Overweight among children and adolescents in the United States is now the most common nutritional health problem, and continues as an upward trend in the current decade. National Health and Nutrition Examination Surveys (NHANES) III, the Bogalusa Heart Study, and baseline data from the National Heart, Lung and Blood Institute’s Growth and Health Study show increases in overweight prevalence among children and adolescents between the years 19631994 with the highest increase seen occurring between 1980 and 1994.

The prevalence of overweight among children in the United States has exceeded the previous decade by 3 to 5%, and for the periods between 1988-1994 and 1999-2000 the increase is >10 percentage points in non-Hispanic black and Mexican-American adolescents. Although obesity-associated morbidities are more frequent in adults, psychosocial problems, and other comorbidities such as sleep apnea, pseudotumor cerebri, orthopedic problems, hyperlipidemia, hypertension, abnormal glucose tolerance, and antecedents of adult cardiovascular disease occur with increased frequency in obese children and adolescents.

Troiano and Flegal used data from the National Health Examination Survey (NHES) cycles II (1963 to 1965) and cycle III (1966 to 1970) to establish the body mass index (BMI) percentiles for children in the United States. From the National Health and Nutrition Examination Surveys (NHANES I, 1971 to 1974; NHANES II, 1976 to 1980; and NHANES III, 1988 to 1994), they reported 25% of children and adolescents between 1988 and 1994 had a BMI greater than the 85th percentile. The BMI has now emerged as a good clinical measure for the definition and classification of overweight in children with some caution when used in pread-olescent boys.
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The management of obesity in children is noted to vary significantly among clinicians and is somewhat related to differences in provider characteristics. An expert committee convened by the Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services, developed recommendations for practical guidance to pediatric clinicians in the areas of early diagnosis, assessment of level of readiness, diet and physical activity habits, early treatment, and family involvement in a stepwise approach to obtain permanent changes for managing childhood obesity.

The primary purpose of this paper is to assess provider practice pattern, including recognition and intervention, and estimate prevalence of overweight including associated blood pressure and cholesterol levels among pediatric patients from a multi-ethnic inner-city population attending a community clinic. The results of this study will help to develop programs for provider education, enhance treatment and preventative approaches, and identify areas for further development of research programs to manage overweight or obesity and its risk factors in children of a multi-ethnic inner-city clinic population. trusted canadian pharmacy