Mandatory Physical Education

Dodging the Dodgeball of Childhood Obesity with Mandatory Physical Education

Dodging the Dodgeball of Childhood Obesity with Mandatory Physical Education

Thesis: Physical Education should be mandatory for all students between kindergarten and high school graduation because it is necessary for receiving the recommended amount of daily physical activity, it is essential to maintaining a better quality of life from childhood into adulthood, and it is important for developing a positive lifelong attitude towards physical activity. I. Physical Education is needed to receive an adequate amount of physical activity.

A. Children are mainly sedentary and spend most of their waking hours in school
B. statistics on the rise for obesity in children
C. Parents are generally unable to gage if their children are receiving enough physical activity, and there is lack safe play areas.

II. Physical Education enhances physical health.

A. prevention of disease
B. strengthening of bone and muscle, and improvement of mood
C. Mandatory Physical Education is needed to establish lifelong habits

III. Physical Education enhances mental health

A. Team sports help elevate self-esteem in teen girls.
B. There is a marked decline in participation in team sports.
C. “Mandatory Physical Education could provide the opportunity to complement the positive global self-perception derived from both participation in team sports and individual exercise, and increase overall participation in extracurricular activities.”

IV. Physical Education improves academic performance
A. There is a relationship between fitness levels and achievement.
B. This relationship creates leverage for mandatory Physical Education.
C. strategies for using scarce funding in schools

V. The crucial role of recess and extracurricular activities
A. Recess accounts for the majority of physical activity.
B. “It is important for schools to put into place programming that combines the efforts of both physical education and recess…”
C. the potential of movement themes and “mini-recess”
D. “… Team sports reach take on a new character of physical, mental and the academic benefit for older children because the supervision and monitoring involved in youth sports may contribute to reducing youth crime and school dropout rates.”
E. “The role of mandatory Physical Education in a setting where physical activity is integrated into the school environment and valued as extracurricular endeavor, is to lay a solid foundation on which all other initiatives can be built.”

VI. Guidelines for physical activity
A. “Physical Activity Guidelines for Americans,”
B. the guidelines to minimize sedentary activity
C The challenge of physical activity “illiteracy” could be avoided if active living was firmly entrenched since youth through the wide scale implementation of mandatory Physical Education.

VII. The modern approach to Physical Education
A. “Physical Education Programs, as well as Physical Education teacher preparation programs need to be re-imagined and restructured.”
B. The highlights of the proposal
C. “The challenge of physical activity “illiteracy” could be avoided if active living was firmly entrenched since youth through the wide scale implementation of mandatory Physical Education.”

VIII. Practical applications for Physical Education
A. examination of specific interventions
B. Mandatory Physical Education can set the standard for both elementary teachers and principals as a model for physical activity interventions outside of physical activity class.
C. “Mandatory Physical Education can be the hub for the more sophisticated physical activity needs of older students, such as competitive and intramural sports, as well noncompetitive alternative activities.”
D. Mandatory Physical Educational is also essential for maintaining a consistent strategy for meeting the United States government recommendations for physical activity.
E. “The credentials of Physical Education teachers should be as important as an instructor for any other academic pursuit.”

Conclusion

Abstract

Physical Education should be mandatory for all students between kindergarten and high school graduation because it is necessary for receiving the recommended amount of daily physical activity, it is essential to maintaining a better quality of life from childhood into adulthood, and it is important for developing a positive lifelong attitude towards physical activity. In order to address this issue, the research for how physical activity enhances physical, and mental wellbeing, as well as academic achievement will be examined. How mandatory Physical Education can complement these benefits are emphasized. Supplementary physical activities of recess and extracurricular activities in relation to mandatory Physical Education will also be analyzed. The later section of this paper will concentrate on guidelines for physical activity and sedentary behavior. The need to restructure Physical Education programs, including as Physical Education teacher preparation programs is emphasized. In conclusion, practical solutions for Physical Education are outlined.
Dodging the Dodgeball of Childhood Obesity with Mandatory Physical Education Unless a former student managed to breeze through high school as a popular captain of a popular sports team, the student, years later, may have a terrible memory of being pelted with rubber balls in the Phys. Ed. bullying contest, popularly called “dodgeball.” A woman from this generation, now having children of her own, was recently portrayed in a series of public service announcements making the statement,” What do you mean my kid doesn’t get enough physical activity??? He goes to soccer 3 times a week!” The parent figure is then pelted with a wave of water. The purpose of this PSA was to inform the public of research demonstrating children need at least 60 minutes a day of vigorous exercise, and the reality that the majority of children in North America are simply not achieving this amount of activity. The bad news is obesity in our children is reaching epidemic proportions. The good news is, however, that Physical Education has evolved over the years, taking into consideration new research and employing new methods, giving this discipline great potential in ensuring each child gets the adequate amount of exercise for an enhanced quality of life. Physical Education should, therefore, be mandatory for all students between kindergarten and high school graduation because it is necessary for receiving the recommended amount of daily physical activity, it is essential to maintaining a better quality of life from childhood into adulthood, and it is important for developing a consistent approach for promoting lifelong physical activity.
Physical Education is Needed to Receive Adequate Physical Activity

