Childhood Obesity: A Worldwide Pandemic

Richard Smith
Nevada State College 12/2/2010

Childhood Obesity: A Worldwide Pandemic Abstract

Serious health concerns are raised all over the world. Unfortunately for North America, we have the additional worry of our youth being conditioned with excess body fat and diagnosed with childhood obesity. While this is most definitely a worldwide pandemic, North American children are the most overweight and obese on the planet. But why are we, North Americans, so at risk? What is obesity, exactly? How is one classified as obese or even overweight? Who gets it? How does one get it? What are the consequences? How does one get treatment? There is an urgent need for children and adolescents to make long-term changes to their dietary and physical activity behavior in order to prevent childhood obesity, a worldwide pandemic.

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Childhood Obesity: A Worldwide Pandemic

What is obesity? Obesity is defined as having a greater-than-20 percent increase over healthy body weight, based on BMI (body mass index), a ratio of weight to height associated with body fat (Berk, 2008). The body mass index is the most widely accepted measurement of weight and obesity. It should be noted however, that while BMI is an accepted screening tool for the initial assessment of body fatness in children and adolescents, it is not a diagnostic measure because BMI is not a direct measure of body fatness. For children and adolescents (aged 219 years), the BMI value is plotted on the CDC (Centers for Disease Control) growth charts to determine the corresponding BMI-for-age percentile (Centers for Disease Control and Prevention,
2009). As defined by the BMI, children are classified as overweight if their body mass index is

at or above the 85th percentile and lower than the 95th percentile. Children are classified as obese if their body mass index is at or above the 95th percentile for children of the same age and sex. As opposed to the BMI categories used for adults, childrens weight status is determined based on an age and sex specific percentile. These classifications for overweight and obese children, and adolescents, are age and sex specific because children's body composition varies both as they age and it varies by what gender he/ she is. Who gets is? Who gets overweight and obese? According to the U.S. Department of Health and Human Services, 2006, countries throughout the world are seeing a rise in overweight and obesity. During the past several decades, a rise in overweight and obesity has occurred in many western nations, with dramatic escalations in Canada, Finland, Greece, Great Britain, Ireland, New Zealand, and especially in the United States. [With] smaller increases [occurring] in other industrialized nations, including Australia, Germany, Israel, the Netherlands, and Sweden (Berk, 2008). Its quite alarming to see that there are dramatic increases especially in

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Childhood Obesity: A Worldwide Pandemic the United States. The National Governors Association considers childhood obesity in the United States an event of epidemic proportions. Citing that, Today, more than 23 millionor nearly one in every threeAmerican children are overweight or obese (2009). In general, obesity rates in the United States have risen 250 percent since 1980, and now affect 71 million Americans. With nearly one-third of the nations children being overweight or obese, Americas children are not immune to this trend. Over the past forty years, for children of all ages, obesity has more than doubled among children ages two to five, quadrupled among children ages six to eleven and more than tripled among adolescents ages twelve to nineteen (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009). Overweight and obesity affect everyone. Although it spans gender, socioeconomic status, race, geography, some children are at a greater risk than others. According to the Robert Wood Johnson Foundations Commission to Build a Healthier America, three of the more influential social characteristics influencing a childs health are the familys household income, a households educational attainment, and the childs race and ethnicity (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009). Children living in low income households have the challenge of eating healthy diets because of monetary issues. Additionally, higher educational attainment often means a higher paying job for parents, which in turn leads to a higher family income and the ability to buy proper, healthy foods. Research shows that children living in households in which family members have only a high school diploma are twice as likely to be in poor health [as] children living with someone who has some college education. That figure increases to four times as likely when the educational attainment level decreases to a household with no high school diploma (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009).

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Childhood Obesity: A Worldwide Pandemic Finally, the childs race and ethnicity play a large role in predicting health. Obesity prevalence has increased by more than 120 percent in the past decade among African Americans and Hispanics (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009). In comparison to Caucasian children, children in racial and ethnic minorities are more at risk for being overweight or obese. Surprisingly, one report, from the Robert Wood Johnson Foundation Commission to Build a Healthier America, found that even at different income levels, black and Hispanic children reported poorer health status than their Caucasian counterparts (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009). These alarming statistics do not pose a positive outcome for our future, as overweight and obesity rise with age (Berk, 2008). Eighty percent of affected children grow up to be overweight adults. What causes childhood obesity? According to the United States Center for Disease Control and Prevention, Childhood obesity is the result of an imbalance between the calories a child
consumes as food and beverages and the calories a child uses to support normal growth and development, metabolism, and physical activity (2009). That basically means that the child is consuming more

