Obesity among schoolchildren in developing countries.

The threat of worldwide obesity in children is a reality and has become pandemic. Previously a concern of only developed countries, rapid, escalating rates of overweight children now dominate the public health concerns of middle-and low-income nations as well. There are, of course, many influences that have literally shaped the global population, but there is also a recent observable pattern that is shared by those developing countries with increasingly obese children: a grand structural shift in diet and activity levels on every continent and in every region has occurred in the last quarter century, accompanied by rising rates of obesity. Two central public health concerns drive the need for effective interventions: the immediate health of children and the imminently crushing blow that is coming to health care systems and developing economies due to high rates of chronic disease. In developed nations, the role of gatekeeper has shifted to childcare providers, media, and schools, but in the developing world the traditional role of the mother as home manager has remained intact. Accepting the mother as the primary care provider within the child's nuclear environment places the mother as the guardian of the family's resources, which may be a viable alternative to the types of health-promotion efforts found in past ineffective models.