter 15 Is Prenatal Exposure to Maternal Obesity Linked to Child Mental Health?;172
9.5.1;Behavior Problems in Children;173
9.5.2;Concept of Prenatal Programming;174
9.5.3;Potential Mechanisms Linking Maternal Obesity and Child Behavior Problems;174
9.5.4;Confounding Factors;178
9.5.5;Conclusion;178
9.5.6;References;179
9.6;Chapter 16 Sleep and Obesity in Children and Adolescents;182
9.6.1;Introduction;182
9.6.2;Prevalence of Obesity and Short Sleep in Children and Adolescents;182
9.6.3;Epidemiological Evidence of a Link Between Sleep Loss and Obesity;184
9.6.4;Laboratory Evidence for a Link Between Sleep Loss and Obesity;187
9.6.5;Putative Mechanisms Linking Sleep Loss and The Risk of Weight Gain and Obesity;188
9.6.6;Sleep Disorders and Obesity in Children;192
9.6.7;Conclusion;193
9.6.8;References;194
9.7;Chapter 17 Cellular Remodeling during the Growth of the Adipose Tissue;198
9.7.1;Mature Adipocytes;198
9.7.2;Adipocyte Precursor Cells;199
9.7.3;Adipose Tissue-Derived Stromal Cells (ASCs);199
9.7.4;At Microcirculation and at-Derived Endothelial Cells;199
9.7.5;Immune Cells;200
9.7.6;Conclusion;202
9.7.7;References;202
9.8;Chapter 18 Children Obesity, Glucose Tolerance, Ghrelin, and Prader-Willi Syndrome;206
9.8.1;Introduction;206
9.8.2;Clinical Features of PWS: Childhood-Onset Obesity, Body Composition, and Hyperphagia;206
9.8.3;Glucose Metabolism and Insulin Sensitivity;208
9.8.4;Ghrelin and Obestatin Regulation;209
9.8.5;Prader-Willi Syndrome (PWS), Glucose Metabolism, and Ghrelin System: What is the Link?;210
9.8.6;Conclusion;211
9.8.7;References;212
9.9;Chapter 19 Insulin Resistance and Glucose Metabolism in Childhood Obesity;216
9.9.1;Introduction;216
9.9.2;Insulin Resistance;216
9.9.3;Insulin and Normal Insulin Signaling;216
9.9.4;Effects of Insulin in Adipose Storage;217
9.9.5;Adipose Tissue and Insulin Resistance;217
9.9.6;Visceral Fat and Insulin Resistance;217
9.9.7;Pathophysiology of Insulin Resistance;218
9.9.8;Metabolic Syndrome in Childhood Obesity;218
9.9.9;Inflammation and Cardiovascular Risk in Obesity;218
9.9.10;Insulin Sensitivity and Nutrient Availability;220
9.9.11;Prevention;220
9.9.12;Conclusion;220
9.9.13;References;221
9.10;Chapter20 Insulin Resistance in Pediatric Obesity;224
9.10.1;Introduction;224
9.10.2;Fat Storage and Fat Metabolism: the Role of Insulin;224
9.10.3;Regulation of Entrance of Fatty Acids into Mitochondria;225
9.10.4;Measuring Insulin Function;226
9.10.5;Insulin Resistance and Weight Gain;226
9.10.6;Insulin Sensitivity in Obese Children;227
9.10.7;Why Insulin Sensitizing Increases Weight;227
9.10.8;Diet Studies on Children;228
9.10.9;Health Aspects of a Low-Carbohydrate Diet;229
9.10.10;The Insulin System in an Evolutionary Perspective;230
9.10.11;Amalgamation;231
9.10.12;References;232
9.11;Chapter 21 Role of Fatty Liver Disease in Childhood Obesity;236
9.11.1;Introduction;236
9.11.2;Pathogenesis;237
9.11.3;Diagnosis;238
9.11.4;Fatty Liver, Cardiovascular Disease, and type 2 Diabetes;239
9.11.5;Treatment;241
9.11.6;Conclusion;242
9.11.7;References;242
10;Section IIIPsychological and Behavioral Factors;246
10.1;Chapter 22 An Overview of Psychosocial Symptoms in Obese Children;248
10.1.1;Background;248
10.1.2;Bias and discrimination;248
10.1.3;Self-esteem;249
10.1.4;Depression;250
10.1.5;Body dissatisfaction;251
10.1.6;Disordered eating;251
10.1.7;Quality of life;252
10.1.8;Social functioning (peer relations and bullying-victimization);253
10.1.9;Relationship between psychosocial symptoms;254