Since children and teens spend most of their waking hours in school, they need Physical Education to receive the recommended amount of physical activity. This situation may not have always been the case. If a mother from the 1950s, 1960s, 1970s, or even the 1980s were asked if she felt her child received an adequate amount of physical activity, between 60 and 90 minutes a day, she would likely laugh and say, “of course.” In times past, it did not matter that parents tended to be poor judges on how much physical activity their children were getting; it simply did not matter in most cases. Every young person has heard stories from their elders describing playing outside all summer long, from sun up to sun down, forced inside only to devour a meal or two. Physical activity came as a side effect of being a child. In the modern age, it appears that hide and seek and jump rope have been replaced by video games and “Facebook.” Evidence of this change can easily be seen in the alarming growth of childhood obesity over the past 25 years. “Obesity” is defined by the World Health Organization (2011) as BMI greater than 30, while “overweight” is defined as a BMI great than 25 (para. 2). The World Health Organization (2004) also cites the rate of overweight American youth, between the ages 6 to 18 years, has increased from 15 percent in the 1970s to more than 25 percent in the 1990s (para. 4). The upward trend continues; an estimated 16.9% percent of children and adolescents between the ages of 2 to19 years are obese, as reported by the Center for Disease Control (2010, para. 2). Other statistics cited by Dauenhauer and Keating (2011) show that more than 37 percent of children in this age range are overweight (p. 512). Certainly children still engage in many after school physical activities, such as organized sports and swimming lessons, although not frequently enough to ensure good health. As the description of the Public Service Announcement demonstrates, many parents feel by placing their children into soccer a couple days week they have provided their children with adequate opportunities for physical activity. Even this minimum level of structured play may be out of the reach of lower economic status families, especially urban Hispanic and African American youth. In a study examining physical activity in relation to these populations, Dauenhauer and Keating (2011) point out there is often a lack of access to safe play spaces outside of school (p. 517). To be fair, parents of all backgrounds can do only so much to structure their children 's leisure time in healthy ways, considering the easy availability of sedentary activities. Considering this vast trend of inactivity, a powerful impact could be made by providing mandatory Physical Education. Alderman, Beighle, Erwin and Morgan observe (2012) nearly all children are enrolled in school and spend as much as 30 percent of their waking hours in that environment (p. 103); therefore, school is not only a perfect environment to provide actual exercise, but also a perfect environment to instill positive lifelong habits through education.

