Childhood obesity is a condition in which excess body fat negatively affects the health or well-being of a child. Because the method for determining body fat is directly difficult, the diagnosis of obesity is often based on BMI. Because of the increasing prevalence of obesity in children and many adverse health effects it is recognized as a serious public health problem. The term overweight rather than obese is often used in children due to less stigmatization.
Video Childhood obesity
Classification
Body mass index (BMI) is acceptable for determining obesity for children two years and older. This is determined by weight ratio to height.
The normal range for BMI in children varies by age and sex. While BMI above the 85th percentile is defined as being overweight, BMIs greater than or equal to 95 percent are defined as obese by the Centers for Disease Control and Prevention. It has published a table to determine this in children.
The US Preventive Services Task Force reports that not all children with high BMI need to lose weight. High BMIs can identify possible weight problems, but do not differentiate between fat or lean tissue. In addition, BMI may mislead some children with excess adipose tissue. It is therefore useful to complement the reliability of BMI diagnosis with additional screening tools such as adipose tissue or skin fold measurements.
Maps Childhood obesity
Health effects
Psychological
The first problem that occurs in obese children is usually emotional or psychological. Obese children often experience intimidation by their friends. Some are harassed or discriminated against by their own families. Stereotypes abound and can lead to low self-esteem and depression.
Physical
However, childhood obesity can also lead to life-threatening conditions including diabetes, high blood pressure, heart disease, sleep problems, cancer, and other disorders. Some other disorders include liver disease, premature puberty or menarche, eating disorders such as anorexia and bulimia, skin infections, and asthma and other respiratory problems.
The initial physical effects of obesity during adolescence include, almost all the organs of children affected, gallstones, hepatitis, sleep apnea and increased intracranial pressure. Overweight children are also more likely to grow into overweight adults. Obesity during adolescence has been found to increase mortality during adulthood.
A 2008 study has found that obese children have carotid arteries that are over thirty years old and have abnormal cholesterol levels.
Long-term effects
Obese children tend to become obese as adults. Thus, they are more at risk for adult health problems such as heart disease, type 2 diabetes, stroke, some types of cancer, and osteoarthritis. One study showed that children who became obese as early as age 2 were more likely to be obese as adults. According to an article in The New York Times, all these health effects contribute to a shorter life span of five years for these obese children. This is the first time in two centuries that the generation of children in America today may have a shorter life span than their parents.
Cause
Childhood obesity can be caused by various factors that often act in combination. "Obesogenic Environment" is a medical term set aside for a mixture of these elements. The biggest risk factor for childhood obesity is the obesity of both parents. This may be reflected in the family environment and genetics. Other reasons may also be due to psychological factors and body type of the child.
The 2010 review suggests that childhood obesity may be the result of natural selection interactions that benefit those with more parsimonious energy metabolism and today's consumer society with easy access to solid energy-dense foods and less energy needs in daily life -day.
Factors include increased use of technology, increased snack and portion servings, and decreased physical activity of children. A study found that children who use electronic devices 3 hours or more a day have between 17- 44% increased risk of overweight, or 10- 61% increased risk of obesity (Cespedes 2011).
Childhood obesity is common among children from, low-income, African American and Hispanic communities. This is mainly because minority children spend less time playing outdoors and stay active. Some of the contributors to obesity are that parents prefer their children to stay indoors because they fear that gangs, drug violence, and other dangers might harm them.
Genetics
Childhood obesity is often the result of an interaction between many genetic and environmental factors. Polymorphism in various genes that control appetite and metabolism affects individuals for obesity when enough calories are present. More than 200 genes affect weight by determining activity levels, food preferences, body type, and metabolism. Having two copies of an allele called FTO increases the likelihood of obesity and diabetes.
Thus, obesity is a central feature of a number of rare genetic conditions that are often present in childhood:
- Prader-Willi syndrome with events between 1 in 12,000 and 1 in 15,000 live births is characterized by hyperphagia and food preoccupation leading to rapid weight gain in those affected.
- Bardet-Biedl Syndrome
- MOMO syndrome
- Leptin receptor mutation
- Congenital leptin deficiency
- Mutation of melanocortin receptors
In children with severe early onset obesity (defined by onset before age ten years and body mass index over three standard deviations above normal), 7% have one mutation locus.
One study found that 80% of the offspring of two obese parents were obese, in contrast to less than 10% of the offspring of two parents who were of normal weight. The percentage of obesity that can be attributed to genetics varies from 6% to 85% depending on the population under study.