calories than he is using. Calories are a unit of energy, and specific foods with a high calorie concentration contribute to excessive energy intake in children and teens. Large portion sizes for food and beverages, eating meals away from home, frequent snacking on energy-dense foods and consuming beverages with added sugar are often hypothesized as contributing to excess energy intake of children and teens (Centers for Disease Control and Prevention, 2009), and this excess energy intake leads to energy imbalance which ultimately leads to obesity. These meal trends are a big contributing factor in the obesity epidemic. Sugar-sweetened drinks, in particular, are frequently associated with obesity because of their high calories. Rather than meals prepared at home, families, possibly because of cost and time pressures, are dining out more and eating convenience foods and restaurant meals with higher calories and higher fat but low in valuable
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Childhood Obesity: A Worldwide Pandemic nutrients. These meals are often given as very large portion sizes. The frequent consumption of such food increases the chances of obesity in children and adolescents as well as in adults (Sallis, J., & Glanz, K., 2006). Along with high energy intake, lack of physical activity is playing a role in childhood obesity. Children are far less active than they were twenty years ago. Inactivity is both a cause and consequence of excessive weight gain (Berk, 2008). In North America, the lack of physical activity is often associated with time spent watching videos, using computers, playing video games and especially watching television. Researchers have found that the more TV children watched, the greater their body fat was. Children who devoted more than three hours per day to TV accumulated forty percent more body fat than those devoting less than 1 hours (Berk, 2008). Participating in physical activity is important for children and adolescents because it has beneficial effects on body weight, blood pressure and bone strength. Physically active children are also more likely to remain physically active throughout adolescence and possibly into adulthood. A hindrance in increasing childrens physical activity is a lack of having park and recreation facilities to play in. Children and adolescents with access to recreational facilities and programs, usually near their homes, are more active than those without such access. The more often young adolescents use recreational facilities, the greater their total physical activity (Sallis, J., & Glanz, K., 2006). In addition, children without safe places to play near their home may spend more time being inactive indoors. An additional cause of overweight and obesity is heredity. Studies indicate that certain genetic characteristics may increase an individual's susceptibility to excess body weight. Overweight children tend to have at least one overweight parent. According to the Center for

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Childhood Obesity: A Worldwide Pandemic Disease Control and Prevention, however, genetic susceptibility may need to exist in conjunction with contributing environmental and behavioral factors such as, the aforementioned, high-calorie food intake and lack of physical activity, to have a significant effect on weight (2009). With the exception of rare genetic disorders (such as Prader Willi syndrome) that play in a role obesity, heredity only accounts for tendency to gain weight. Family influence and parental feeding practices help contribute to overweight and obesity. Overweight children have similar food patterns to their, often, overweight parents. When children are in distress, some parents interpret the discomfort for a desire for food and they anxiously overfeed their children as a means to comfort them. Others pressure their children to eat, a practice common among immigrant parents and grandparents, who as children themselves lived through deadly famines or periods of food deprivation due to poverty (Berk, 2008). These eating habits lead obese children to develop maladaptive eating habits. Obese children are more responsive than normal-weight individuals to external stimuli associated with food-cues. They eat faster and chew their food less thoroughly (Berk, 2009). What are the consequences? Childhood obesity is associated with various health-related consequences. Obese children and adolescents may experience immediate health consequences and may be at risk for weight-related health problems in adulthood (Centers for Disease Control
and Prevention, 2009). In childhood and adolescence the most common complications of obesity

are increased risk of orthopedic problems (particularly in the foot and hip) and asthma symptoms (Reilly, J., 2007). High blood pressure, high cholesterol levels, respiratory abnormalities, and insulin resistance begin to appear in the early school years - symptoms that are powerful predictors of heart disease and other circulatory difficulties, type 2 diabetes, gall bladder disease, sleep and digestive disorders, many forms of cancer, and early death (Berk, 2008). Previously

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Childhood Obesity: A Worldwide Pandemic known as adult-onset diabetes because it was rarely seen in childhood, type 2 diabetes, is rising rapidly among overweight children, sometimes leading to early, severe complications, including stroke, kidney failure, and circulatory problems that heighten the risk of eventual blindness and leg amputation (Berk, 2008). Obesity is not only taking American lives [and legs]; it is draining Americans pocketbooks. The medical expenses that resulted from obesity in the year 2003 were $75 billion. Over half of this overwhelming amount was paid by Medicare and Medicaid (Costley, K., & Leggett, T., 2010). Additional consequences of childhood and adolescent obesity are psychosocial. Obese children and adolescents are targets of early and systematic social discrimination. In Western societies, both children and adults rate obese youngsters as unlikable, stereotyping them as lazy, sloppy, dirty, ugly, stupid and deceitful. In school, obese children are often socially isolated. Persistent obesity from early childhood into adolescence predicts serious disorders, including defiance, aggression, and severe depression (Berk, 2008). The psychological stress of social stigmatization can cause low self-esteem which, in turn, can hinder academic and social functioning, and persist into adulthood (Centers for Disease Control and Prevention, 2009). The psychological consequences of obesity combine with continuing discrimination to result in reduced life chances. Overweight adults are less likely than their normal-weight-age-mates to be given financial aid for college, to be rented apartments, to find mates, and to be offered jobs. And they report frequent mistreatment by family members, peers, co-workers, and health care professionals (Berk, 2008). How does one get treatment? Treating childhood obesity can be difficult. But its important for parents to take charge in helping their children overcome the overweight and obesity pandemic. Parents are key to developing a home environment that fosters healthful