10.1.10;Not all children experience psychosocial symptoms: why?;255
10.1.11;Implications for intervention and prevention;256
10.1.12;References;257
10.2;Chapter 23 Childhood Obesity: Depression, Anxiety and Recommended Therapeutic Strategies;260
10.2.1;Introduction;260
10.2.2;Obesity and depression;260
10.2.3;Obesity and anxiety;261
10.2.4;Empirically supported treatments;263
10.2.5;Interventions for pediatric obesity;263
10.2.6;Enhanced treatment;267
10.2.7;Conclusion;268
10.2.8;References;269
10.3;Chapter 24 The Emotional Impact of Obesity on Children;272
10.3.1;Introduction;272
10.3.2;Obesity and psychological disorders;272
10.3.3;The psychological history of obesity;273
10.3.4;The metaphysical consequences for obese children;273
10.3.5;Teasing and bullying;274
10.3.6;Emotional consequences;274
10.3.7;Problems with school and social functioning;275
10.3.8;Suicidal behavior;276
10.3.9;Interventions;276
10.3.10;Conclusion;277
10.3.11;References;277
10.4;Chapter 25 Psychiatric Illness, Psychotropic Medication, and Childhood Obesity;280
10.4.1;Introduction;280
10.4.2;Pediatric Obesity;280
10.4.3;Prevalence of Psychiatric Illness in Childhood;280
10.4.4;Obesity Associated With Psychiatric Illness;281
10.4.5;Psychotropic Medication Utilization: Second-Generation Antipsychotics;281
10.4.6;Weight Gain on Antipsychotics;282
10.4.7;Mechanism;285
10.4.8;Treatments for Antipsychotic Associated Weight Gain;286
10.4.9;Future Directions in Research;287
10.4.10;Conclusion;288
10.4.11;References;288
11;Section IVConsequences;294
11.1;Chapter 26 Childhood Obesity;296
11.1.1;Incidence of Child Obesity: United States and Globally;296
11.1.2;Health Effects and Medical Treatment;297
11.1.3;Causal Factors;298
11.1.4;U.S. Solutions in Practice;299
11.1.5;Conclusion: Multiple-Front Approaches Needed;301
11.1.6;References;301
11.2;Chapter27 Childhood Obesity and Juvenile Diabetes;304
11.2.1;Introduction;304
11.2.2;Weight, Weight Gain, and Risk of Type 1 Diabetes;304
11.2.3;Weight Gain and Obesity in Children and Adolescents with Type 1 Diabetes;305
11.2.4;Overweight and Obesity and Complications of Type 1 Diabetes in Children and Adolescents;307
11.2.5;Conclusion;308
11.2.6;References;308
11.3;Chapter 28 Bone Health in Obesity and the Cross Talk between Fat and Bone;312
11.3.1;Introduction;312
11.3.2;Bone Mineral Density as a Surrogate Marker For Bone Strength;312
11.3.3;Relation of Bone Mass to Body Weight;313
11.3.4;Fat Mass or Lean Mass: what Influences Bone Mass?;313
11.3.5;Bone Mass in Obese Children;314
11.3.6;Bmd and Fracture Risk in Diabetes;314
11.3.7;Vitamin D;314
11.3.8;Bone and Energy Metabolism;314
11.3.9;Conclusion;315
11.3.10;References;316
12;Section VPrevention and Treatment;318
12.1;Chapter29 A Community-Level Perspective for Childhood Obesity Prevention;320
12.1.1;Introduction;320
12.1.2;Theory and Rationale;321
12.1.3;Community-Based Research: Design, Methods, and Analysis;322
12.1.4;Community Interventions: Progress and Promise;325
12.1.5;Future Directions;329
12.1.6;Summary;331
12.1.7;Conclusion;331
12.1.8;References;331
12.2;Chapter 30 School-Based Obesity-Prevention Programs;334
12.2.1;Introduction;334
12.2.2;The School as a Critical Setting for Obesity Prevention;334
12.2.3;Overview of School-Based Intervention Strategies;335
12.2.4;Theoretical Foundations to School-Based Obesity-Prevention Programs;336
12.2.5;Effectiveness of School-Based Obesity-Prevention Programs;337
12.2.6;Factors that may Influence the Effectiveness of School-Based Programs;339
12.2.7;International Perspectives on School-Based Obesity Prevention;340