Physical Education Enhances Physical Health

The impact of these lifelong habits cannot be underestimated. Regular exercise makes an essential contribution to a better quality of life, both mentally and physically. Bright Futures (n.d.) at Georgetown University states that regular physical activity in men and women of all ages enhances overall health and well-being. Specifically, regular physical activity contributes to the prevention of chronic disease, such as heart disease, osteoporosis, colon cancer, and diabetes mellitus. Regular physical activity also plays an important role in the prevention of hypertension, and in the reduction of elevated blood pressure. Other benefits include: the strengthening of bone and muscle, the increasing of lean muscle mass, the reduction of body fat, the enhancement of psychological well-being, the minimizing of symptoms of depression or anxiety, and the improvement of mood (para 1 &2). It should be emphasized that a consistent routine must take place over many years to experience the full extent of health benefits. As adults become exposed to the widely available information about the benefits of exercise, many make it their mission to become more physically active. Of course, there are numerous resources available for adult physical fitness; there are options ranging from aerobics classes, to extreme fitness boot camps, and everything in between. Almost every sport imaginable has a “fun” league, which is a noncompetitive option for beginners. Nonetheless, it can be notoriously difficult for a 30 year old woman, for instance, who has settled into a sedentary lifestyle over a number of years to reinvent herself as an active person, even in light of all the resources available. If her last exposure to structured physical activity was when she was 14 years old in the last mandated Physical Education class, it can be very difficult to know where to begin, let alone establish a routine. What is more specific than being overwhelmed by the sheer number of activity options is the concept of reinvention. The process of re-conceptualization from the identity of an inactive person into the identity an active person can be the biggest barrier. Once this massive undertaking is achieved, the benefit to a positive self-concept is immeasurable.
Physical Education Enhances Mental Health A crucial area of investigation by College, Ference and Muth (2004) involves the role of physical activity in counteracting the decline of “positive global self-perception” that typically occurs in young adolescence, especially girls. Researches presented by the authors indicate team sports may play a significant role in the development of social self-perception, and in the conceptualization of competence and ability. In addition, young females who exercise in an informal manner may have higher self-esteem, and more energy than inactive females, enabling them to better cope with everyday stress. The authors also point out the unfortunate reality that during middle school years when participation in sports and exercise would be the most beneficial is the time when there is a marked decline physical activity, a trend likely to continue into adulthood. When an overall result was produced in the study, the statistics revealed almost half of eighth grade girls exercised independently less than three times a week, while over half participated in team sports at least once each year (pp. 28, 29 & 31). Mandatory Physical Education could provide the opportunity to complement the positive global self-perception derived from both participation in team sports and individual exercise, and increase overall participation in extracurricular activities. This priority will give the Physical Educator the best resources to tailor the most beneficial programs for the young adolescent girl.
Physical Education Improves Academic Performance Another surprising finding documented in the research is the relationship between physical activity and academic performance. In a comprehensive synthesize of research, Fedewa and Ahn (2011) compiled several measures of children 's cognitive outcomes and academic achievement attained in reading, Mathematics, English, and Science. In 20 cross-sectional studies where physical fitness was measured using a child 's total fitness levels, there was a significant relationship between cognition and achievement; therefore, the more physically active the child, the better the academic outcomes tended to be. This discovery is essential leverage to advocate for increased Physical Education in school, in light of the shortsighted attitude that physical education is expendable because of budget constraints, and considering the increasing pressure on school administrations to perform well on national standardized tests Fedewa and Ahn (2011) describe the climate of Physical Education in schools in this manner:
As pressure grows to reduce the time spent in physical education or physical activity to make room for increased instructional time, it is imperative to share these results with stakeholders who will make these types of decisions. Acknowledging the significant effects of physical activity on these two areas of academic performance is critical if physical education programs are going to survive and children are going to excel, not only academically, but physically and psychologically (p. 530). Another interesting dimension of the findings revealed that individualized exercise programs did not have better results compared to both large and small group based physical activity programs. Thus, a prudent use of costly school resources may be to specifically focus on children in a small group setting who can exhibit the most dramatic results, both academically and physically (pp. 528, 530, & 531).
