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Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W2041, Baltimore, MD 21205, E-mail: bcaballe{at}jhsph.edu
This book reflects the experience of European scientists, most of them participants in the European Childhood Obesity Group, which for a number of years has been an important force in the field of pediatric obesity in Europe and elsewhere. Although several textbooks on obesity were published in recent years, few, if any, focused on child and adolescent obesity, and thus this volume is a welcome addition to the literature. The editors set an ambitious scope for their book, aiming to cover all aspects of child obesity, from etiology and mechanisms to prevention and treatment. For this book of relatively modest size (400 pages of text), they had to make some choices between depth and breadth of coverage.
The book is divided into 3 sections: 1) Causes, 2) Consequences, and 3) Prevention and Management. The Causes section includes 6 chapters, which focus on measurement, genetics, epidemiology, dietary factors, physical activity, and psychosocial factors. The chapter on measurement provides a good update on standardization of anthropometric techniques and selection of cutoff for the definition of obesity. There is, however, only limited consideration of the technical aspects of the different methods of body-composition measurement as they apply to a pediatric population. The chapter on physical activity provides a very good overview of the fundamentals of exercise physiology and energy balance, but it includes only a brief discussion of the role of physical activity in obesity and body-weight homeostasis.
The 5 chapters in the Consequences section describe the clinical manifestations of obesity, including endocrine disorders and genetic syndromes such as the Prader-Willi and Laurence-Moon syndromes. One chapter focuses on cardiovascular disease risk and includes discussion of body composition and fat patterning, which complements the corresponding chapter on measurement in the Causes section.
The last section, Prevention and Management, comprises 10 of the 21 chapters and almost one-half of the book’s pages. Only one chapter in this section focuses on prevention. Each of the other chapters discusses a specific treatment approach, including diet, physical activity, drug therapy, surgery, psychotherapy, and ambulatory, home-based, and institutional approaches. These chapters are very informative and include useful bibliographies.
Although environmental issues are briefly discussed in several chapters, it would have been desirable for the editors to include a separate chapter focused on the social and cultural changes associated with the obesity epidemic. Factors such as fast-food and other out-of-home eating, television and other media, transportation, urban design, and the school environment are receiving increasing attention as potential targets for interventions to prevent child obesity.
In summary, this book is a useful compendium of the wide range of issues and disciplines related to pediatric obesity, presented from a European perspective. The book offers something for everyone, but health professionals working with obese children will find particularly useful the chapters on management and will benefit as well from the discussion of current issues relating to the causes, mechanisms, and assessment of child obesity.