Abstract
Childhood obesity being a result of difference between intake and expenditure of energy, disturbing initial steady state and forming a new steady state at a higher level, resulting in increased body-fat storage. To avoid obesity, child needs to balance tissue synthesis, responsible for picking-up height, with fat storage, responsible for putting-on weight (mass). During 2002-2012, child growth and obesity were modeled, introducing the terms, estimated-adult BMI, pseudo-gain of height/mass and energy-channelization (co-existence of wasting and tallness/stunting and obesity). During 2013-2017, our group put forward first- to sixth-generation solutions of childhood obesity, which included new a definition of childhood obesity. This paper unveils seventh-generation solution, placing height-percentile-based-optimal mass and BMI-basedoptimal mass on equal footing by defining modified status (pertaining-to-mass) in terms of that optimal mass, which is closer to net mass. Similarly, current-age-mid-parental height and current-age-army-cutoff height are treated on equal footing by defining modified status (pertaining-to-height) in terms of that current-age height, which is closer to recorded height. This leads to a modification of definitions of ‘instantaneous obesity/wasting’ and ‘true obesity/wasting’. Polarcoördinate representation of nutritional-status classification is expanded to 10 categories, viz. energy-channelization III (puberty-induced energy-channelization), obesity dominated over-nutrition, tallness dominated over-nutrition, tallness dominated energy-channelization I, wasting dominated energy-channelization I, stunting dominated energy-channelization II, obesity dominated energy-channelization II, stunting dominated under-nutrition, wasting dominated under-nutrition, acute malnutrition. Growth-and-Obesity Vector-Roadmap 2.1 includes ‘away-from-normality index’ and ‘polar angle’ in addition to build assigned from scaled percentiles, modified as well as descriptive statuses (pertaining-to-height) and (pertaining-to-mass). Vector-Roadmap 2.1 proposes a range for 6 monthly height-management-target values and 6 monthly mass-management-target ranges. Target ranges, instead of single values, render the task of optimal-mass management easier. In this work, lifestyle adjustment, diet and exercise plans have been expanded to achieve the recommended targets. Vector-Roadmap 2.1 is generated from height and mass measurements to least counts of 0.005 cm and 0.005 kg, respectively. Computations are performed using Extended CDC Growth Charts and Tables containing percentiles in the range 0.01 to 99.99. In the appendices, true obesity implying instantaneous obesity and instantaneous wasting implying true wasting are proved using rigorous mathematical arguments, with illustrative examples for each condition.
