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Obesity and undernutrition are serious problems for healthcare providers to deal with worldwide.
Not too much, not too littleeven Goldilocks knew the importance of just right. A recently released report by the Worldwatch Institute highlights the difficulty of achieving Goldilocks' standard. That research group has found that the number of overweight people in the world for the first time equals the number who are underfed. The report goes on to point out something every pediatrician knows: "The hungry and the overweight share high levels of sickness and disability, shortened life expectancies, and lower levels of productivity." Malnutrition associated with an inadequate food supply affects 1.2 billion people around the world and leads to the death of five million children each year. Its impact is most horribly felt during natural and man-made humanitarian disasters. whose effects on children are described in this issue by Karen Olness, MD.
The malnutrition more familiar to pediatricians in the United States, however, is obesity, the subject of next month's cover story by Stephen Sondike, MD, and Marc Jacobson, MD. Among adults in the United States 55% are said to be overweight, and 23% are obese. In the United States, one out of every five children is overweight. Genes and the normally more sedentary lifestyle of adulthood undoubtedly play a role in the obesity observed later in life, but so do the eating and exercise habits formed in childhood.
Undernutrition among children in the developing world is not caused by overeating among children in the United States, of course. Though the wealth and know-how of developed countries should be applied to the economic, nutritional, and educational inadequacies of poorer populations, overweight and starvation cannot be remedied by simply taking food from one group and giving it to the other. It's a coincidence that in the early 21st century the number of people who are fat is roughly equal to the number who don't get enough to eat. The fact that children in the United States are increasingly overweight is a separate problem from the poverty and starvation of children around the world. Both problems are important for child health-care providers, however, and sometimes it seems that they will be equally impossible to solve.
Julia A. McMillan, MD, Editor-in-chief of Contemporary Pediatrics, is Vice Chair, Pediatric Education, and Director, Residency Training, Johns Hopkins University School of Medicine, Baltimore.
Julia McMillan. Too much, too little - When what's needed is just right.