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Childhood Obesity: A Worldwide Pandemic eating and physical activity among children and adolescents. Parents shape their childrens dietary practices, physical activity, sedentary behaviors, and ultimately their weight status in many ways. Parents knowledge of nutrition; their influence over food selection, meal structure, and home eating patterns; their modeling of healthful eating practices; their levels of physical activity; and their modeling of sedentary habits including television viewing are all influential in their childrens development of lifelong habits that contribute to normal weight or to overweight and obesity (Lindsay, A., Sussner, K., Kim, J., & Gortmaker, S. 2006). The most effective interventions are family-based and focus on changing behaviors (Berk, 2008). Programs where both parent and child revise their eating patterns, exercise daily and reinforce each other with praise and points for progress, serve as a positive, special activity family time. These programs found that the more weight the parents lost, the more their children lost. Follow-ups after five and ten years showed that children maintained their weight loss more effectively than adults a finding that underscores the importance of intervening at an early age (Berk, 2008). Although parents play a huge role in treating their childs obesity, schools also need to take responsibility in treatment and prevention. More than 11 million children under the age of five currently participate in some form of child care every week, and more than 55 million children are enrolled in primary and secondary schools throughout the nation. In fact, on any given weekday, one-fifth of the nations population is in a school setting (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009). With children consuming one-third of their daily energy intake at school, it is important for prevention strategies to be made. It is the responsibility of each individual state to establish laws and implement programs for children in public schools (Costley, K., & Leggett, T. 2010). Thankfully many states see overweight and obesity as a problem and are beginning to pass legislation toward eliminating sugar from schools

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Childhood Obesity: A Worldwide Pandemic and set up physical fitness programs. The state of New Jersey, for example, has passed a bill that bans all soft drinks, candy, and any other item with sugar listed as the first ingredient from schools altogether (Costley, K., & Leggett, T. 2010). And after learning that 32 percent of students in an Oklahoma elementary school were obese, the Walk Across Oklahoma program was developed and implemented. Students were challenged to walk 5 miles a day. Five miles a day equals about 10,000 to 12,000 steps per day (Costley, K., & Leggett, T. 2010). The importance of state governments to pass legislation in obesity prevention is essential. Several governors have stood out in exercising the bully pulpit to prevent childhood obesity. In 2007, for instance, Governor Tim Pawlenty, of Minnesota set a goal to reduce childhood obesity by 50 percent by 2012 and directed the states Department of Health to institute a common plan and direction to centralize state childhood obesity efforts. As a result of Governor Pawlentys leadership, an unprecedented investment of state funds in tobacco and obesity prevention has been launched. In August 2009, the Department of Health announced $47 million in grant to 39 Minnesota communities. The state estimates that this investment and resulting initiatives will reduce health care costs by nearly $2 billion by 2015 (Mulheron, J., Vonasek, K., & National Governors Association, C., 2009). Childhood overweight and obesity has quickly become a worldwide pandemic. It is the responsibility of the parent, schools and the child to prevent and treat their health problems. This big problem facing the youth of the world takes a lot of work, but overweight and obesity can be defeated.

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Childhood Obesity: A Worldwide Pandemic References

Berk, L. E. (2008). Infants and children (6th ed.). Boston: Pearson/Allyn And Bacon. Costley, K., & Leggett, T. (2010). Childhood Obesity: A Heavy Problem. Online Submission, Retrieved from ERIC database. Obesity and Overweight for Professionals: Childhood: Defining | DNPAO | CDC. (2009, October 20). Centers for Disease Control and Prevention. Retrieved December 1, 2010, from http://www.cdc.gov/obesity/childhood/defining.html Lindsay, A., Sussner, K., Kim, J., & Gortmaker, S. (2006). The Role of Parents in Preventing Childhood Obesity. Future of Children, 16(1), 169-186. Retrieved from ERIC database. Mulheron, J., Vonasek, K., & National Governors Association, C. (2009). Shaping a Healthier Generation: Successful State Strategies to Prevent Childhood Obesity. NGA Center for Best Practices, Retrieved from ERIC database. Reilly, J. (2007). Childhood Obesity: An Overview. Children & Society, 21(5), 390-396. Retrieved from ERIC database. Sallis, J., & Glanz, K. (2006). The Role of Built Environments in Physical Activity, Eating, and Obesity in Childhood. Future of Children, 16(1), 89-108. Retrieved from ERIC database.

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