You have called the phenomenon of childhood obesity a tsunami. What do you mean by that?
David Ludwig, MD:
Well the full impact of the childhood obesity epidemic is still a long time in the future.We're really only seeing the tip of the iceberg, or to use another metaphor, uh, a tsunami, we can't wait to see the tidal wave rising 50 feet over Manhattan,about to swallow up the financial district before we take action. To understand this think of the childhood obesity epidemic as occurring in several phases.The first phase is what we've seen since the 1970s, which is this dramatic increase in prevalence rates, from 3 or 5 % to up to 15 or 20 % if we include overweight,and some minorities communities, 50%.But it takes a period of time for that increased prevalence to translate into serious complications, like type II diabetes, fatty liver, high blood pressure, high cholesterol,and we're just now entering that second phase, where type II diabetes is becoming as common as type I or juvenile diabetes, the kind we've always had in adolescence.And then it will take an additional period of time for those complications to translate into life threatening events, like a heart attack, a stroke, or kidney failure.You know, it's one thing for a overweight 45 year old to get type II diabetes at 55, and then suffer a stroke or a heart attack at 65.It's a very different thing if the clock starts ticking at age 10.