Researchers and health organizations refer to obesity as a ‘major health crisis’. And this is indeed true, for obesity is not limited to adults.
Childhood obesity can be defined as excess body weight for a given height, age, and gender of the child.
In this article, we use the term ‘Childhood obesity’ to refer to it as a health condition and with no intentions of stigmatizing young minds.
CDC reports that approximately 17% or 12.7 million children aged 2-19 years are obese. If you run a net search on ‘Childhood obesity’ you will get a lot of detailed statistics on this topic and the figures are pretty alarming.
In 2011-2012, 8.4% of 2- to 5-year-olds had obesity compared with 17.7% of 6- to 11-year-olds and 20.5% of 12- to 19-year-olds.
In US, obesity rates have tripled over the past three decades and the country now has highest obesity rates in the world: 1 out of 6 children are obese.
It is a general trend to ignore childhood obesity under the idea that he or she is just a healthy kid and they will be fine when they grow up. But that is not what studies say.
Eighty percent of overweight 10-14-year-old adolescents are at risk of becoming overweight adults compared to 25% of overweight preschool children (< 5 years old) and 50% of 6-9-year-old overweight children.
A review of 25 studies conducted all around the world also reported that overweight and obese youth are at significantly increased risk of being overweight adults.
So the need of the hour is to nip childhood obesity in the bud and what could be better than identifying causative factors in the first place.
Top Seven Alarming Causes of Childhood Obesity
Here is a list of causative factors for childhood obesity and you will be surprised to know that it is not the ‘big bones’ or ‘family genes’ that cause your child to be overweight.
1.Your child’s diet quality
Poor diet has been greatly linked to childhood obesity.
Over the last few decades, there has been a drastic shift in children’s food choices from healthy foods to energy dense refined foods.
Soft drinks or soda consumption has greatly increased in children.
A 19-month study demonstrated that the likelihood of obesity in children increased by 1.6 times for every additional soft drink consumed each day.
The sugar content of these beverages makes them addictive and the amount consumed exceeds the daily limit for sugar. 30-50% of adolescents have 3 or more 8-ounce servings of soda a day.
Increased accessibility of fast food or snacks also contributes to childhood obesity.
A fast food meal (burger, fries, soda, and dessert) packs 2200 kcal and if you were to expend 50 calories every mile you run, then only a marathon could help you burn down this load.
Increased portion sizes, eating away from home, missing breakfasts, reduced energy intake at breakfasts and increased at dinner are few other factors involved.
Additionally, the nutritional content of the diet also matters.
An overall evaluation shows that children get a highly reduced percentage of nutrients than what has been recommended under Food Guide Pyramid and the quality of nutrients suffer.
For example, fried potatoes account for almost half of daily vegetable servings for children. Food provided at school or child care facility should keep it in mind to provide nutritious food in compliance with the dietary regulations.
Parents should also promote such habits.
What does this mean?
Children have easier access to high calorie foods such as sugar sweetened beverages and fast food. Poor nutritional quality and habits such as skipping breakfast or buying lunch from school cafeteria also tips the scale towards a positive energy balance.
2.Your child’s playtime
Physical activity plays an important role in obesity. Children who do not engage in regular physical activity are likely to be obese.
1 hour of daily physical activity is recommended. Only 48.9 % of boys and 34.7 % of girls aged 6–11 meet the physical activity guidelines.
Children spent most of their time in sedentary activities such as using a computer, watching TV, playing video games.
Children snack more while watching television. Watching TV for more than 2 hours a day is associated with unfavorable changes in weight in children.
Physical activity in children does not reduce obesity alone but also reduces the risk of cardiac diseases and diabetes.
It also improves mental health and well being. Physical inactivity in children continues in adulthood. Only 2% of inactive adolescents turn out to be active adults.
What does this mean?
Lack of physical activity and increased engagement in sedentary behaviours heavily contribute to childhood obesity. Physical inactivity in childhood is carried on in adult lifestyle and apart from obesity, physical inactivity increase risk of metabolic diseases.
3. The environment your child grows up in
Socio-environmental factors are factors in various settings like home, school, and community that influence children’s eating habits and physical activity.
Parent-child interaction is very crucial to a child’s development. For example, researchers believe that increased parental control over eating habits can result in poor self-regulation of child’s energy intake.
Parental food preferences directly shape their children’s food choices.
