Our Overweight Children. What Parents, Schools and Communities Can Do to Control the Fatness Epidemic, by Dalton S. Berkeley and Los Angeles, Calif: University of California Press; 2004. 292 pp.
The United States of America along with many other countries around the world is facing the problem of a rapidly increasing number of overweight children who are expected to become obese adults with major health problems. This book, written for parents of overweight children, provides an excellent insight into the problems, causes, and solutions to this major health crisis. The author highlights the need for every member of society to do something. Although the book is primarily written for parents, it will be equally useful to grandparents, schoolteachers, child care workers, politicians, community leaders, and health professionals.
The book is divided into 3 sections. Part 1, "How we meet a growing epidemic," sets out definitions and tools to help parents and others decide if a child has a serious weight problem. It gives a step-by-step guide to calculating and evaluating body mass index (BMI). It also discusses the medical, physical, and psychological toll of childhood obesity and its prevalence and impact on different population groups. Part 2, "Why kids are getting fatter," explores the influence of the family and genetics, the home environment and places beyond the home, and the effects these have on children's eating and activity levels. Current health recommendations are discussed and comparisons made to current nutritional intakes and activity levels of the US population. These are highlighted in a table, which looks at each recommendation and compares it to reality. For example, the recommendation "to be physically active each day" (Dietary Guidelines for Americans) is compared to information from studies that reveal that "only 29% of high school students and 35% of middle school students participate in daily school physical education." Part 2 also explores the problems of promoting healthy lifestyle in educational institutions. The influences of the fast food industry and general society are discussed using the author's personal observations and professional experience to illustrate.
In part 3 (the largest of the 3 sections), "How we can fight the epidemic," Dr Dalton gives practical suggestions for developing healthy eating and exercise patterns, both within and outside the home. She reviews some of the weight management programs currently available, discussing their merits and limitations. A large and very useful chunk is devoted to discussing parenting strategies and the need for authoritative parenting, which uses role modeling, negotiation, and reasoning to support raising healthy and resilient children. This part of the book also looks at the social stigma attached to being overweight and the section on insights from children's fiction is fascinating.
Throughout the book, stories of real children are used to illustrate difficulties and strategies for change. There is an excellent "notes" section at the end of the book, which gives full reference citations clearly linked to relevant chapters.
Dr Dalton's prevailing message is one of moderation, long-term weight management, not crash diets, and especially the need for support from all sections of society. Her recommendations are practical and sensible, emphasizing the importance of the family meal and the need for moderation and "a realignment of attitudes about food and physical activity." I particularly liked the way that Dr Dalton has succeeded in writing a scientific book with detailed reference to medical evidence in such a down to earth, well laid out, readable format.
One limitation of the book is that it may not reach some of those parents and families who would derive great benefit from much of the information provided, those from minority, lower socioeconomic groups, particularly where literacy levels are also low.
In criticism, I think the book would have been enhanced with more illustrations and some color pictures.
Overall, however, this is an excellent book that should become required reading for all dietitians and nutritionists, no matter what their area of specialization. I strongly recommend Our Overweight Children to anyone with an interest in obesity, as they will take from it practical ideas for strategies and actions that will help influence changes to improve the health of future generations of children and adults around the world.