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Rapid response to:

Primary Care

Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.38077.458438.EE (Published 20 May 2004) Cite this as: BMJ 2004;328:1237

Rapid Response:

All school children are not obese: why?

Sir:

This study directly targets one very well known factor, i.e.,
consumption of carbonated drinks rich in sugar in the etiology of obesity
in school children, which is a major public health problem and also
reported to have multiple biopsychosocial consequences in adulthood, some
of which such as myocardial infarction and strokes are fatal while others
such as diabetes, musculoskeletal disorder, depressions and eating
disorders are chronic in nature. Notably, schools are the places where
effective educational messages as evident in this study (1) can get
through a large number of targeted population of children and adolescents
who have tendency to become pathologically obese.

Certainly, a proportion of children in schools are not obese at all,
though they are cosuming carbonated drinks like their counterparts who are
obese. Likewise, a proportion of children are obese, though they are not
consuming rather avoiding carbonated drinks. Thus, four groups of children
could be identified in schools, 1) obese drinking carbonated drinks, 2)
obese but not drinking carbonated drinks, 3) not obese but drinking
carbonated drinks, and 4) neither obese nor drinking carbonated drinks.
Hence, accordingly this study has only addressed and targeted about one
quarter of population of school children. One interesting question emerges
is that why children not obese and drinking carbonated drinks should or
should not continue driking such enjoyable drinks? Simply the answer is
"no" because over a two year period or so they are also likely to be
obese.

Finally, I feel that the preventive strategies targeting only single
etiological factor in the complex disorder like obesity will not have much
successful and sustained effective effects on longterm basis.

Reference:

Janet James, Peter Thomas, David Cavan, and David Kerr. Preventing
childhood obesity by reducing consumption of carbonated drinks: cluster
randomised controlled trial
BMJ 2004; 328: 1237-0

Competing interests:
None declared

Competing interests: No competing interests

29 May 2004
Dr.Naseem A. Qureshi MD, IMAPA, LMIPS
Medical Director(A), Director CME&R
Buraidah Mental Health Hospital, Postcode:2292, Saudi Arabia