A study showed that in comparison to those who eat lesser than 3 meals per week, adolescents who ate 4-5 family meals a week were 19% less likely to report poor consumption of vegetables and dairy, and 22% less likely to report poor consumption of fruits.
For many children eating is a social event and children tend to mimic the food preferences of other adults and siblings.
Studies show that children who grow up in a single parent family are more likely to be overweight than children in two-parent families and women working outside home coincides with an increase in child’s weight problems.
Since children spend most time at school, the school can promote healthy food choices and physical activity in children.
In school environments such as availability of courts, nets fields and well supervised physical education classes can contribute to physical activity in middle schools.
Child care facilities should also be monitored for encouraging healthy eating and physical activity.
Experts feel that the physical environment is an important driving factor for rising of obesity.
Lack of safe outdoor recreation space, neighborhood crime, unavailability of public transport are a few factors that inhibit children from having a safe environment outside.
Children spend a good deal of time traveling to and from school and this time and route can be utilized for daily physical activity.
Lack of street lighting, lack of safe bike paths and busy traffic can impede children from biking or walking to school which otherwise could have contributed to daily physical activity.
Availability of fast food joints in the neighborhood or snack vending machines at school can also add to the burden of obesity.
Socio-economic status is found to be negatively associated with being overweight or obese in children, however it varies upon race/ethnicity.
Factors involved could be less healthy eating patterns, less physical activities and cultural perceptions about body weight and image.
What does this mean?
Social environment perhaps dictates the possibility of being overweight. Parental influences on eating habits take the first place followed by environment at school and neighbourhood. Socio-economic status is also correlated with developing obesity and the trend varies depending upon ethnicity.
4.The enticing food advertisements
There is considerable debate on the link between food promotion and children’s eating habits.
Food advertisements influence children’s food choices and shift it towards fast food, sugary cereals or foods high in calories, trans fat, sugar, sodium etc.
The link between watching TV and obesity has been established and every additional hour spent watching TV increases obesity by 2%.
Children of the age group 2-11 years watch on an average of 3 hours of TV each day and see about 5500 food ads in a year.
A study conducted by Dr Connors monitored the kind of advertisements on children’s TV channels.
In the 9 am to 1 pm slot, 130 food-related ads were presented.
Half of these were aimed at children and most of them were fast food or sugary cereals. Fast food restaurants include toys in their meals which children are eager to collect.
40% of the children ask their parents to take them to fast food restaurants on a daily basis.
However, the food provided is not in line with dietary recommendations for kids. Children are more likely to consume foods that were depicted in food advertisements as fun and with taste appeal.
It is also observed that the foods which are requested by most of the children during shopping at the supermarket are foods that are high in fat and sugar.
What does this mean?
Food industry advertisers are looking for early brand recognition in children by equating food with happiness, fun and appealing taste. This shifts children’s choices towards food rich in trans fat and sugar which contributes to childhood obesity.
5.The usual victim of blame game: Genetics
When nothing seems to work, we easily blame our genes for every possible condition. Over 250 genes related to obesity have been identified.
However, these genes alone are not responsible for obesity.
Their interaction with the environment, however, can cause obesity. Genes can affect metabolism, appetite, body type, food preferences etc.
Cases of genetically related obesity do exist but affect a very small population.
Around 6 genetic defects have been identified and interestingly they affect fewer than 150 people. Heredity of such genes has a varying influence on the risk of developing obesity.
Studies suggest that 50-75% an individual’s body weight and degree of fatness is influenced by genes. If both parents are obese, then there s a 75% chance that the child will be overweight and 25-50% chance if one parent is overweight.
What does this mean?
Obesity related genetic defects affect a small number of people and studies suggest that hereditary does increase the likelihood of child being obese. But genes alone do not predispose one towards developing obesity; it is their interaction with environmental factors that matters.
6.Underlying Medical Conditions that your child might be suffering from
Childhood obesity can also be a result of underlying medical conditions. Few of the genetic syndromes involved are:
- Prader Willi syndrome
- Bardet Biedl syndrome
- Down syndrome
- Turner syndrome
Metabolic disorders that are linked to childhood obesity are:
- Cushing’s syndrome
- Growth hormone deficiency
- Hypothyroidism
- Precocious puberty
- Polycystic ovary syndrome
Certain medications like antidepressants, sulfonylureas, cortisol or glucocorticoids etc can also contribute to weight gain.
What does this mean?
Childhood obesity could occur as a consequence of certain medical conditions and for this treating the medical condition is necessary in order to keep the weight in control.
