Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. The prevalence has increased at an alarming rate. Globally, in 2016 the number of overweight children under the age of five, is estimated to be over 41 million. Almost half of all overweight children under 5 lived in Asia and one quarter lived in Africa.
Overweight and obese children are likely to stay obese into adulthood and more likely to develop noncommunicable diseases like diabetes and cardiovascular diseases at a younger age. Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity therefore needs high priority.
The WHO Member States in the 66th World Health Assembly have agreed on a voluntary global NCD target to halt the rise in diabetes and obesity.
The prevalence of overweight and obesity in adolescents is defined according to the WHO growth reference for school-aged children and adolescents (overweight = one standard deviation body mass index for age and sex, and obese = two standard deviations body mass index for age and sex).
In the United States, the percentage of children and adolescents affected by obesity has more than tripled since the 1970s.1 Data from 2015-2016 show that nearly 1 in 5 school age children and young people (6 to 19 years) in the United States has obesity.
Many factors contribute to childhood obesity, including:
- Metabolism—how your body changes food and oxygen into energy it can use.
- Eating and physical activity behaviors.
- Community and neighborhood design and safety.
- Short sleep duration.
- Negative childhood events
Genetic factors are difficult to change. However, people and places can play a role in helping children achieve and maintain a healthy weight. Changes in the environments where young people spend their time—like homes, schools, and community settings—can make it easier for youth to access nutritious foods and be physically active. Schools can adopt policies and practices that help young people eat more fruits and vegetables, eat fewer foods and beverages that are high in added sugars or solid fats, and increase daily minutes of physical activity. These kinds of school-based and after-school programs and policies can be cost-effective and even cost-saving.
HOW TO KNOW IF THE CHILD IS OBESE
Children grow at different rates at different times, so it is not always easy to tell if a child is overweight. Body mass index (BMI) uses height and weight measurements to estimate how much body fat a child has. However, while BMI is usually a good indicator, it is NOT a perfect measure of body fat and can even be misleading at times when children are experiencing periods of rapid growth.
If your child registers a high BMI-for-age measurement, your health care provider may need to perform further assessments and screenings to determine if excess fat is a problem.
Understanding how children become overweight in the first place is an important step toward breaking the cycle. Most cases of childhood obesity are caused by eating too much and exercising too little. Children need enough food to support healthy growth and development. But when they take in more calories than they burn throughout the day, the result is weight gain.
CAUSES OF CHILD OBESITY
Causes of weight problems in children may include:
- Busy families cooking at home less and eating out more.
- Easy access to cheap, high-calorie fast food and junk food.
- Bigger food portions, both in restaurants and at home.
- Kids consuming huge amounts of sugar in sweetened drinks and hidden in an array of foods.
- Kids spending less time actively playing outside, and more time watching TV, playing video games,
- and sitting at the computer.
- Many schools eliminating or cutting back their physical education programs.
OBESITY MYTHS AND FACTS
Myth 1: Childhood obesity is genetic, so there’s nothing you can do about it.
Fact: While a person’s genes do influence weight, they are only one small part of the equation. Although some children are more prone to gaining weight than others, that doesn’t mean they’re destined for weight problems. Most kids can maintain a healthy weight if they eat right and exercise.
Myth 2: Children who are obese or overweight should be put on a diet.
Fact: Unless directed by your child’s doctor otherwise, the treatment for childhood obesity is not weight loss. The goal should be to slow or stop weight gain, allowing your child to grow into his or her ideal weight.
Myth 3: It’s just baby fat. Children will outgrow the weight.
Fact: Childhood obesity doesn’t always lead to obesity in adulthood, but it does raise the risks dramatically. The majority of children who are overweight at any time during the preschool or elementary school are still overweight as they enter their teens. Most kids do not outgrow the problem.
PREVENTION OF CHILD OBESITY
Childhood Obesity is on the Rise
The number of overweight children in the United States has increased dramatically in recent years. Approximately 10 percent of 4 and 5 year old children are overweight, double that of 20 years ago. Overweight is more prevalent in girls than boys and in older preschoolers (ages 4-5) than younger (ages 2-3).