The Crucial Role of Recess and Extracurricular Activities Another interesting finding in Fedewa and Ahn 's (2011) analysis was that children benefited from physical activity irrespective of the experience level of the leader (p 531). This assertion is encouraging, since physical education alone cannot possibly address all physical activity needs. David Kahan (2008) makes the observation in his article “Recess, Extracurricular Activities, and Active Classrooms” when pedometers are used to measure weekday physical activity during lunch recess and other recess periods, the results show there is an accumulation of 23 to 25 percent of school children 's step count, while physical education only provides 8 to 11 percent of the step count (p. 26). The author proposes that both Physical Educators and classroom teachers need to work together to safeguard or expand recess for all grade levels of elementary school. Simply providing recess, however, may not be enough. An interesting experiment concluded that children who received games, activity cards, and prompts made by teachers modeling active behavior increased their moderate-to-vigorous physical activity. It is important for schools to put into place programming that combines the efforts of both physical education and recess, while enhancing the availability of physical activity spaces. An interesting intervention involves re-conceptualizing elementary school Physical Education to be supplemented with classroom lessons that revolve around movement themes. Another less complicated initiative calls for the introduction of mini-recesses designed to periodically get students physically active for short intervals, as a break from academic “seatwork” (pp. 28-31). When moving focus from elementary school to high school, obviously the concepts of active classrooms and recess may no longer be age appropriate. An essential component of teenager physical activity should include extracurricular sports. In a study published by Cohen, Schuster, Taylor, Vestal, and Zonta (2007), it is observed that the benefits of team sports reach take on a new character of physical, mental and the academic benefit for older children because the supervision and monitoring involved in youth sports may contribute to reducing youth crime and school dropout rates. Extracurricular sports are especially important for lower income neighborhoods because these areas tend to be less likely to have access to both structured activities, and open space and parks for unstructured activities (pp. 81, 84 & 85). The significance of citing research concerning extracurricular sports is to show the integral relationship between all available outlets for exercise and physical activity within the in school setting. The role of mandatory Physical Education in a setting where physical activity is integrated into the school environment and valued as extracurricular endeavor, is to lay a solid foundation on which all other initiatives can be built. The above recommendations require planning of strategy and investment of resources, so The Physical Education teacher will be valued in the roles of the educator, consultant, and facilitator within this framework.
Guidelines for Daily Physical Activity Obviously an important cornerstone of the foundation is the incorporation of specific measurable goals for daily physical activity. According to the United States Department of Health and Human Services in the document “Physical Activity Guidelines for Americans,” (2008) children and adolescents should engage in at least 60 minutes a day of physical activity. Most of the 60 minutes should be either moderate to vigorous intensity aerobic physical activity, and vigorous physical activity should occur at least three days a week. The guidelines are broken down further to include at least three hours a week of both muscle-strengthening and bone-strengthening activities (para. 6). Another set of guidelines established by Tremblay et al. (2011) moves focus away from physical activity to address the increasing evidence that sedentary behaviors have a separate and profound impact on health. The final recommendations state both children and teenagers should minimize sedentary activities, which can be achieved by: limiting recreational screen time to two hours per day, decreasing the reliance on motorized transport, minimizing extending sitting, and lessening time spent inside throughout the day (pp. 59 & 60) . It should be emphasized that a consistent routine must take place over many years for an individual to experience the full extent of health benefits. Those who teach Physical Education and other school-based initiatives are key in interpreting the sterile scientific recommendations, and transforming them into a dynamic lifestyle of active living. As adults also are exposed to the highly publicized information about the benefits of exercise, many will make it their mission to become more physically active. Of course, there are numerous resources available for adult physical fitness; there are options from aerobics classes to extreme fitness boot camps, and everything in between. Almost every sport imaginable has a “fun” league, which is a noncompetitive option for beginners. Nonetheless, it can be notoriously difficult for a 30-year- old woman, for example, who has settled into a sedentary lifestyle over a number of years to reinvent herself as an active person, even in light of all the resources available. If her last exposure to structured physical activity was when she was 14 years old in the last mandated Physical Education class, it can be very difficult to know where to begin; establishing a routine may be beyond conception. The process of re-conceptualization from the identity of an inactive person, into the identity an active person can be the biggest barrier. This challenge of physical activity “illiteracy” could be avoided if active living was firmly entrenched since youth through the wide scale implementation of mandatory Physical Education.
