The Pediatric Obesity Crisis

The rising rate of obesity in the United States has resulted in increased attention to nutrition and long-term health. In 2009-2010, 16.9% of US children and adolescents were obese, defined as having a body mass index (BMI) greater than or equal to the age- and sex-specific 95th percentiles of the 2000 CDC growth charts. Prevalence rates were higher among teens and school-aged children than preschool-age children and among boys than girls (Figure 1).

Figure 1: Prevalence of Obesity Among Children and Adolescents Ages 2-19, United States (2009-10)
CDC/NCHS, National Health and Nutrition Examination Survey, 2009-2010

Recent studies indicate that obesity levels in the United States have begun to level off—there was no change in the prevalence of obesity among children from 2007-2008 to 2009-2010. Even so, several public health concerns remain.

In South Carolina, obesity rates have doubled since 1990, with more than one-third of middle school students considered overweight and nearly one-third of high school students (31%) considered overweight or obese. Approximately one-half of all African American children in rural areas of South Carolina are overweight or obese. In the most recent CDC data, South Carolina is the state with the second highest percentage of obese children in the nation. Compared to the rest of the United States, South Carolina has the 4th highest percentage of residents with high cholesterol, 5th highest percentage of adults eating less than 1 serving of fruits and vegetables per day, and 3rd highest percentage of adults with hypertension.

If current trends continue, one out of three children born in South Carolina in the year 2000 will be a high risk for type 2 diabetes, primarily because of poor diet and lack of physical activity.

Children’s diets have become inadequate or deficient in several crucial nutrients, based on key recommendations of the Dietary Guidelines for Americans (DGA) 2010. Consistently, 30% to 40% of daily energy consumed by children and adolescents comes from calorie-dense, nutrient-poor foods and drinks.

Energy balance—the balance of calories consumed through eating and drinking with calories burned through physical activity—is one of many reasons to promote healthful eating habits in children. Age-appropriate energy and nutrient intake are essential to support normal growth and development. Healthy eating and physical activity can reduce the risk of early development of diet-related chronic diseases such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis. Furthermore, these healthy habits promote learning and academic success.

A variety of factors combine to contribute to the complexity of childhood obesity: energy imbalance, inactive lifestyle, poor sleep habits, emotional factors, genetic factors, medications, and environmental issues. There is no simple solution. Providers, families, and communities are starting to recognize the task at hand. Parents and other caregivers need education about nutrition and mealtime behaviors that promote the adoption of healthy eating habits in their children’s lives.

Find out how you can get involved locally in your church, school, YMCA, or community organization to encourage proper nutrition and exercise.


Eat Smart, Move More South Carolina, a 501(c)(3) nonprofit organization, is dedicated to positively impacting the health of all South Carolinians by promoting healthy eating and active living where we live, learn, work, pray and play. The organization also assists in the implementation of South Carolina’s Obesity Prevention Plan.

LiveWell Greenville, formed in 2011 by the Piedmont Health Care Foundation, is a partnership of more than 100 public and private organizations committed to making Greenville County a healthier place to live, work and play. It brings community partners and individuals together to shepherd positive initiatives such as creating safe places to bike and walk and providing healthier foods in schools and workplaces, nutritious snacks in child care centers and better access to parks.

YMCA Greenville is part of the nation’s leading nonprofit committed to strengthening communities through youth development, healthy living and social responsibility. The YMCA encourages good health and fosters connections through fitness, sports, fun, and shared interests. Families receive support, guidance and resources needed to achieve greater health and well-being.

Kids Eat Right (Academy of Nutrition and Dietetics and its Foundation) provides comprehensive, science-based resources for families on eating right, cooking healthy, and shopping smart, with tips, recipes, videos, and in-depth information.

USDA’s MyPlate provides science-based resources for parents and educators, including tip sheets on nutrition as well as games, activity sheets, videos, songs, and recipes for kids.

Adapted from Childhood Nutrition: Challenges and Tools

Article author Kristan Stewart, MPH, MS, RD, LD, is the dietitian for New Impact, a comprehensive weight-management program for children up to age 21 at Children’s Hospital of Greenville Health System (GHS).


Yang L. , Colditz, B. Prevalence of Overweight and Obesity in the United States, 2007-2012. JAMA Intern Med. 2015;175(8):1412-1413.

Wansin B, Van Inttersum K. Portion Size Me: Downsizing Our Consumption Norms. Journal of the American Dietetic Association. 2007;107:925-945.

Position of the Academy of Nutrition and Dietetics: Nutrition Guidance for Healthy Children Ages 2 to 11 Years. Journal of the Academy of Nutrition and Dietetics. 2014;114:1257-1276.

Position of the Academy of Nutrition and Dietetics: Total Diet Approach to Healthy Eating. Journal of the Academy of Nutrition and Dietetics. 2013;113:307-317. AAP Committee on Snacks, Sweetened Beverages, Added Sugars, and Schools. Pediatrics. 2015;135(3):575-583.

Healthier School Meals: A Summary of the New USDA Standards for School Breakfast and Lunch.