Extra weight among young infants and children continues to be a significant issue in the health of population worldwide although the problem has raised concerns for the past few decades. Obesity among children across all ages has increased rapidly for children above 5 years of age. The obesity among children of ages between 2-4 years doubled between 1975 and 2015 (Di Cesare et al. 2019). The main contributing factors for the existing obesity epidemic is due to the varying food systems and a drop in level of physical activities (Ogden et al., 2016). Studies in the recent past estimates that 40 million children below 5 years and more than 330 million children aged between 5 and 19 years had excess weights or obesity (Fanzo et al., 2018). The increasing trend in the prevalence of obese children and excess weight attracted the attention of the World Health Organization which endorsed an initiative to reduce the cases by 2025.
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First, the world has experienced an increase in the supply of totally affordable and less expensive foods and beverages which are characteristically energy-dense and ultra-processed. Globalization of food supply which involves consideration of the profitability when producing and marketing processed high energy content foods than fresh products has contributed to the changing food systems. On the other hand, the number of individuals including children who practice inactive routines with high prevalence of physical inactivity has tremendously increased (Di Cesare et al., 2019). Children develop a right to choose the foods they consume and the levels of physical activities they engage in which in turn affect their current and forthcoming behaviors.
Excess weight during childhood has several significant effects which can be both lasting and short-lived. Obese children are vulnerable to psychological comorbidities like anxiety, depression, low self-esteem, depression and a chain of sensitive and behavioral defects. Long-term effects of excess weight during childhood raises the dangers of developing cardiovascular complications, diabetes, a variety of cancers and musculoskeletal problems at later ages (Fruh, 2017). The emerging conditions are also likely to result to disability and premature deaths. Management and treatment of obesity in adulthood is difficult yet children move to their adulthood stages with the overweight conditions (Di Cesare et al., 2019). As such, the robust persistence of the excess weight conditions and low accuracy of the existing treatments imply the need to prevent such conditions at the earliest ages of life among children.
Causes of Weight Gain
Several factors contribute to the enormous increase in weight of an individual. High-energy intake involving unbalanced quantities of refined carbohydrates and processed foods. Such diet increases the insulin secretion and fat storage. On the other hand, low levels of physical activities enhance the rates of weight gain (Xu and Xue, 2016). Other factors that can affect the choices of an individual concerning life include environmental, behavioral, biological and genetic factors which have contributed to the global prevalence of excess weights (Skinner et al., 2018). An obese intrauterine environment among pregnant women and instant changes in weight during infancy contribute to the excess weight gain in children. Enlargement of the obesogenic settings raises the probability of children to eat high calorie foods and beverages that are also energy dense, low in nutrients and enhancement of inactive lifestyles.
Economic and political factors are significant determinants of excess weight in the world’s population. Globalization and commercial benefits initiate the production of less expensive and high-energy foods and beverages (Della Torre et al., 2016). There is also the inadequate political will to intervene on the economic causes of the obesity prevalent. Socio-economic discrepancies also contribute to the obesity epidemic in which high rates of excess weight occur among the marginalized communities living in higher socio-economic backgrounds Fanzo et al., 2019). In comparison, the numbers of obese cases are high in neighborhoods with higher socio-economic status.
Nutrition-Based Multidisciplinary Intervention Measures
A multilevel approach based on diet and health related programs are more beneficial as a childhood excess weight intervention measure. Social support aspects including personal coaching, text messaging, in-person communication and internet-based strategy with a theoretical perspective would be effective to alter the dietary-based actions among these categories of children. Several governments have adopted various programs to intervene on diets for children with excess weight.
A program, “Let’s Move,” that the United States adopted can be an effective method for dietary-related interventions. The approach offers internet-based resources for BMI and diet to avail activity screening, counseling, and advocacy methods. The technique involves using health information technology to provide personal coaching for behavior transformation among the clients (Kim and Lim, 2019). Text messaging would also enhance outreach support for weight management. These programs can help achieve healthy diet interventions similar to the face-to-face support. Another intervention approach based on social cognitive theory, social ecology and system theory considers the interactions of psychosocial aspects, socioenvironmental and physical factors in determining the health results. Wholesalers, takeout restaurants, and recreation centers can work collaboratively to enhance the availability, purchasing and consumption of healthier diets.
Community Based Intervention Strategy
Community based intervention strategy would be most appropriate for child excess weight prevention. The method has various components that are essential for implementation according to the local context. The approach would target various behaviors that affect the possibility of child attaining excess weight. The measures would include increase in fruit and vegetable intake along with reduction in high sugar beverage consumption. Another component is a drop in the levels of fats, saturated fats, slats and sugar in foods. Reducing the periods for television viewing and other screen related entertainments is significant (Drewa and Zorena, 2017). The children can also participate in both competitive and non-competitive sports programs along with active transport to schools. Altering these behavioral elements can be achievable through education campaigns, changes in institutional policies, activities, establishing promotion programs and engaging wide range of shareholders in the community.
Community Based Intervention in children of 4-5 and 10-11 Year olds
Most of the children between the age of 4 and 11 attend schools. The intervention programs targeting school environments would directly affect children within this particular age group. The measures should also focus on the food services and classroom syllabus. According to Goldthorpe et al. (2020), making such consideration can boost efforts to reduce cases of excess weight. Various procedures would be appropriate for implementation to promote healthy behavior among the children.
The curriculum should incorporate elements of healthy eating, physical activity, and body image. The whole of the school will need to exhibit sessions of physical activity and the improvement of basic movement tactics. The school management and stakeholders should monitor the nutritional quality of foods available for students in the school canteens. There is need to set up an environment and culture in the school which promotes consumption of nutritious foods and participation in active programs on each day. School teachers and other staff need support to implement health promotion activities through capacity building and professional development (Drewa and Zorena, 2017). Lastly, parents would be involved to support activities in home environment to inspire children to participate in more active programs along with consuming more nutritious foods while spending less time in screen-related undertakings.
Responsibility as a Health Professional
Schools play an important role in determining the health diet of children since they spend most of their time in school. I will therefore facilitate a 3-5 days training during a summer vacation before the start of the new school year. I would also develop a manual with all appropriate materials necessary for teaching along with plans for acclimatizing the current lesson plans to accommodate DPAS recommendations. The program will require about three years for effective implementation.
The Effect of the Intervention Measure
Community based intervention measure to address incidences of excess weight among infants would result in several accomplishments. The process would lead to improved diet and physical activity schedules at the primary school levels (Bleich et al., 2018). The strategy will also encourage behavioral change such as high daily active play, increase in daily water intake, consumption of fruits and vegetables and a drop in television viewing and screen related programs.
Although several institutions have enacted intervention measures to prevent excess weight in children, the critical interventions would include strengthening the existing policies and regulatory frameworks and approaches. Guidelines and criteria on food, nutrition, and physical activities in preschools and primary learning institutions need strengthening and effective implementation. Although schools and parents can enhance intervention programs, the performance of regulations on the marketing of foods and non-alcoholic beverages to children would promote a healthy diet among these groups. Subsidies on nutritious foods while imposing high taxes on “junk foods” and sugary drinks would also discourage young children’s level of consumption (Bleich et al., 2018). Besides the above efforts, nutrition literacy and physical education in primary schools would be the most appropriate way of promoting healthy diets and reducing excess weight among children.
Bleich, S.N., Vercammen, K.A., Koma, J.W. and Li, Z. (2018) ‘Trends in beverage consumption among children and adults, 2003-2014’, Obesity, 26(2), pp. 432-441.
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