Obesity increases even more as children get older. For ages 6 to 11, at least one child in five is overweight. Over the last two decades, this number has increased by more than 50 percent and the number of obese children has nearly doubled.
For most children, overweight is the result of unhealthy eating patterns (too many calories) and too little physical activity. Since these habits are established in early childhood, efforts to prevent obesity should begin early.
Determining if a Child is Overweight
Parents should not make changes to a child’s diet based solely on perceptions of overweight. All preschoolers exhibit their own individual body structure and growth pattern. Assessing obesity in children is difficult because children grow in unpredictable spurts. It should only be done by a health care professional, using the child’s height and weight relative to his previous growth history.
Helping Overweight Children
Weight loss is not a good approach for most young children, since their bodies are growing and developing. Overweight children should not be put on a diet unless a physician supervises one for medical reasons. A restrictive diet may not supply the energy and nutrients needed for normal growth and development.
For most very young children, the focus should be to maintain current weight, while the child grows normally in height.
The most important strategies for preventing obesity are healthy eating behaviors, regular physical activity, and reduced sedentary activity (such as watching television and videotapes, and playing computer games). These preventative strategies are part of a healthy lifestyle that should be developed during early childhood. They can be accomplished by following the Dietary Guidelines for Americans. The Dietary Guidelines provide general diet and lifestyle recommendations for healthy Americans ages 2 years and over (not for younger children and infants). The most recent edition of the Dietary Guidelines can be found on www.ChooseMyPlate.gov. Following these guidelines can help promote health and reduce risk for chronic diseases.
Promote a Healthy Lifestyle
Parents and caregivers can help prevent childhood obesity by providing healthy meals and snacks, daily physical activity, and nutrition education. Healthy meals and snacks provide nutrition for growing bodies while modelling healthy eating behaviour and attitudes. Increased physical activity reduces health risks and helps weight management. Nutrition education helps young children develop an awareness of good nutrition and healthy eating habits for a lifetime.
Children can be encouraged to adopt healthy eating behaviours and be physically active when parents:
Focus on good health, not a certain weight goal. Teach and model healthy and positive attitudes toward food and physical activity without emphasizing body weight.
Focus on the family. Do not set overweight children apart. Involve the whole family and work to gradually change the family’s physical activity and eating habits.
Establish daily meal and snack times, and eating together as frequently as possible. Make a wide variety of healthful foods available based on the Food Guide Pyramid for Young Children. Determine what food is offered and when, and let the child decide whether and how much to eat.
Plan sensible portions. Use the Food Guide Pyramid for Young Children as a guide.
DIET FOR OBESE CHILDREN
Encourage healthy eating habits.
There’s no great secret to healthy eating. To help your children and family develop healthy eating habits:
- Provide plenty of vegetables, fruits, and whole-grain products.
- Include low-fat or non-fat milk or dairy products.
- Choose lean meats, poultry, fish, lentils, and beans for protein.
- Serve reasonably-sized portions.
- Encourage your family to drink lots of water.
- Limit sugar-sweetened beverages.
- Limit consumption of sugar and saturated fat.
- Remember that small changes every day can lead to a recipe for success!
Look for ways to make favourite dishes healthier.
The recipes that you may prepare regularly, and that your family enjoys, with just a few changes can be healthier and just as satisfying.
Remove calorie-rich temptations!
Although everything can be enjoyed in moderation, reducing the calorie-rich temptations of high-fat and high-sugar, or salty snacks can also help your children develop healthy eating habits. Instead only allow your children to eat them sometimes, so that they truly will be treats! Here are examples of easy-to-prepare, low-fat and low-sugar treats that are 100 calories or less:
- A medium-size apple.
- A medium-size banana.
- 1 cup blueberries.
- 1 cup grapes.
- 1 cup carrots, broccoli, or bell peppers with 2 tbsp. hummus.