7.The factors that you ignore
Psychological factors influence a child’s eating habits. Children tend to binge eat or overeat in order to combat stress and depression.
Attention Deficit Hyperactivity Disorder has also been linked with obesity.
Researchers discovered that decreased self-esteem led to 19% of obese children feeling sad, 48% of them feeling bored, and 21% of them feeling nervous.
In comparison, 8% of normal weight children felt sad, 42% of them felt bored, and 12% of them felt nervous.
Adequate sleep is essential for a healthy lifestyle. The risk for obesity is nearly three times higher for children who sleep less than eight hours per night.
Use of technology such as TV and cell phones also affect sleep duration and increase stress and anxiety.
Breastfeeding is said to be protective against obesity.
A study states that breastfeeding may encourage healthier eating habits since breastfed babies may eat until satiated while bottle-fed babies are encouraged to eat till formula feed is finished.
What does this means?
Even factors such as sleep duration, mental well being, breastfeeding at infancy, which we ignore can contribute to the likelihood of child being overweight.
Why Preventing Childhood Obesity so Important?
Just as in adults, obesity in children is a gateway to a number of medical conditions such as:
- Cardiovascular problems
- Metabolic diseases like diabetes and insulin resistance
- Joint problems
- Fatty liver disease, gallstones, heartburn
- Breathing problems like sleep apnea and asthma
- Skin conditions and menstrual abnormalities
- Psychological problems like low self-esteem, depression
These medical conditions can further affect academic performance and also lead to emotional consequences.
Children are way too sensitive and fragile to deal with any of these conditions and it is our duty to protect them from the same.
8 Ways Parents Can Prevent Childhood Obesity
A child’s development and behaviour is influenced maximum by parents which makes them important players in the prevention of childhood obesity.
Here are a few ways which are clinically proven as a measure against childhood obesity.
1. Offer a healthy nutrient balanced plate
You definitely don’t need to guess this one.
As parents, providing children a healthy balanced diet and also normal portion sizes is perhaps the best thing you can do to prevent childhood obesity.
The way parents feed their children influences the manner in which children will learn to regulate their food intake. So what exactly would constitute a balanced diet?
A great blend of fruits, vegetables, dairy, whole grains and protein would be the answer. Use healthy oils like coconut and olive oil to prepare the dishes and water should be the first choice among beverages.
USDA’s MyPlate initiative provides great resources about balanced nutrition. Another chart I came across gives detail regarding portion sizes for kids of different age groups.
In addition to providing healthy food, keep a tab on the not so healthy sources or even avoid them in totality.
Intake of sugar-sweetened beverages should be regulated.
A study reported that children (2-5 years) who drank more than 12 ounces of fruit juice a day were likely to be overweight than those drinking less.
A good alternative would be unsweetened real fruit juices or even a whole fruit.
Absolute restriction of fast foods is not possible but providing healthier versions of the same dish is a wise decision.
What does this mean?
Providing children with a balanced diet with a variety of options is the strongest action you can take against childhood obesity. Healthier (as well as tasty) versions or alternatives to not so healthy foods can promote a child’s interest towards healthy eating.
2.Start moving
Physical activity plays an important role in energy balance.
An 8-year long study found that children (3-5 years) who were highly active had lower BMI in comparison to less active counterparts.
Parents should encourage outdoor play. Children who spend more time outdoors have higher physical activity.
Change in parent’s physical activity and ffamily-basedobesity prevention programs have a positive impact on children’s physical activity levels.
A study involving a combined physical activity and nutritional intervention reported that children without parental obesity experienced a significant decrease in BMI compared to those children with both parents showed obesity.
Your job is not over when you take kids to the parks but getting involved in their play is a part of your duty.
Design fun games in your backyard which would involve you and your kids moving about and having a great time.
Encouraging older kids to take up a sport or signing up for dance classes is another option.
With parental and professional supervision, if it interests your child, you can enrol them for yoga, gym or related activities.
What does this mean?
Increasing kid’s physical activities means faster burning of calories and excess fat. It also improves your child’s health quotient. Encouraging outdoor play or enrolling them for sports, dance and physical activity related classes are a few initiatives you can take. By incorporating physical activity in your own lifestyle you will inspire your children to do the same.
3. Cut down screen time
Few studies establish a link between TV viewing, obesity and reduced physical activity . One study demonstrated that viewing TV and videos and having TV in the bedroom was liked with increasing prevalence of childhood obesity.
