Pediatric Nursing and Healthcare

Obesity is one of the major nutrition-related disorders, and its rapid rise in the whole world has been paralleled with a dramatic shift from traditional, more nutritionally dense dietary patterns toward more energy-rich, unhealthy patterns. The importance of nutrition in prevention and treatment of obesity has gained much attention from public health professionals. The etiology of obesity is multifactorial and involves complex interplays between dietary factors and various ‘internal’ (e.g., genomic, epigenomic, and metabolic profiles) or external (e.g. lifestyle) exposures. The past 10 years have witnessed speedy advances in research of genomics, which has made great strides in detection of genetic variants associated with body weight regulation and obesity. In addition, emerging data have shown that the genetic variants may interact with dietary factors in relation to obesity and weight change. Moreover, recent studies on other global characteristics of the human body, such as epigenomics and metabolomics, suggest more complex interplays may exist at multiple tiers in affecting individuals’ susceptibility to obesity, and a concept of ‘personalized nutrition’ has been proposed to integrate these new advances with traditional nutrition research. The root of obesity etiology is imbalance between dietary energy intake and energy expenditure. Human evolution has favored a preference for energydense and fatty foods, as a consequence of exposure to ancestral famine. This leaves humans susceptible to modern obesogenic environments regarding rise of energy intakes and subsequent elevation of obesity risk. Data from the National Health and Nutrition Examination Survey have shown a marked upward shift of energy intake, increasing by 7% in men and 22% in women from 1971-1974 to 1999-2000, in parallel with a rapid increment of obesity in the same period of time.