The Modern Approach to Physical Education It is, of course, a widely held belief that the educational experience has a crucial role to play in the formation of a self-concept and social skills. The potential for Physical Education to establish the groundwork for healthy lifestyle is a great opportunity. In the opening paragraph, the tone was set with the cliché of the gym class staple of dodgeball, and undoubtedly this game is not an example of a gym activity that is appropriate in the modern context. The question, then, needs to be asked: How does Physical Education develop beyond from the antiquated activities such as dodgeball and move towards the innovative programs, such as active classrooms? The driving force behind the transition away from aggressive, marginalizing, and overly competitive sports is through implementation of a more sophisticated, inclusive, and relevant Physical Education program. “The Journal of Physical Education, Recreation, & Dance” makes the statement in “Health and Physical Education Pedagogy in the 21st century - a Statement of Consensus” (2011) that Physical Education programs, as well as Physical Education teacher preparation programs need to be re-imagined and restructured. This article calls for action by students, physical educators, leisure professionals, policy makers, legislators and citizens, to ensure a committed effort to enhancing the health and well-being of the population. Below are some highlights of the proposal: The starting point is focusing on content to develop healthy active lifestyles for youth, including the integration of skill development, nutrition, and leisure design in a manner that leads to a life-long, self-directed approach to physical activity. Another tenant accentuates the importance of incorporating other stakeholder within the school and the wider community, including classroom teachers, administrators, and parents to encourage daily physical activities in both formal and informal education. Thirdly, the suggestion is made to use technology to support individualized programs, and enhancing assessment strategies with accountable goals and objectives. The last principle is the insurance that qualified professionals teach physical education (p. 7). Mandatory Physical Education can create momentum towards the monumental task of pedagogical redevelopment to address the complexities of 21st century crisis of obesity and lifestyle related health concerns. As the above principle implies, this momentum can only be maintained by well trained and experienced Physical Education teachers.
Practical Applications for Physical Education In order to gain some perspective on how new physical education approaches can be incorporated into the established mandates of physical activity, it is helpful to examine some specific examples. For instance, a qualitative investigation conducted by Boyce, Combs and Elliot studied the use of recess packs to help achieve 150 minutes of mandated physical activity per week. One of the outcomes was the discussion around the persistence of developmentally inappropriate games such as dodgeball, kickball and relays. Interestedly, three out of four of the principals involved in the study indicated they considered dodgeball and kickball to be suitable games for increasing physical activity. This problematic scenario makes apparent one reason for the need of more thorough training programs, and a concrete application of the advancement of Physical Education pedagogy (pp 150 & 160). Mandatory Physical Education can set the standard for both elementary teachers and principals as a model for physical activity interventions outside of physical activity class. When addressing the needs of middle school girls, College, Ference and Muth (2004) acknowledge that sports and Physical Education teachers should meet the needs of adolescent females by designing programs that focus on goal setting, which reflect their current interests and abilities, and emphasize lifelong physical activity skills (p. 33). Again, here is an additional time frame where mandatory Physical Education can play an important role by providing a consistent routine during this turbulent period of lifespan development. In a high school setting, mandatory Physical Education can be the hub for the more sophisticated physical activity needs of older students, such as competitive and intramural sports, as well noncompetitive alternative activities. A helpful trend in Physical Education is moving the focus away from exclusively traditional sports into non-traditional sports which originate around the world, giving children positive exposure to multiculturalism. Moving the emphasis away from traditional sports is more inclusive for children not interested in traditional sport. Innovative Physical Education teachers are also integrating stress relieving activities, such as yoga and tai chi into their curriculum. Mandatory Physical Educational is also essential for maintaining a consistent strategy for meeting the United States government recommendations for physical activity. For instance, if the gym period is only 40 minutes, then the Physical Educators has to be proficient in planning for 30 minutes of vigorous exercise. Even the If the gym period is 60 minutes, the teacher needs to offer a variety of activities, so the students can sustain a sufficient activity level throughout the entire period. Being able to accommodate children with physical disabilities with able bodied children is a skill every instructor should be capable of. Clearly, the credentials of Physical Education teachers should be as important as an instructor for any other academic pursuit. Fostering a good attitude towards physical activity and confidence in physical abilities, regardless of inherent skill, illness, injury, developmental disability, and physical impairment, including obesity, is one of the most important lifelong resources a child can be given. Implementing mandatory Physical Education for a student’s entire primary and secondary educational career also prioritizes educational policy to ensure each child has access to the best Physical Education program possible.
Conclusion
The days that children spend mostly sitting, from school desk, to a computer desk, to a couch, must end. Needless to say, “the good old days,” where a child simply receives enough exercise as a result of “being a kid” are long in the past. Mandatory Physical Education should be one of essential tools that Americans use to adjust to our rapidly changing society. All citizens, not only parents and teachers, have a responsibility to make certain that the next generation has the best opportunity to achieve the highest level of wellbeing. We cannot afford to delay in the implantation of mandatory Physical Education, considering the explosive growth of lifestyle related diseases. Taking measures against this grim reality has a positive note; Physical Education has the potential to enhance all the dimensions of the human experience in an extremely positive way.