12.2.8;Gaps in Research on School-Based Obesity-Prevention Interventions;340
12.2.9;Research Limitations of School-Based Obesity-Prevention Studies;341
12.2.10;Summary and Future Directions;341
12.2.11;Conclusion;344
12.2.12;References;344
12.3;Chapter 31 School-Based Obesity Prevention Interventions Show Promising Improvements in the Health and Academic Achievement ...;348
12.3.1;Introduction;348
12.3.2;Methods;349
12.3.3;Data Analyses;351
12.3.4;Results;352
12.3.5;Discussion;355
12.3.6;Conclusion;356
12.3.7;References;357
12.4;Chapter 32 School and Community-Based Physical Education and Healthy Active Living Programs;360
12.4.1;Introduction;360
12.4.2;Global Epidemic of Obesity;360
12.4.3;Epidemic of Childhood Obesity;361
12.4.4;Changes and Shifts in Diet and Physical Activity Patterns;361
12.4.5;An Integrated Approach of Physical Education, Physical Activity, and Wellness in School;362
12.4.6;Baptist (Sha Tin Wai) Lui Ming Choi Primary School (Hong Kong-China): A Holistic Approach;362
12.4.7;North Vista Primary School (Singapore): the Community of Learners at the School of the Future;365
12.4.8;Grundy Center (Iowa, United States) Community Schools/Polar Electro, Inc./University of Northern Iowa: a Partnership of ...;366
12.4.9;The Innovative Polar Scholars Program;367
12.4.10;Global Forum for Physical Education Pedagogy (2010) (GoFPEP 2010);368
12.4.11;Conclusion;368
12.4.12;Authors' Note;369
12.4.13;References;369
12.5;Chapter33 Schools as ``Laboratories'' for Obesity Prevention;374
12.5.1;Introduction;374
12.5.2;Schools as ``Hubs'' of Obesity Prevention: A Multilevel, Multiagency Approach;374
12.5.3;Conclusion;381
12.5.4;References;384
12.6;Chapter34 Fitness and Fatness in Childhood Obesity;386
12.6.1;Introduction;386
12.6.2;Physical Activity, Physical Fitness, And Motor Competence InnbspObese Children;386
12.6.3;Physical Activity Guidelines fornbspObese Children;390
12.6.4;Conclusion;392
12.6.5;References;393
12.7;Chapter35 Pharmacotherapy in Childhood Obesity;398
12.7.1;Introduction;398
12.7.2;Orlistat;399
12.7.3;Sibutramine;399
12.7.4;Metformin;401
12.7.5;Conclusion;401
12.7.6;References;402
12.8;Chapter36 Beverage Interventions to Prevent Child Obesity;404
12.8.1;Introduction;404
12.8.2;Beverages for Obesity Interventions;404
12.8.3;Perspectives on Beverage Interventions for Obesity Prevention;410
12.8.4;Conclusion;412
12.8.5;References;412
12.9;Chapter 37 Psychotherapy as an Intervention for Child Obesity;416
12.9.1;Obesity: A Disease Put Into Perspective;416
12.9.2;Why Do We Need New Treatments?;416
12.9.3;Psychodynamic Therapy;417
12.9.4;Behavioral and Cognitive Therapies;417
12.9.5;Group Therapy;417
12.9.6;School-Based Treatments and Prevention;418
12.9.7;Early Treatment;418
12.9.8;Family Therapy;418
12.9.9;Systemic Family Medicine;419
12.9.10;Solution-Based Brief Therapy;419
12.9.11;Soft;420
12.9.12;The Processes in Therapy;420
12.9.13;A Case;422
12.9.14;The Questions are the Answers;423
12.9.15;Conclusion;424
12.9.16;References;424
12.10;Chapter 38 Childhood Obesity;426
12.10.1;Introduction;426
12.10.2;Psychological Correlates of Pediatric Obesity;426
12.10.3;Empirically Supported Treatments for Pediatric Obesity;427
12.10.4;Summary;429
12.10.5;Recommendations;430
12.10.6;Areas of Focus;430
12.10.7;Conclusion;430
12.10.8;References;430
12.11;Chapter39 Dietary Supplements in the Prevention and Treatment of Childhood Obesity;434
12.11.1;Introduction;434
12.11.2;Strategic Considerations;435
12.11.3;The Treatment Program for Childhood Obesity;437
