The world is undergoing a quick nutritional and epidemiological transition that has been characterized by the prevailing nutritional deficiencies, as proved by the prevalence of anemia, stunting, and iron and zinc deficiencies. Simultaneously, there is a progressive increase in the incidence of diabetes, obesity, and other nutrition associated chronic diseases (NRCDs) such as obesity, cardiovascular disease, diabetes, and some types of cancer. Obesity has attained epidemic levels in developed nations. The largest prevalence rates of childhood obesity have been seen in developed nations; however, its prevalence is rising in developing nations as well. Females are more likely to be obese in comparison to males, owing to inherent hormonal differences.
It is developing convincingly that the genesis of Type 2 Diabetes and Coronary Heart Disease starts in childhood, with childhood obesity catering as a crucial factor. There has been a phenomenal increase in the proportions of children carrying obesity in the past 4 decades, mainly in the developed space. Studies coming from varied parts of India within the last decade are also indicative of similar trends. This notion has been challenged over recent years and we presently consider these as varied forms of the global malnutrition issue. This new conceptualization takes us to simultaneously address the root issues of nutritional deficiencies which in turn will have a contribution to the control of under nutrition and the prevention of diabetes, obesity, and other NRCDs. This summary offers a public health overview of chosen key problems that are related to childhood obesity prevention along with chronic diseases with a life-course perspective of child growth and nutrition.
Childhood obesity is among the most serious public health issues of the 21st century. The problem is global and is constantly impacting many low and middle income nations, mainly in urban settings. The prevalence has risen at an alarming rate. Globally in 2010, the measure of overweight children under the age of five is anticipated to be more than 42 million. Close to 35 million of these are living in developing nations.
Childhood Obesity: Definition
Even though the definition of obesity and overweight has altered over time, it can be illustrated as an excess of body fat (BF). There is no agreement on a cut-off point for excess fatness of overweight or obesity in adolescents and children. A study that has been conducted by Williams et al. (1992), on 3,320 children within the age group of 5–18 years classified them as fat if their percentage of body fat was at least 25 percent for males and 30 percent for females, respectively. The Center for Disease Control and Prevention illustrates overweight as at or above the 95th percentile of body mass index (BMI) for age and “at risk for overweight” as among 85th to 95th percentile of BMI for age. European researchers classified this term as at or above 85% and obesity as at or above 95% of BMI.
An Indian research study has illustrated obesity and overweight as obesity (≥95th percentile) and overweight (between ≥85th and <95th percentile). Another research has followed WHO (World Health Organization) 2007 growth reference for illustrating overweight and obesity.
Childhood Obesity: Causes
It is broadly accepted that the rise in obesity outcomes from an imbalance between expenditure and energy intake, with a rise in positive energy balance being closely related with the lifestyle accepted and the dietary intake preferences. However, there is rising evidence that indicates that a genetic background of an individual is crucial in evaluating obesity risk. Research has made crucial contributions to our understanding of the factors related to obesity. The ecological model, as illustrated by Davison et al., recommends that child risk factors for obesity have physical activity, dietary intake, and sedentary behavior. The effect of such risk factors is moderated by elements like age, gender. Family characteristics, parents’ lifestyles, parenting styles also play a crucial role. Environmental factors like demographics, school policies, and parents’ work-related factors further influence activity and eating behaviors.
Genetics are among the biggest factors examined as a reason for obesity. Some studies have examined that BMI is 25–40% heritable. However, genetic susceptibility often requires being coupled with contributing behavioral and environmental factors in order to impact weight. The genetic factor accounts for less than 5 percent of cases of childhood obesity. Hence, while genetics can play a crucial role in the development of obesity, it is not the reason for the dramatic rise in childhood obesity.
Basal metabolic rate has also been examined as a possible reason for obesity. Basal metabolic rate, or metabolism, is the expenditure of energy of the body for normal resting operations. Basal metabolic rate is accountable for 60 percent of total energy consumption in sedentary adults. It has been assumed that obese individuals have lower basal metabolic rates. However, variations in basal metabolic rates are not likely to be held responsible for the increasing rates of obesity.
A review of the literature finds out factors behind poor diet and provides numerous insights into how parental factors may affect obesity in children. They further note that children learn by modeling peers’ and parents’ preferences, willingness, and intake to try the latest foods. Accessibility of, and repeated exposure to, healthy foods is primary to developing preferences and can beat dislike of foods. Mealtime infrastructure is crucial with evidence that suggests that families who eat together intake more healthy foods. Along with that, eating out or watching TV while eating is related to a higher intake of fat. Parental feeding style is also important. The authors found that authoritative feeding is related to positive cognitions about healthy foods and also healthier intake. Interestingly, authoritarian limitation of “junk food” is related to the raised desire for unhealthy food and higher weight.
Social policies and government could also potentially promote healthy actions. Research indicates taste, which is followed by hunger and price, is the most crucial factor in adolescents’ snack choices. Other studies illustrate that adolescents relate junk food with pleasure, convenience, and independence, whereas liking healthy food is thought odd. This recommends investment is needed in changing the meanings of food, and social thinking of eating behavior. As proposed by the National Taskforce on Obesity (2005), fiscal policies like taxing unhealthy options, offering incentives for the distribution of inexpensive healthy food, and also investing in convenient recreational facilities or the esthetic quality of neighborhoods can develop healthy eating and physical activity.
Dietary features have been studied in depth for their possible contributions to the increasing rates of obesity. The dietary factors that have been studied include the consumption of fast food, sugary beverages, portion sizes, and snack foods. These are among the top 10 causes for childhood obesity.
Fast food Consumption
Increased consumption of fast food has been associated with obesity in recent years. Many families, mainly those with two working parents, opt for these places as they are at times favored by their children and are both inexpensive and convenient. Foods served at fast food restaurants tend to have a high portion of calories along with low nutritional values. A study measured the eating habits of lean and overweight adolescents at fast food restaurants. Researchers found that both groups had more calories eating fast food than they would typically do in a home setting but the lean group remunerated for the higher caloric intake by adjusting their caloric intake prior to or after the fast food meal in expectation or compensation for the excess calories intake during the fast food meal. Even though many studies have shown weight gain with frequent consumption of fast food, it is hard to establish a causal relationship between obesity and fast food.
A study that examined children aged 9–14 from 1996–1998, found that intake of sugary beverages rose BMI by small amounts over the years. Sugary drinks are another significant factor that has been examined as a powerful contributing factor to obesity. Sugary drinks are often considered as being limited to soda, but other sweetened beverages like juice fall into this category. Many studies have examined the connection between sugary drink intake and weight and it has been always found to be a contributing factor to being overweight.
Portion sizes have risen dramatically in the last decade. Intaking large portions, along with frequent snacking on highly caloric items, contribute to a high caloric intake. This energy imbalance can lead to weight gain, and consequently obesity.
The rising problem of childhood obesity can be slowed, if society aims at the childhood obesity causes. There are many elements that play a role in childhood obesity, some being more vital in comparison to others. A mixed diet and physical activity intervention carried on in the community with a school component is more efficient at stopping obesity or being overweight. Moreover, if parents enact a healthier lifestyle at their home, many obesity issues could be avoided. What children learn at home related to eating healthy, exercising, and making the apt nutritional choices will eventually spill over into other dimensions of their life. This will have the largest influence on the choices kids make when choosing foods to have at school and fast-food restaurants and selecting to be active. Aiming at these causes may, over time, reduce childhood obesity and lead to a healthier society as a whole.