TV viewing reduces physical activity and gives rise to unhealthy eating habits.
For example, if you are eating a meal while watching TV you might not have a control over the portion size.
Also, TV exposes children to advertisements promoting unhealthy food options thus altering their food requests and preferences.
Even inadequate access to the Internet is likely to pose these problems. Studies show that reducing TV can reduce children’s BMI and obesity risk.
Limiting physical access to TV by avoiding TV in bedrooms can help limit its usage. Parents can also help by limiting their own time for TV watching.
What does this mean?
Reducing TV and screen time improves a child’s physical activity levels, eating habits and sleep patterns. This would involve removing TV sets from your child’s room and regulating the time for watching TV. It would be helpful to provide alternative activities to watching TV.
4. Pay attention to your child’s emotions
Rarely is childhood obesity treated as a psychological disturbance?
Yet even young children recognize their weight issues and there is a stigma attached to anything that is far from normal.
Normal weight children perceive overweight children as less healthy, less active and have poor eating habits.
Even overweight children as young as 5 years old are aware of their own overweight status and assess all emotional and psychological factors associated with it in a derogatory manner.
Some studies suggest that overweight children have low self-esteem in comparison to normal weight children.
A number of behavioral factors could be the reasons behind your child’s overweight status: stress-induced eating, eating disorders, depression, parent and family influences, binge eating, ADHD etc.
If this is the case then you as a parent can bring a massive shift in your child’s attitude. Your mental health and well being will reflect in your child’s personality.
To deal with this aspect you will have to play a dual role of a parent and friend to your child.
A positive parent-child relationship is associated with lower weight, healthy eating and more physical activity in children.
Increased motivation in family-based guided weight loss programs is found to bring significant reductions in children’s BMI.
If there is any factor that is causing stress to your child, please take whatever possible steps to address it.
Paying attention and expressing your concern towards your child’s weight will definitely encourage your child to address the same problem, especially if you are a mother.
If needed please consult a clinician to nip your child’s psychological problems in the bud.
What does this mean?
Addressing emotional problems can indirectly ameliorate your child’s overweight condition. Reducing stress from your side, from the family and instead motivating (but not pressurising) the child to eat healthy and be active can help.
5. Find out if your child’s health condition is not responsible for his weight
If you have read our article 7 Alarming Causes behind Childhood Obesity, you might have come across various medical conditions that could be responsible for childhood obesity.
A few genetic conditions like Prader Willi syndrome, Barder Biedlt syndrome affect children in which obesity is a symptom.
Metabolic and hormonal disorders like Cushing’s syndrome and polycystic ovarian syndrome can lead to weight gain.
Consult a physician to rule out these causes and if diagnosed ask the doctor or a dietician for a weight management course along with proper treatment of the disease.
What does this mean?
Find out whether your child’s overweight condition is not a result of any medical condition. If diagnosed with any such disease, seek appropriate treatment and weight management technique for the same.
6. Eating out should be an occasional event
I don’t need to explain to you the link between increased weight and fast food. After all fast food is high in calories, unhealthy fats and sugars.
Also, the portion sizes are larger than what is generally recommended for an individual.
Fast food consumption is high in childhood and increases with adolescence and it is also associated with a high BMI.
But how can you battle your child’s urge for fast food?
A good start would be educating your child about nutrition.
Taking an example of a superhero and asking ‘What this person would eat?’ unhealthy (French fries) or healthy (apple slices) is a good way to influence your kid’s food habits.
A study was conducted wherein adolescents were asked to choose food items from a fast food restaurant menu and then were given a 30-minute nutrition education session.
After that, they were asked to reselect food items and a positive change in calories and fat content of the choice was observed.
Parent moderated behaviours can successfully shift the child’s preferences towards healthy food.
Make eating out an occasional event, educate your child about healthier fast food options or provide them with healthier versions of fast food at home.
What does this mean?
Educating your child about nutrition and the possible healthier options that he/she can opt for when eating out can aid in offsetting the effect of fast food consumption on weight. As far as very young children are concerned make visits to fast food restaurants an occasion and give them healthier versions of fast food at home.
7. Start transitioning to a healthy lifestyle
Parents should provide access to healthful eating options.
Early exposure and accessibility to nutritious food like fruits and vegetables promotes the children’s interest in such foods and they eat more of them.
Eating dinner together promotes children’s interests in healthy food choices such as fruits, vegetables, whole grains and reduces preferences towards fats and soft drinks.
