Guest Editorial-SOLUTIONS OF CHILDHOOD OBESITY-AND-MALNUTRITION

Childhood obesity and malnutrition have taken up prime importance for the medical community. This becomes much more important for the sport academies, who like to train and to groom national and international athletes. As early as the turn of this century, Ludwig (2007) discussed 4 phases of obesity pandemic, deliberating upon their long-term effects. Phase I, from 1970 till 2007, would have cases of obesity on rise due to lack of awareness of its damaging effects. After 2007, Phase II would appear with grave medical conditions as type-II diabetes, fatty lever and a number of psychosocial problems. In Phase III, the situation would, further, deteriorate and life-threatening diseases, like coronary heart disease, kidney failure and many more would increase mortality rate and shorten life expectancy of population of the United States. In Phase IV, the prevalence of weight-related diseases would accelerate more resulting in non-genetic influences in children, if such a trend continued. In an e-communication to Rafia Imtiaz (student of the author), Ludwig explained, “Phase IV of the epidemic would develop slowing over time, as obese children grow up and give birth to the next generation of children.” A year earlier, Collins et al. (2006) described programs for management of severe acute malnutrition in children. The author and his group have been working in devising solutions of childhood obesity-and-malnutrition since the turn of this century. The first- to the tenth-generation solutions have been proposed from 2013 to this year (Kamal, 2022b). The prime challenges are (a) weight management according to the height, computed from Growth-and-Obesity Roadmaps, within the next half-a-year, so that the youngster does not become wasted based on recommendations according to the most-recently-measured height and (b) absence of a proper definition of obesity in children. Professor Claude Marcus, Head, Division of Pediatrics, Karoliska University Hospital, National Childhood Obesity Center, Karoliska Institutet, Sweden, commented on the author’s proposed definition of childhood obesity (Kamal, 2017): “Thank you very much. We are deeply concerned about how to define obesity and degree of obesity so we can follow effects of treatment over time and association with co-morbidities. The present obesity curves are unreliable and we are now trying to identify new ways to follow obese children over time. Therefore, your paper is welcome to us.” These solutions have extended nutritional-status categories from pre-2014, three to twenty three in 2021, differentiating between instantaneous obesity (wasting) and true obesity (wasting), combined with instantaneous tallness (stunting) and true tallness (stunting). Severity of acute malnutrition is categorized as mild, intermediate and extreme, in order to make it easy to devise appropriate intervention strategies (Kamal, 2022b). These efforts have paid off in terms of saving the life of a cardiac patient (Kamal, 2015) and sparing an apparently-stunted child from unnecessary treatment (Kamal, 2022a). Future work should feature the eleventh-generation solution of childhood obesity-and-malnutrition, Growth-and-Obesity Roadmaps 5.0 for children of still-growing parents (expected to appear in January 2023) as well as Growth-and-Obesity Roadmaps for children participating in gymnastics. The author hopes that these mathematical-statistical tools should help school-health-team members, sport instructors, teachers and parents devise and implement programs to raise healthy and fit children, which should become pride of our nation!