Changes in childhood food consumption patterns: a cause for concern in light of increasing body weights

Childhood obesity is currently at its highest: recent statistics show that 16% of children between the ages of 6 and 11 y are overweight [greater than or equal to 95th percentile of body mass index (BMI; in kg/m(2)) for age] and that an additional 14.3% are at risk of becoming overweight (greater than or equal to 85th percentile but < 95th percentile of BMI for age). As chidren's body weights have increased, so has their consumption of fast foods and soft drinks. The proportion of foods that children consumed from restaurants and fast food outlets increased by nearly 300% between 1977 and 1996. Children's soft drink consumption has also increased during those years, and now soft drinks provide soft drink consumers 188 kcal/d beyond the energy intake of nonconsumers. These changes in food intakes among children may partly explain the rise in childhood obesity observed in the past few years. Although the mechanism of appetite regulation will not be explored in this report, it is hypothesized that the greater energy intakes in children who consume large amounts of soft drinks and fast foods are not compensated for by increased physical activity or decreased energy intakes. Furthermore, overweight and obesity in childhood may predispose persons to morbidity in adulthood. Blood pressure and fasting insulin and cholesterol concentrations are higher in overweight children than in normal-weight children. This review focuses on current food patterns and eating habits of children, in an attempt to explain their increasing BMI. In addition, a critical review of food service and political practices regarding food choices for children at school is included.