12.11.4;Discussions;442
12.11.5;Conclusion;444
12.11.6;References;444
12.12;Chapter 40 The Role of Arginine for Treating Obese Youth;448
12.12.1;Introduction;448
12.12.2;The Growing Obesity Crisis Worldwide;448
12.12.3;Treatment of Obesity in Youth;449
12.12.4;Arginine Supplementation in Humans: Safety, Efficacy, and Pharmacokinetics;450
12.12.5;Role of Nitric Oxide (No) in Fat Metabolism;452
12.12.6;Dietary Arginine Supplementation Reduces Fat Mass in Adult Zucker Diabetic Fatty Rats;453
12.12.7;Dietary Arginine Supplementation Reduces Fat Mass in Diet-Induced Obese Rats;453
12.12.8;Arginine Increased in Vitro Lipolysis in Human Adipocytes;454
12.12.9;Conclusion;454
12.12.10;References;455
12.13;Chapter41 Prevention of Childhood Obesity with Use of Natural Products;458
12.13.1;Introduction;458
12.13.2;Importance of AMPK in Controlling Obesity and Metabolic Disorders;459
12.13.3;Structure and Expression of AMPK;460
12.13.4;Antiobesity Action of a Pharmacological AMPK Activator;460
12.13.5;Prevention of Obesity by AMPK Activators Found in Natural Products;461
12.13.6;Conclusion;463
12.13.7;References;464
13;Section VICommentary and Recommendations;468
13.1;Chapter42 The Role of United States Law to Prevent and Control Childhood Obesity;470
13.1.1;Introduction;470
13.1.2;Access to Healthy Food;470
13.1.3;Healthy Places;472
13.1.4;Zoning and the Built Environment;472
13.1.5;Schools;472
13.1.6;Nutrition;472
13.1.7;Physical Activity and Physical Education;473
13.1.8;Marketing in Schools;472
13.1.9;Conclusion;472
13.1.10;References;475
13.2;Chapter43 Childhood Obesity as an Amplifier of Societal Inequality in the United States;478
13.2.1;Introduction;478
13.2.2;Symbolic Capital and Obesity;479
13.2.3;Inequality, Ethnicity, and Obesity;481
13.2.4;Food and the Body as Two Types of Cultural Capital;483
13.2.5;The Impacts of Childhood Obesity on Society;485
13.2.6;Conclusion;485
13.2.7;References;486
13.3;Chapter44 Childhood Obesity, Food Choice and Market Influence;490
13.3.1;Introduction: The DGA and Then Some, or Small Fries and a Coke, Please;490
13.3.2;Obesity as a Problem;491
13.3.3;What Young People Eat: Sofaas, Not Fruit `N' Veg;491
13.3.4;Influences on Dietary Consumption;492
13.3.5;Mediating Effects on Food Choice;493
13.3.6;Recent Steps in the Right Direction;496
13.3.7;Conclusion;497
13.3.8;References;497
13.4;Chapter45 The Role of Media in Childhood Obesity;502
13.4.1;Children’s Media Use Patterns;502
13.4.2;The Relationship Between Children’s Heavy Media Use and Childhood Overweight;502
13.4.3;Mechanisms for Explaining The Association;503
13.4.4;Can Media be a Part of the Solution?;504
13.4.5;Recommendations;505
13.4.6;Is There a Role for Public Policy?;505
13.4.7;Conclusion;506
13.4.8;References;506
13.5;Chapter 46Evaluation and Management of Childhood Obesity in Primary Care Settings;510
13.5.1;Introduction;510
13.5.2;Current Physician Practices and Attitudes;510
13.5.3;Core Medical Evaluation;511
13.5.4;Evaluation for Other Problems;513
13.5.5;Weight-Management Counseling;513
13.5.6;Advantages and Limitations of 5As Approach;514
13.5.7;References;514
13.6;Chapter 47 The Future Directions and Clinical Management of Childhood Obesity;516
13.6.1;Introduction;516
13.6.2;Knowledge Gap 1: Etiology ofnbspChildhood Obesity;517
13.6.3;Knowledge Gap 2: Screening and Non-modifiable Risk Factors;521
13.6.4;Knowledge Gap 3: Lessons from Medical Models of Obesity;522
13.6.5;Knowledge Gap 4: Interventions;523
13.6.6;Conclusion;527
13.6.7;References;527
14;Index;530