As kids grow older they tend to spend less time at home for meals which is why parents need to intervene and maintain family eating practices.
However, there is one thing parents should keep in mind.
Parents’ attempts to control what their child eats may shift the child’s attention from internal hunger and satiety cues towards appealing tastes of the food.
Imposing strict restrictions may shift the child’s preferences towards high fat, energy dense foods.
When you make a shift of being engaged in physical activity and exercise, your child will follow the same route. Other few habits that you might need to work on:
- Regular bedtime since lack of sleep is associated with increased with weight gain
- Snacking but only on healthy options
- No skipping meals or breakfast
- No midnight snacking or late night TV viewing
- Making family meals a joyful event so that kids follow the same practice when dining out
A slow gradual shift towards a healthy lifestyle is advisable so that kids are not overwhelmed by the number of changes.
What does this mean?
Simple changes in lifestyle such as regulating eating behaviours, sleeping habits, engaging in family meals can serve as preventive measures against childhood obesity.
8. You are your child’s hero, start behaving like one
Children mimic their parents’ behaviours with respect to a number of factors. Eating pattern is one.
At an early age, children will eat only what is provided in the household.
Children imitate their parent’s food choices and eating behaviours, especially their mother’s. So if parents overeat their children may follow the same pattern.
Role modeling is a clinically proven measure of childhood obesity.
A great start would be changing your own eating habits and food choices.
Try new healthy foods yourself and introduce your child to it. Make shopping for food and preparing food a parent-child activity.
When your child says he is hungry, offer a healthy snack and do not use sugary food (eg: candies, cake) as a meal replacement.
Parents’ interest and understanding of the importance of physical activity can influence a child’s behaviour.
The Framingham Children’s study demonstrated that children of active mothers are twice as likely to be active than children of inactive mothers.
If both parents were active then children were 5.8 times likely to be active than children of sedentary parents.
Reduce your own as well as your child’s screen time.
Encourage and be involved in your child’s physical activity. Walking to school or using the bike are good initiatives to incorporate exercise in your child’s daily routine.
What does this mean?
Children mimic their parents. So if you incorporate healthy eating habits and value exercise, your child is likely to follow the same pattern.
Parent-based childhood obesity prevention programs
Researchers have designed programs focussed on reducing childhood obesity by incorporating parent’s involvement.
Family-based approach
In one parent based intervention , families of 7-12-year-old children were selected to receive only counseling or counseling and behavioural therapy.
Both groups observed a decrease in use of TV and video games.
The behavioural group mentioned a significant increase in physical activity and playing outside.
There was a decrease in overall household TV use and in meals eaten while watching TV in this group.
The 8-week HENRY (Healthy Exercise Nutrition for the Really Young) program guided parents to take a step against childhood obesity.
At the end of 8 weeks, parents reported increased consumption of fruits and vegetables, decreased consumption of sweetened foods and improved eating behavior in children.
School & parent based approach
In a school-based intervention, it was evaluated how a school-based health report affects a family’s awareness and concerns regarding child’s weight.
Parents of overweight children receiving such reports were more aware of their child’s weight status and took up more activities to control it rather than parents who did not receive such reports.
An approach involving reduction of screen time
A study called ‘Switch-Play’ was designed to reduce TV time and increase physical activities.
Results showed that more than 50% of the children reduced TV time and less than 50% increased physical activity. And most of the children enjoyed alternative activities.
Parents vs. Parent & Children program
This study involved either parents alone or parents and the obese child as a medium of change in order to improve the child’s weight.
The study lasted for a year.
The parents were asked to employ positive parenting styles. In the parents only approach, a significant reduction in BMI was observed at the end of 1 year.
A positive change in food habits was also observed in this group.
Researchers concluded that keeping the child from actively participating in a health program is beneficial but what I infer from here is how crucial is a parent’s involvement in this matter.
What does this mean?
These are a few random parent based childhood obesity prevention/treatment programs that I thought of sharing with you just to highlight the idea of how vital is a parent’s role in regulating a child’s eating habits and nutritional pattern, even through a scientific point of view.
Conclusion
If you observe the maximum of the causative factors for childhood obesity are external or from the environment and this makes the problem solvable.
Efforts from parents and family followed by support from a school environment can definitely reduce the burden of obesity in children.
Just as we protect children from infection by providing a hygienic environment or secure their future financially, in the same way, we can protect them from obesity by providing healthy food, adequate portions, and good eating habits.