References
Ahn, S., & Fedewa, A. L. (2011). The effects of physical activity and physical fitness on children 's achievement and cognitive outcomes: a meta-analysis. Research Quarterly for Exercise and Sport, 82.3, 521-535. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA268788502&v=2.1&u=lom_lsuperiorsu&it=r&p=HRCA&sw=w
Alderman, B., Beighle, A., Erwin, H., & Morgan, C. F. (2012). Children 's in-school and out-of-school physical activity during two seasons. Research Quarterly for Exercise and Sport, 83.1, 103-107. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA282580675&v=2.1&u=lom_lsuperiorsu&it=r&p=HRCA&sw=w
Boyce, R., Combs, S., & Elliott, S. (2011). Recess physical activity packs in elementary schools: a qualitative investigation. Physical Educator, 68.3, 150-162. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA272432648&v=2.1&u=lom_lsuperiorsu&it=r&p=HRCA&sw=w
Bright Futures. (n.d.). Physical activity in children and adolescents. Retrieved from http://www.brightfutures.org/physicalactivity/intro/006_011.html
Carroll, M. Ogden, C. (2006, April). Prevalence of obesity among children and adolescents: United States, trends 1963–1965 through 2007–2008 . Retrieved from United States Center for Disease Control website: http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.pdf
Cohen, D. A., Schuster, M.A., Taylor, S. L., Vestal, K. D., & Zonta, M. (2007). Availability of high school extracurricular sports programs and high-risk behaviors. Journal of School Health, 77.3, 80-86. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA158907086&v=2.1&u=lom_lsuperiorsu&it=r&p=SPJ.SP23&sw=w
College, B., Ference, R., & Muth, K. D. (2004). Helping middle school females form a sense of self through team sports and exercise. Women in Sport & Physical Activity Journal, 13.1, 28-35. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA122536746&v=2.1&u=lom_lsuperiorsu&it=r&p=HRCA&sw=w
Colley, R. C., Duggan, M., Hicks, A., Janssen, I., Kho, M. E., LeBlanc, A. G., Tremblay, M. S., Murumets, K. (2011). Canadian sedentary behaviour guidelines for children and youth. Applied Physiology, Nutrition, and Metabolism, 36.1, 59-63. doi: 10.1139/H11-012
Dauenhauer, B. D., & Keating, X. D. (2011). The influence of physical education on physical activity levels of urban elementary students. Research Quarterly for Exercise and Sport, 82.3, 512-520. Retrieved form http://go.galegroup.com/ps/i.do?=GALE%7CA268788501&v=2.1&u=lom_lsuperiorsu&it=r&p=HRCA&sw=w
Health and physical education Pedagogy in the 21st century--a statement of consensus. (2011). JOPERD--The Journal of Physical Education, Recreation & Dance, 82.8, 7. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA270980816&v=2.1&u=lom_lsuperiorsu&it=r&p=SPJ.SP23&sw=w
Kahan, D. (2008). Recess, extracurricular activities, and active classrooms: means for increasing elementary school students ' physical activity; Physical education alone is not enough! JOPERD--The Journal of Physical Education, Recreation & Dance, 79.2, 26-40. Retrieved from http://proxy.lssu.edu:2100/ps/i.do?id=GALE%7CA175445428&v=2.1&u=lom_lsuperiorsu&it=r&p=SPJ.SP23&sw=w
United States Department of Health & Human Services. (2008). Physical Activity Guidelines for http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.pdfAmericans. Retrieved from http://www.health.gov/paguidelines/guidelines/chapter3.aspx
World Health Organization. (2011, March). Obesity and overweight. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/
World Health Organization. (2004, March). Fight childhood obesity to help prevent diabetes, say WHO & IDF. Retrieved from http://www.who.int/mediacentre/news/releases/2004/pr81/en/#.T15kjim8SyU.email

References: World Health Organization. (2011, March). Obesity and overweight. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/ World Health Organization