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Obesity in children: primary prevention of pediatric obesity

It is not unreasonable to ask a child to replace one sedentary event with walking/active play. This is an achievable goal that will prevent the gain of too much fat during the growing period. The science predicts that substituting physical activity (such as moderate walking) for a sedentary event (such as TV viewing) significantly contributes to a reduction in body fat gain.

If the physical activity were to be more vigorous than walking, then fewer minutes would be needed each day to consume the number of calories required to prevent the gain of 22 pounds of fat in the 10-yr-period. One additional confounding variable in these calculations is that children become more sedentary as they age. Indeed, the evolution of sedentary habits while growing up is likely a major contributor to the gain of body fat.

Prescribing increased physical activity is most effective for the prevention of a gain in body fat, as the body defends itself against a loss in body fat by unknown mechanisms. However, the body does not lower resting metabolism when physical activity is increased to prevent a weight gain. Thus, it is common sense to prevent gain in body fat, rather than try to lose fat once already gained.