Family Practice
In the last few decades, family practice has changed significantly, and some of these practices strongly contribute to childhood obesity:
- With a decrease in the number of mothers who breastfeed, more babies become obese children as they grow and are raised with formula milk instead.
- Fewer children come out and engage in active games as technology, such as television and video games, keeping children indoors.
- Instead of walking or cycling to a bus stop or going straight to school, school-aged children are more pushed into school by their parents, reducing physical activity.
- When family size decreases, power disrupts children, their ability to force adults to do what they want, increases. This ability allows them to have easier access to calorie-filled foods, such as sweets and sodas.
- the social context around family mealtimes plays a role in childhood obesity
Social policy
Different societies and countries have adopted various social practices and policies that are beneficial or harmful to the physical health of children. These social factors include:
- school lunch quality
- school emphasis on physical activity
- access to vending machines and fast food restaurants
- prevalence and access to parks, bike paths, and sidewalks
- government subsidies for corn and sugar oil
- fast-food restaurant and candy
- healthy and unhealthy food prices
- access to fresh, healthy, and affordable food
Ads
Unhealthy food advertisements correlate with child obesity rates. In some countries ads of sweets, cereals, and fast food restaurants are illegal or restricted to children's television channels. The media defends itself by blaming parents for giving in to the demands of their children for unhealthy food.
Socioeconomic status
It is much more common for youths from racial or ethnic minorities, or for those with low socioeconomic status, to become overweight and to engage in less healthy behaviors and sedentary activities.
Prevention
Schools play a major role in preventing childhood obesity by providing a safe and supportive environment with policies and practices that support healthy behaviors. At home, parents can help prevent their children becoming overweight by changing the way families eat and exercise together. The best way children learn is to set an example, so parents should lead by example by living a healthy lifestyle. Screening for obesity is recommended for those over the age of six.
Diet
The effects of eating habits in obese children are difficult to determine. A randomized, controlled 3-year study of 1,704 grade 3 children who provided two healthy meals a day in combination with exercise programs and diet counsellings failed to show a significant reduction in body fat percentage when compared to the control group. This is partly due to the fact that although children believe that they eat less caloric intake is actually not reduced by intervention. At the same time observing energy expenditure remains the same among the groups. This occurs even though the intake of fat from food decreases from 34% to 27%. A second study of 5,106 children showed similar results. Although children eat an improved diet no effects are found in BMI. Why this study did not bring the desired effect of curbing obesity has been linked to inadequate intervention. Changes are made primarily in the school environment while it is felt that they must occur at home, community, and school simultaneously to have a significant effect.
A Cochrane review of low-fat diets in children (30% or less of total energy) to prevent obesity finds evidence of very low to moderate quality, and firm conclusions can not be made.
Calorie-rich drinks and foods are readily available for children. Consumption of soft drinks containing sugar can lead to obesity in childhood. In a study of 548 children over a 19-month period the likelihood of obesity increased 1.6 times for each additional soft drink consumed per day.
Prepared calorie snacks are available in many locations frequented by children. Because obesity in childhood has become more common, snack vending machines in school environments have been reduced by law in a small number of areas. Several studies have shown that increased availability of junk food in schools can account for about a fifth of the average increase in BMI among teenagers over the past decade. Eating at fast food restaurants is very common among young people with 75% of 7th to 12th grade students who eat fast food in a week. The fast food industry is also guilty of rising obesity. The industry spends about $ 4.2 billion on advertising intended for children. McDonald's itself has thirteen websites viewed by 365,000 children and 294,000 adolescents each month. In addition, fast food restaurants provide toys in children's food, which help persuade children to buy fast food. Forty percent of children ask their parents to take them to fast food restaurants every day. To make matters worse, of the 3000 combinations made from popular items on the children's menu at fast food restaurants, only 13 meet the recommended nutritional guidelines for children. Some literature has found a link between fast food consumption and obesity. Including a study that found that fast food restaurants near the school increased the risk of obesity among the student population.
Consumption of whole milk 2% versions of milk consumption in children aged one to two years has no effect on weight, height, or body fat percentage. Therefore, pure milk continues to be recommended for this age group. But the tendency to replace sugary drinks for milk has been found to cause overweight.
Legal
Some jurisdictions use laws and regulations in an attempt to direct children and parents to make healthier food choices. Two examples are calorie counting laws and prohibit soft drinks sold in vending machines in schools. In the UK, the Obesity Health Alliance has called on anyone who wins the election to take action to reduce childhood obesity by forbidding ads for unhealthy food before 21:00 and prohibiting sports sponsorship by unhealthy food producers. The current failure of the British government to cut sugar, fat and salt content in food has been criticized. Health experts, committees and health-care campaigns describe the Conservative plan on childhood obesity as "weak" and "dilute".
