CHILDHOOD OBESITY: CAUSES, RISK FACTORS AND PREVENTION
Obesity is fast becoming one of the world's largest global epidemics due to increasingly sedentary lifestyles and overly processed foods. Having an unhealthy weight puts one at risk for contracting chronic lifestyle diseases such as diabetes, heart disease and more. Children who are obese are at an even higher risk for these health concerns, both currently and later on in life. 1
Though the meaning of obesity has evolved through time, it is still characterized as an overabundance of body fat. There is no known limit point for too much fat in obesity among children. According to Williams et al’s study which involved 3,320 children between 5– 18 years old, excess fat is defined as body fat of at least 25 percent for males and 30 percent for females. 2
The Center for Disease Control and Prevention has characterized overweight as at or over the 95th percentile of body mass index for age and is at risk for being overweight, as between 85th to 95th percentile of BMI for age.3 European scientists has categorized overweight as at or above the 85th percentile and obesity as at or above 95th percentile of BMI. 4
Childhood obesity has been connected to various medical conditions. These conditions are composed of fatty liver disease, sleep apnea, Type 2 diabetes, asthma, cardiovascular disease, elevated cholesterol levels, gallstones, skin problems, menstrual irregularities, hormonal imbalances, and bone and joint problems. 5
The medical conditions mentioned above have been observed in adults; however, they are greatly predominant among obese children nowadays. Though majority of these medical conditions are preventable and can vanish when a child achieves a healthy weight, some keep on having negative complications all through adulthood. These conditions can even lead to mortalities. Three of the most common medical issues related to childhood obesity are diabetes, sleep apnea, and cardiovascular disease.6 In this article, we will discuss the risk factors for childhood obesity as well as some preventive strategies.
Genetic Risk Factors
Obesity is ordinarily known to be inherited in families. Aside from this families share environments and habits too. Obesity in kids connects with obesity in their parents.7
Obesity is also related to genetic disorders that run in families. The following genetic disorders can also predispose children to obesity: 8
- Trisomy 21
- Prader-Willi syndrome
- Albright's hereditary osteodystrophy
- Cohen syndrome
- Bardet-Biedl syndromes
- Alstrom syndrome
- WAGR (Wilms' tumor, aniridia, genitourinary anomalies, and retardation)
- Leptin deficiency
- Leptin receptor mutations
- Proopiomelanocortin deficiency
- Preproconvertase deficiency
- Melanocortin 4 receptor mutations
- Growth hormone deficiency
- Cushing's syndrome
- Hypothalamic obesity
- Polycystic ovary syndrome
Environmental/Societal Risk Factors
The child’s living condition, both in the home and in the community, can add to a higher risk for obesity. Here are some of the risk factors that can contribute to the development of obesity: 9
- Living in low income neighborhoods
- Parent’s impression of food and physical activity
- Poor access to a food store offering fruits and vegetables
- Environment is far from parks
- Dangers in the neighborhood
- Food instability
Behavioral Risk Factors
Nutrition and Diet
Despite the fact that it may appear to be sensible that increased calorie intake is related to a higher risk of childhood obesity, there is less scientific evidence to prove this. Low intake of dairy products and calcium is seen to increase the risk for childhood obesity. Beverage choice such as sweetened beverages and sodas also contribute to childhood obesity.
