Childhood Obesity

Childhood Obesity

Keeping “baby fat” for too long can put a child’s health at risk. How can you help your child get fit and maintain a healthy weight into adulthood? The following steps may be helpful:

  • Be Active! Get your family focused on fitness. Go bike riding in the park or running around the block. There are so many great activities to do.
  • Maintain a healthy balanced diet and stick to it. Encourage all the family to make better dietary choices for themselves.
  • Visit your doctor for medical advice

These recommendations are not comprehensive and are not intended to replace the advice of your health provider.

About childhood obesity

Ten percent of children (at least 155 million youngsters) worldwide are overweight or obese. [1] Around 30-45 million within that figure are classified as obese – accounting for 2-3% of the world’s children aged 5-17. The majority of overweight or obese children appear to be in Western countries. Here are some statistics:

Australia: [4]

  • 20-25% of children are overweight or obese
  • Overweight children doubled between 1985-1995
  • Obese children tripled between 1985 and 1995

North and South America: [2]

  • Nearly half of the children predicted to be overweight by 2010
  • An increase of one-third in recent years
  • US: 20-30% of children are obese

United Kingdom: [3]

  • Number of obese children has tripled in 20 years
  • 10% of six year olds are obese
  • 17% of 15 year olds are obese

European Union: [4]

  • Childhood obesity highest in southern Europe, 20-35% children overweight
  • Northern Europe 10–20% of children are overweight

The proportion of overweight children are also expected to increase significantly in the Middle East and Southeast Asia while Mexico, Chile, Brazil and Egypt have rates comparable to fully industrialized nations [6].

A survey conducted in Saudi Arabia from 1994 to 1998 included 12,701 children aged 1-18 years old, showed that 11-12% of children were overweight , and over 6% were obese [6].

Asia lags behind the U.S. and Europe in obesity, but Thailand, Malaysia, Japan and the Philippines have all reported troubling increases in childhood obesity in recent years. In China, the rise in childhood obesity is particularly alarming. Up to 10% of China’s 290 million children are believed to be overweight or obese, and that percentage is expected to double a decade from now [4].

The rapid modernisation of China and other Asian countries has produced an alarming spike in the rate of obesity and diabetes. The rate of obesity among Asian children is increasing by 1% each year, roughly the same rate as in Britain, the US and Australia [4].

Major contributors to childhood obesity include genetics, unhealthy diets, and sedentary lifestyles. Overweight children often become adults with weight problems that contribute to a wide variety of health problems, but even during childhood and adolescence, being overweight can contribute to such disorders as type 2 diabetes, high cholesterol, high blood pressure, insulin resistance, and liver disease. Being overweight also has social and psychological consequences for children in terms of social discrimination, poor self-esteem, and depression.

Parents, family members, and others who are important people in a child’s life can either help or harm an obese child’s situation. As with all children, those with weight problems need acceptance, support, and encouragement from their family. Eating, exercising, and other health habits of family members play important roles in influencing the same behaviors in children.

What are the symptoms?

The ideal weight for a growing child or adolescent should be determined with the help of a health professional, who can also determine whether any unusual medical problems might be contributing to weight gain, whether any current health problems exist that are related to being overweight, and appropriate weight control methods.

Dietary changes that may be helpful

Unhealthy eating patterns resulting in overconsumption of foods high in fat, calories, or added sugars are a major contributor to childhood obesity. Since these patterns often include habits learned from the family, attention should be paid to providing fresh healthy food to the entire family and encouraging healthy eating by example.