Physical activity
Physical inactivity of children also proves to be a serious cause, and children who fail regular physical activity are at greater risk of obesity. The researchers studied the physical activity of 133 children over a three-week period using an accelerometer to measure the level of physical activity of each child. They found obese children were 35% less active in school days and 65% less active on the weekend compared to non-obese children.
Physical inactivity as a child may result in physical activity as an adult. In a fitness survey of 6,000 adults, the researchers found that 25% of those considered active at age 14 to 19 were also active adults, compared with 2% of those who were not active at 14 to 19 years, who are now said to be adults active. Staying off physically leaves the unused energy in the body, which is mostly stored as fat. Researchers studied 16 men over a 14-day period and gave them 50% more energy needed daily through fat and carbohydrates. They found that excess carbohydrate intake yields 75-85% of the excess energy stored as body fat and excess fat produces 90-95% of excess energy storage as body fat.
Many children fail to exercise because they spend time doing immovable activities such as using computers, playing video games or watching television. Technology has a big factor on the activity of children. The researchers gave technological questionnaires to 4,561 children, aged 14, 16, and 18 years. They found children 21.5% more likely to be overweight when watching 4 hours of TV per day, 4.5% more likely to be overweight when using a computer or more hours per day, and unaffected by the potential weight gain of play video games. A randomized trial showed that reducing TV viewing and computer usage may decrease age-adjusted BMIs; reducing caloric intake is considered as the largest contributor to BMI decline.
Technological activities are not the sole influence of childhood obesity households. Low-income households can influence a child's tendency to gain weight. For three weeks the researchers studied the socioeconomic status relationship (SES) with body composition in 194 children, ages 11-12. They measure weight, waist circumference, stretching stretch, skin fold, physical activity, TV viewing, and SES; Researchers found that SES is clearly more likely to be upper-class children compared with lower-class children.
Children's inactivity associated with obesity in the United States with more children becomes overweight at a younger age. In pre-school studies in 2009, 89% of preschool children were found to be inactive while the same study also found that even when outside, 56 per cent of activity remained immobile. One factor that is believed to contribute to the lack of activity found is little teacher motivation, but when toys, such as spheres are available, children are more likely to play.
Home environment
Children's food choices are also influenced by family meals. The researcher gave a household food questionnaire to 18,177 children, ranging in age from 11 to 21, and found that four out of five parents allowed their children to make their own food decisions. They also found that compared with teenagers who ate three or fewer meals per week, those who ate four to five family meals per week were 19% less likely to report poor vegetable consumption, 22% less likely to report poor fruit consumption, and 19% reported less consumption of processed foods are poor. Teenagers who ate six to seven family meals per week, compared with those who ate three or fewer family meals per week, were 38% less likely to report poor vegetable consumption, 31% less likely to report poor fruit consumption, and 27% were less likely to report poor dietary intake. The survey results in the UK published in 2010 imply that children raised by their grandparents are more likely to be obese as adults than those raised by their parents. An American study released in 2011 found more and more working mothers, more and more children are more likely to be overweight or obese.
Development factors
Various developmental factors may affect the rate of obesity. Breastfeeding for example can protect against obesity later in life with the duration of breastfeeding inversely associated with the risk of being overweight later on. Child growth patterns can affect the tendency to gain weight. The researchers measured standard deviation (SD [weight and length]) scores in a cohort study of 848 infants. They found that infants who scored SDs above 0.67 had been pursuing growth (they tended to be more severe) than babies with an SD score of less than 0.67 (they were more likely to gain weight).
A child's weight may be affected when she is a baby. The researchers also conducted a cohort study in 19,397 infants, from their birth to age seven and found that obese babies at four months were 1.38 times more likely to be overweight by the age of seven compared with normal weight babies. Infants overweight at the age of one year are 1.17 times more likely to be overweight by the age of seven compared with normal weight babies.
Medical illness
Cushing's syndrome (a condition in which the body contains excess amounts of cortisol) can also affect obesity. Researchers analyzed two isoforms (proteins that had the same goal as other proteins, but were programmed by different genes) in 16 adult cells undergoing stomach surgery. They found that one type of isoform creates oxo-reductase activity (cortisol to cortisol change) and this activity increases 127.5 pmol of mg soup when other types of isoforms are treated with cortisol and insulin. The activity of cortisol and insulin can activate Cushing's syndrome.
