child obesity a major challenge of current healthcare system.

BMI for Children and Teens

Body mass index (BMI) is a measure used to determine childhood overweight and obesity. Overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and sex. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex.

BMI is calculated by dividing a person's weight in kilograms by the square of height in meters. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age. A child's weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults. This is because children's body composition varies as they age and varies between boys and girls. Therefore, BMI levels among children and teens need to be expressed relative to other children of the same age and sex.

For example, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would have a BMI of 22.9 kg/m2. This would place the boy in the 95thpercentile for BMI, and he would be considered as obese. This means that the child’s BMI is greater than the BMI of 95% of 10-year-old boys in the reference population.

The CDC Growth Charts are the most commonly used indicator to measure the size and growth patterns of children and teens in the United States. BMI-for-age weight status categories and the corresponding percentiles were based on expert committee recommendations and are shown in the following table.

Weight Status Category	Percentile Range
Underweight	Less than the 5th percentile
Normal or Healthy Weight	5th percentile to less than the 85th percentile
Overweight	85th to less than the 95th percentile
Obese	95th percentile or greater

BMI does not measure body fat directly, but research has shown that BMI is correlated with more direct measures of body fat, such as skinfold thickness measurements, bioelectrical impedance, densitometry (underwater weighing), dual energy x-ray absorptiometry (DXA) and other methods. BMI can be considered an alternative to direct measures of body fat. A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual's health status and risks.

Childhood Obesity Causes & Consequences

Childhood obesity is a complex health issue. It occurs when a child is well above the normal or healthy weight for his or her age and height. The causes of excess weight gain in young people are similar to those in adults, including factors such as a person's behavior and genetics.

Our nation's overall increase in obesity also is influenced by a person's community. Where people live can affect their ability to make healthy choices.

Behavior

Behaviors that influence excess weight gain include eating high-calorie, low-nutrient foods and beverages, not getting enough physical activity, sedentary activities such as watching television or other screen devices, medication use, and sleep routines.

In contrast, consuming a healthy diet and being physically active can help children grow as well as maintain a healthy weight throughout childhood. Balancing energy or calories consumed from foods and beverages with the calories burned through activity plays a role in preventing excess weight gain. In addition, eating healthy and being physically active also has other health benefits and helps to prevent chronic diseases such as type 2 diabetes, cancer, and heart disease.

Use these resources to eat well and be active!

A healthy diet follows the 2015-2020 Dietary Guidelines for Americans that emphasizes eating a variety of vegetables and fruits, whole grains, a variety of lean protein foods, and low-fat and fat-free dairy products. It also limits eating foods and beverages with added sugars, solid fats, or sodium. The Physical Activity Guidelines for Americans recommends children aged 6 years or older do at least 60 minutes of physical activity every day.

Learn more about Healthy Weight—Finding a Balance

Community Environment

It can be difficult for children and parents to make healthy food choices and get enough physical activity when they are exposed to environments that do not support healthy habits. Places such as child care centers, schools, or communities can affect diet and activity through the foods and drinks they offer and the opportunities for physical activity they provide. Other community factors that affect diet and physical activity include the affordability of healthy food options, peer and social supports, marketing and promotion, and policies that determine how a community is designed.

Consequences of Obesity

More Immediate Health Risks

• Childhood obesity is also related to8-10:
  • Psychological problems such as anxiety and depression.
  • Low self-esteem and lower self-reported quality of life.
  • Social problems such as bullying and stigma.
• Obesity during childhood can have a harmful effect on the body in a variety of ways. Children who have obesity are more likely to have(1-7)
  • High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD).
  • Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes.
  • Breathing problems, such as asthma and sleep apnea.
  • Joint problems and musculoskeletal discomfort.
  • Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).

Future Health Risks

• Children who have obesity are more likely to become adults with obesity. Adult obesity is associated with increased risk of a number of serious health conditions including heart disease, type 2 diabetes, and cancer.12
• If children have obesity, their obesity and disease risk factors in adulthood are likely to be more severe.

Fruit & Vegetable Safety: Learn tips to select and prepare fruits and vegetables safely from the store to your table.

Eating a diet with plenty of fruits and vegetables provides important health benefits when you select and prepare them safely.

Fruits and veggies add nutrients to your diet that help protect you from heart disease, stroke, and some cancers. And choosing produce including vegetables, fruits, and nuts—instead of high-calorie foods also helps you manage your weight.

But sometimes raw fruits and vegetables may contain harmful germs, such as Salmonella, E. coli, and Listeria, which can make you and your family sick with food poisoning. In the United States, nearly half of foodborne illnesses are caused by germs on contaminated fresh produce.

Safer choices for fresh produce are washed fresh vegetables, including salads, and cooked vegetables. Unwashed fresh vegetables, including lettuce and salads, are more likely to make people sick with a foodborne illness.

Enjoy uncooked fruits and vegetables while taking steps to avoid food poisoning.

• Check fruits and vegetables for bruising and damage .
• Throw away fruits and vegetables that are spoiled or have been recalled.
• Wash your hands, kitchen utensils, and food preparation surfaces, including chopping boards and countertops, before and after preparing fruits and vegetables.
• Clean fruits and vegetables before eating, cutting, or cooking, unless the package says that the contents have been pre-washed.
  • Wash or scrub all fruits and vegetables under running water—even if you do not plan to eat the peel—so dirt and germs are not transferred from the surface to the inside when you cut the produce.
  • Dry fruit or vegetables with a clean paper towel.
• Keep fruits and vegetables separate from other foods that could contaminate them, such as raw meat and seafood.
• Refrigerate fruits and vegetables that you have cut up, peeled, or cooked as soon as possible, or within 2 hours. Refrigerate within 1 hour if the temperature outside is above 90°F. Chill them at 40°F or below in a clean container.

Anyone can get a foodborne illness, but people in certain groups are more likely to get sick and to have a more serious illness. These groups of people are:

• Young children
• Pregnant women
• Adults aged 65 and older
• People with weakened immune systems

If you or someone you care for has a greater chance of food poisoning, it's especially important to take steps to prevent food poisoning when preparing and eating fresh fruits and vegetables.