Other eating habits that can lead to childhood obesity include skipping breakfast, eating away from home like in fast food restaurants, quick eating, large portion sizes and eating without hunger. 10
In general, diminished physical activity among kids is related to obesity. There is an inverse relationship that exists between some activities and childhood obesity, including sports participation and walking from home to school and vice versa. Sedentary behaviors such as watching TV or playing video games can also lead to obesity in the future. 11 Increased time spent in front of the television and with electronic devices can also increase the risk. 12
It appears that shorter sleep duration is related to excess weight. In some studies, adequate sleep has an inverse relationship with obesity among preschool children. 13
The short-and long term impacts of stress on obesity are a rising territory for research. There are a few types of stress that can affect a child: individual, parental, and family. In spite of the fact that the evidence is mixed, there is a positive relationship between constant stress and obesity. This can show up in childhood and may persist into adulthood. Correspondingly, stress in the family is additionally connected with childhood obesity. 14
Satisfactory management of obesity for children who are already obese is imperative and requires the standards of care. Following the standards of care, the favored treatment is lifestyle modification and, when proper, other treatments such as medications and bariatric surgery may be done. Combined lifestyle changes should include physical activity and diet, as well as incorporating psychological techniques, such as motivation and cognitive behavioral therapy. The intervention phase should emphasize on behavioral changes and weight reduction, and should be followed up by long-term weight maintenance and behavioral support. 15
The family should purchase less foods that are related to obesity, for example, sweetened drinks, including fruit-flavored beverages, high-calorie snacks, or sweets. Healthy options, such as water, fruits, vegetables and other low-calorie foods should be accessible at all times and set on display; for instance, in front of the refrigerator or on the kitchen counter or table. Fruits bowls should replace cookie jars. High calorie food should be packaged in foil or placed in the back of the refrigerator so as to hide them. Children should not be encouraged to eat straight from the package, and high calorie foods should be repacked at home in smaller containers. 16
Childhood obesity is easily preventable; all we need is will power and the right strategies. If we can beat childhood obesity now, we can produce future adults who are healthier and well-rounded.
If you are worried about your child's weight, visit a children's hospital or medical center, or talk to your doctor today. To search for pediatric healthcare providers worldwide, please use the Mya Care search engine.
- 1. Talking to Your Pediatrician. WebMD. https://www.webmd.com/parenting/raising-fit-kids/weight/features/talking-to-pediatrician#2. Published 2018. Accessed December 28, 2018.
- 2. Williams DP, Going SB, Lohman TG, Harsha DW, Srinivasan SR, Webber LS, et al. Body fatness and risk for elevated blood-pressure, total cholesterol, and serum-lipoprotein ratios in children and adolescents. Am J Public Health. 1992;82:527.
- 3. Flegal KM, Wei R, Ogden C. Weight-for-stature compared with body mass index-for-age growth charts for the United States from the Centers for Disease Control and Prevention. Am J Clin Nutr. 2002;75:761–6.
- 4. Ghosh A. Explaining overweight and obesity in children and adolescents of Asian Indian origin: The Calcutta childhood obesity study. Indian J Public Health. 2014;58:125–8.
- 5. Niehoff V. Childhood obesity: A call to action. Bariatric Nursing and Surgical Patient. Care. 2009;4:17–23.
- 6. American Academy of Pediatrics. About childhood obesity. [Last accessed 2014 Jul 14]. Available from: http://www.aap.org/obesity/about.html
- 7. Brown CL, Halvorson EE, Cohen GM, Lazorick S, Skelton JA. Addressing Childhood Obesity: Opportunities for Prevention. Pediatr Clin North Am. 2015;62(5):1241-61.
- 8. Savona-Ventura C, Savona-Ventura S. The inheritance of obesity. Best Practice & Research Clinical Obstetrics & Gynaecology. 2014
- 9. Ohri-Vachaspati P, DeLia D, DeWeese RS, Crespo NC, Todd M, Yedidia MJ. The relative contribution of layers of the Social Ecological Model to childhood obesity. Public health nutrition. 2014:1–12.
- 10. Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics. 2007;120(Suppl 4):S229–253.
- 11. Must A, Tybor D. Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth. International Journal of Obesity. 2005;29:S84–S96.
- 12. Tremblay MS, LeBlanc AG, Kho ME, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. The international journal of behavioral nutrition and physical activity. 2011;8(1):98.
- 13. Bell JF, Zimmerman FJ. Shortened nighttime sleep duration in early life and subsequent childhood obesity. Archives of pediatrics & adolescent medicine. 2010;164(9):840–845.
- 14. Wilson SM, Sato AF. Stress and paediatric obesity: What we know and where to go. Stress and Health. 2014;30(2):91–102.
- 15. Seidell JC, Halberstadt J, Noordam H, Niemer S: An integrated health care standard for the management and prevention of obesity in The Netherlands. Fam Pract 2012;29(suppl 1):i153-i156.
- 16. Wansink B. From mindless eating to mindlessly eating better. Physiol Behav. 2010;100(5):454–463
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