Hypothyroidism is a hormonal cause of obesity, but it does not significantly affect obese people who have it more than fat people who do not have it. In a comparison of 108 obese patients with hypothyroidism to 131 obese patients without hypothyroidism, the researchers found that those with hypothyroidism had only 0.077 points more on the caloric intake scale than those who did not have hypothyroidism.
Psychological factors
Researchers surveyed 1,520 children, aged 9-10 years, with a follow-up of four years and found a positive correlation between obesity and low self-esteem in four years of follow-up. They also found that a decrease in self-esteem led to 19% obese children feeling sad, 48% feeling bored, and 21% feeling uneasy. By comparison, 8% of normal-weight children feel sad, 42% feel bored, and 12% feel uneasy.
Stress can affect a child's eating habits. Researchers tested the stressful supply of 28 college women and found that those who overeat had an average of 29.65 points on a perceived stress scale, compared with a control group having an average of 15.19 points. This evidence can show the relationship between eating and stress.
Feelings of depression can cause a child to overeat. The researchers gave home interviews for 9,374 adolescents, in grades seven through 12 and found that there was no direct correlation with children eating in response to depression. Of all obese adolescents, 8.2% were said to be depressed, compared with 8.9% of obese adolescents who said they were depressed. Antidepressants, however, seem to have a very small effect on obesity. Researchers gave a depression questionnaire to 487 overweight/obese subjects and found that 7% of those with low depressive symptoms used antidepressants and had an average BMI score of 44.3, 27% of those with depressive symptoms were taking antidepressants and had an average average BMI. scores of 44.7, and 31% of those with major depressive symptoms using antidepressants and had an average BMI score of 44.2.
Several studies have also explored the relationship between Attention-deficit Hyperactivity Disorder (ADHD) and obesity in children. A study in 2005 concluded that in the subgroup of children hospitalized for obesity, 57.7% had co-morbid ADHD. The association between obesity and ADHD may appear counter-intuitive, since ADHD is usually associated with higher levels of energy expenditure, considered a protective factor against obesity. However, this study determined that children show more signs of ADHD that tend to be negligent than ADHD-type combined. It is possible, however, that the symptoms of hyperactivity usually present in individuals with ADHD-type combined only masked in obese children with ADHD due to their decreased mobility. The same correlation between obesity and ADHD is also present in the adult population. There is an underlying explanation for the relationship between ADHD and obesity in children including but not limited to abnormalities in the hypo-dopaminergic pathway, ADHD creates an abnormal eating behavior that leads to obesity, or impulsivity associated with binge eating leading to ADHD in obese patients. A systematic review of the literature on the relationship between obesity and ADHD concluded that all of the reviewed studies reported ADHD patients were more severe than expected. However, the same systematic review also claims that all evidence supporting this relationship is still limited and further research is still needed to learn more about this relationship. Given the prevalence of obesity and ADHD in children, understanding possible relationships between them is important for public health, especially when exploring treatment options and management.
Direct intervention for the psychological treatment of childhood obesity has become more common in recent years. A meta-analysis of the psychological treatment of obesity in children and adolescents finds family-based behavioral care (FBT) and the treatment of Parental Behavior Becomes the most effective practice in treating childhood obesity in a psychological framework.
Management
Obesity in children is treated with changes in diet and physical activity. Diet and lost food should be; However, discouraged. The benefits of BMI tracking and providing counseling around minimal weight.
Lifestyle
Exclusive breastfeeding is recommended in all newborns due to their nutritional and beneficial effects. Parents change the diet and lifestyle of their offspring by offering appropriate portions of food, increasing physical activity, and maintaining minimal sedentary behavior can also decrease obesity rates in children.
If children are more mobile and less sedentary, the level of obesity will decrease. Parents should recognize signs and encourage their children to be more physically active. By walking or riding a bike, instead of using a motor vehicle or watching television, will reduce inactive activity.
Drugs
No drugs are currently approved for the treatment of obesity in children. The American Academy of Pediatrics recommends drugs for obesity not recommended. Orlistat and sibutramine may be helpful in managing moderate obesity in adolescence. Metformin is of little benefit. A Cochrane review in 2016 concluded that drugs can reduce BMI and weight to a small extent in obese children and adolescents. This conclusion is based only on low quality evidence.
Surgery
By 2015 there is no good evidence comparing surgery with lifestyle changes for obesity in children. There are a number of high-quality sustainable studies that observe this issue.
Epidemiology
From 1980 to 2013, the prevalence of overweight and obesity in children increased by almost 50%. Currently 10% of children worldwide are overweight or obese. In 2014, the World Health Organization established a high-level commission to end obesity.
