ABSTRACT
There is little doubt that the prevalence of obesity is increasing worldwide and recent reports emphasize that it is increasing at an alarming rate. In the United States the prevalence of obesity increased from 12% to 18% during the period 1991 to 1998 (1), an increase of 50%! In Europe the prevalence of obesity is also high (2, 3), with values of 19% in the United Kingdom (4, 5), which is almost double that observed in the Netherlands and France (3, 6). Although it could be argued that this is a consequence of the aging of the population in Europe and America, obesity in childhood and adolescence is also increasing and is now of growing concern (7-9). In fact, obesity is considered to be the most prevalent disease/metabolic disorder of children and adolescents in the United States (10). Unfortunately this dramatic increase in the prevalence of obesity is not confined to industrialized countries but is pandemic, with evidence of obesity in urban areas of many developing countries experiencing rapid economic growth (11-15).