Making the right food choices when eating outside the home is also a priority. To teach good lifetime eating habits, try the following:

  • Make healthy food easy to see at home and keep unhealthy foods out of sight
  • Plan meals and snacks ahead of time so that healthy choices can be available
  • Avoid using food as a reward or withholding food as punishment
  • Eat slowly and pay attention to when you are hungry and when you are satisfied
  • Eat with the family and avoid eating in front of the TV
  • Try to eat mostly fruit and vegetables throughout the day
  • Drink water when thirsty instead of other beverages
  • Start the day with a healthy breakfast to prevent cravings later on

There is only limited research on the prevention of childhood obesity with diet. Breast-feeding during infancy is usually associated with a reduced risk of developing obesity during early childhood, though the reasons for this effect are unclear. Children 7-12 years of age in a school program designed to reduce carbonated-drink consumption resulted in a reduction in the number of overweight children after 12 months. Most authorities believe that the best diet for treating childhood obesity is a heart-healthy diet low in saturated fat and cholesterol, but high in vitamins, minerals, and other important nutrients.

It has been discovered that overweight adolescents lost more weight with a low-carbohydrate diet than with a low-fat diet. Very-low-carbohydrate (ketogenic) diets have been shown to cause rapid weight loss in very obese children in short-term preliminary and controlled trials, but the long-term safety or this diet are unknown. More research is needed to evaluate low-carbohydrate diets for treating childhood obesity.

The Glycemic index and glycemic load describe the tendency of foods to raise blood sugar. Eating meals containing foods that have a low glycemic index or glycemic load may influence appetite and other body mechanisms that affect excessive weight gain in children. Obese children using a low glycemic index diet lost more weight compared with a similar group on a low fat diet. Further, obese adolescents eating freely on a low glycemic diet lost more weight and body fat after six months than did a similar group of adolescents following a typical low-calorie, low-fat diet.

Very low calorie “modified fasting” diets, typically using high-protein meal replacement beverages, have been tried in preliminary and controlled studies of obese children with good short-term results. These programs are not beneficial long term, with the weight lost in these diets often regained. There are also health risks associated with their use. Little is known about their effect on growth and other health issues in children.

Lifestyle changes that may be helpful

The lack of physical activity is a major contributing cause of childhood obesity. Programs to improve the weight of children are usually enhanced through increased physical activity. Watching television and playing computer games are unhealthy habits that contribute to the sedentary lifestyle of many children, and controlled research has shown that weight control is more successful when these activities are minimised and healthier alternative activities are provided. Children are recommended to get at least an hour of moderate physical activity most days of the week, and more may be necessary to offset genetic and other influences. Fun activities that involve other family members or other children will help make getting more exercise a positive experience.

Weight-loss efforts that are very restricted in calories or protein can prevent a child from gaining lean body mass (such as muscle) during the normal growth process. A healthy moderate diet in combination with an appropriate exercise program is the best program overweight children. A controlled trial found that strength training, when added to a low-calorie diet, resulted in a greater gain of lean body mass (while still promoting weight loss), compared with diet alone in obese children.

Other therapies

Treatment for childhood obesity involves screening for heart disease risk and other health risk factors, and providing information on improving diet and exercise habits. No medications are approved for treating childhood obesity.

Vitamins that may be helpful

Increasing fibre in your child’s diet may be beneficial in a weight-loss program. Dietary fibre ‘dilutes’ calories, slows down the eating process, and may make your child feel full while eating fewer calories. This means lots of fruit and vegetables, grains and cereals.

Holistic approaches that may be helpful

Techniques in changing behavior are considered useful for helping children break old habits and form healthier habits. These techniques may be learned from counseling professionals, support groups, educational programs, or books.

Getting further help

If you want to discuss your child’s eating and activity habits or weight, the following professionals can provide advice and information:

  • Maternal and child health nurse
  • Local GP
  • Paediatrician
  • Community health centre
  • Dietician
  • Psychologist

References

  1. Reuters Health, May 2004
  2. Dept Health and Human services, Center for Disease Control and Preventionhttp://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps
  3. BBC Science and Nature website http://www.bbc.co.uk/science/hottopics/obesity
  4. IASO International Obesity TaskForce
  5. MSNBC http://www.msnbc.msn.com/id/11694799/
  6. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey BMJ 2000;320;1240

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