With over 42 million overweight children around the world, childhood obesity is increasing worldwide. Since 1980, the number of obese children has doubled in the three countries of North America, Mexico, the United States, and Canada. Although obesity rates in children in the United States have stopped rising, the current rate remains high. In 2010, 32.6 percent of adolescents aged 6 to 11 were overweight, and 18 percent of 6- to 9-year-olds were obese.
Canada
The level of overweight and obesity among Canadian children has increased dramatically in recent years. In boys, this figure increased from 11% in the 1980s to 30% in the 1990s.
Brazil
The level of overweight and obesity in Brazilian children increased from 4% in the 1980s to 14% in the 1990s. In 2007 the prevalence of overweight children and obese children was 11.1% and 2.7% in girls, 8.2% and 1.5% in boys, respectively.
United States
The rate of obesity among children and adolescents in the United States nearly tripled between the early 1980s and 2000. However, this figure did not change significantly between 2000 and 2006 with the latest statistics showing rates of more than 17 percent. In 2008, the rate of overweight and obese children in the United States was 32%, and has stopped climbing. In 2011, a national cohort study of infants and toddlers found that nearly one-third of US children were overweight or obese at 9 months and 2 years of age. In a follow-up study, infant weight status (healthy and obese) is strongly associated with pre-school weight status.
Australia
Since the beginning of the 21st century, Australia has found that childhood obesity has followed trends with the United States. The information gathered has concluded that an increase has occurred in lower socioeconomic areas where poor nutritional education has been blamed.
Research
A study of 1800 children aged 2 to 12 in Colac, Australia tested a limited diet program (no drinks or carbonated candies) and improved exercise. The interim results included a 68% increase in after-school activity programs, a 21% reduction in television shows, and an average 1 kg weight reduction compared to the control group.
A survey conducted by the American Obesity Association into parental attitudes toward the weight of their children shows the majority of parents think that the break should not be reduced or replaced. Nearly 30% said they were worried about their child's weight. 35% of parents think that their child's school does not teach them enough about obesity, and over 5% think obesity is the biggest risk to their child's long-term health.
A Northwestern University study shows that inadequate sleep has a negative impact on children's performance in school, their emotional and social well-being, and increases their risk of being overweight. This study is the first nationally represented longitudinal study on the correlation between sleep, Body Mass Index (BMI) and overweight status in children between the ages of 3 and 18 years. The study found that an extra hour of sleep decreases the risk of children being overweight from 36% to 30%, while reducing the risk of children older than 34% to 30%.
Obesity of children and adolescents is more likely to be obese as adults. For example, one study found that about 80% of overweight children at age 10-15 years were obese adults at the age of 25 years. Another study found that 25% of obese adults are overweight as children. Recent studies have also found that if overweight begins before age 8, obesity in adulthood tends to be more severe.
A study also found that overcoming childhood obesity will not cause later eating disorders.
A review of secular trends in the number of overweight or obese children has come to the conclusion that prevalence has increased over the past two decades in industrialized countries, aside from Russia and Poland, and in some low-income countries, especially in urban areas. area. Prevalence doubled or tripled between the early 1970s and late 1990s in Australia, Brazil, Canada, Chile, Finland, France, Germany, Greece, Japan, the United Kingdom, and the United States. In 2010, more than 40% of children in North America and the WHO's Mediterranean region, 38% in Europe, 27% in the western Pacific, and 22% in Southeast Asia were predicted to be overweight or obese. However, in 2006 it reviewed the latest data, which although still too early to ascertain, indicates that the increase in obesity in children in the US, UK, and Sweden may be reduced.
A British longitudinal study found that childhood limited obesity had minimal influence on adult outcomes at age 30. The study also found that, while obesity that continues into adulthood has little effect on male outcomes, it makes women less likely to ever hired or currently have a romantic partner.
A paper from the National Bureau of Economic Research 2017 found that obesity in the United States raises medical expenses of $ 1,354 per year (in 2013 dollars).
See also
- International Journal of Childhood Obesity
- Task Force on Childhood Obesity
- Classification of childhood obesity
- Obesity and walking
- The social stigma of obesity
- EPODE International Network
Footnote
Further reading
- Laura Dawes, Childhood Obesity in America: Biography of the Epidemic. Cambridge, MA: Harvard University Press, 2014.
External links
- "Masyarakat Amerika Utara untuk Gastroenterologi Anak, Hepatologi dan Nutrisi" (PDF) .
Source of the article : Wikipedia
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