Abstract
This research focused on childhood obesity and the facts and circumstances surrounding the prevalence of childhood obesity which has grown almost in proportion with adult obesity. The research centered on its origin and causes, outcomes, prevention and treatment.
This is a worldwide concern because many countries, developed or developing, are largely affected by it. Worldwide population of obese children is staggering – 40 to 50 million school-age children and the population is still growing.
Factors that can lead to childhood obesity were discussed. Obesity results when one takes more energy food and does not have physical activity or exercise. Lifestyle, genetic factors, and socioeconomic factors contribute to obesity. Lifestyle is associated with environmental factors and parents’ efficacy. Parental competence and satisfaction influence children’s personality.
Obesity can lead to diabetes. Diabetes is the result of not having enough β-cell mass to produce insulin leading to more glucose in the blood. Diabetes causes cardiovascular diseases, physical and mental health problems, and even premature death. Obesity and diabetes are caused by genetic and environmental factors.
Early diagnosis can affect the outcomes of obesity. Prevention and treatment are some of the alterations, but health care providers should work hand in hand with the parents or the family in order to provide a lasting solution to obesity.
Search terms: childhood obesity, adult obesity, type-2 diabetes, juvenile diabetes, diabetes statistics, metformin, quality of life of obese children.
Introduction
Childhood obesity is increasingly prevalent in many parts of the world that everyone should be concerned and cooperate to eradicate it.
Parent-child relationship influences childhood behavior and outcomes (Grossklaus and Marvicsin 2014). A theory states that individuals’ self-efficacy determines how much time they exert effort to influence others to change their behavior (Bandura, 1982 as cited in Grossklaus and Marvicsin 2014). In other words, parents’ self-efficacy can influence childhood obesity. The way people evaluate their own capacity to act impacts on how they will deal on a particular situation, and experience is one great source for self-efficacy. Behavior does not just occur on individuals; it happens with experience.
Parent-child relationship influences childhood behavior and outcomes (Grossklaus and Marvicsin 2014). Maternal self-efficacy influences a child’s behavior. Parents have to make sure that they can change their children’s behavior and lifestyles and assure themselves that they can do it. “Parental competence and satisfaction” is associated with self-efficacy which influences children’s personality, family break-ups and family problems (Grossklaus and Marvicsin 2014:75). Parenting self-efficacy can be studied and assessed through the scale known as “parenting sense of competence” (PSOC) which measures “satisfaction in parenting”. PSOC is an assessment tool for the study of child and maternal characteristics and their relationship, and how mothers can effectively use self-efficacy in influencing their children’s behavior.
Body mass index (BMI) is used in measuring overweight and obesity in children (Cowie 2014). Obesity results when there is buildup of adiposity. Measuring body fatness helps determine overweight and obesity in children. Tools that have been used to measure overweight and obesity include laboratory measurement such as “densitometry and dual-energy X-ray absorptiometry (DXA)” (Cowie 2014:20). Densitometry is considered a standard model of measuring adiposity because this calculates the fatty tissue in the body as it absorbs X-ray. An acceptable measuring tool for children’s body fatness, which is less invasive, is measuring the “height, weight, skin-fold thickness and waist circumference” (Cowie 2014:20).
Body mass index (BMI) is used in measuring overweight and obesity in children (Cowie 2014). Measuring BMI must be accurate as this is affected by several factors. Linear and height measurement is not always accurate. Age and sexual maturation are also related with BMI. Some studies found that sexual maturity is effective in measuring the amount of adiposity in children. This is because age of puberty affects changes of body composition. Race and ethnicity also affect body fatness in children. In some studies, researchers found that Caucasian children have more body fat than African black. Other nationalities like Hispanic, Asian and Chinese children accumulate more body fat. Current practice of BMI measurement involves using national reference data than the international data.
Causes of childhood obesity
Genetic and environmental factors are primary causes of childhood obesity (Olsen et al. 2013). Genes of obese parents can be transmitted to their offspring. Hereditary factors are exacerbated by environmental factors. Further, there were studies that found psychological problems can cause childhood obesity, and obesity can also cause behavioral problems. However, there were some gray areas regarding the changes in the body as a result of taking in more food with less physical inactivity. More studies were conducted examining school-aged children who were overweight and obese. In 2010, a study found no association between behavior and body mass index (BMI), and the study did not find any relation between behavioral problems and increase BMI in toddlers aged 18 or 36 months (Olsen et al. 2013).
Genetic and environmental factors are primary causes of childhood obesity (Olsen et al. 2013). Age span had an effect as researchers found a relation between behavioral problems and overweight in 5-year-old children and above. The study recommended further studies to observe children between 3 and 6 years, considered the adiposity period (Olsen et al. 2013). Other studies revealed that behavioral problems were prevalent in children who were from lower socioeconomic sector (SES). Children of color composed a larger population of obese children.
Television programs and technology influence children’s lifestyles and behavior (Educational Journal 2014). A study on the effects of television program and advertising on children found that children were made to believe that some unhealthy food could have positive effect. An example was a TV program in which the characters were shown taking unhealthy food and drinks, but it was made to show that the food and drinks were health foods. The characters were not overweight even though they were taking unhealthy food and drinks. The show did not have positive motivations for health.
Television programs and technology influence children’s lifestyles and behavior (Educational Journal 2014). Television programming, technology and the popularity of the Internet have impacted on children’s lifestyles and sedentary behavior. A study found that since 1981 to 1997, children’s time for playing was reduced because of so-called “structured activities”. A study on school age children revealed the physical inactivity of the children who spent the whole day in class with only an hour spent outside. About 43 percent of the children used more than two hours watching television and playing video games (Educational Journal 2014).
Risk factors in childhood obesity include maternal lifestyle and habits during and after pregnancy (Bammann et al. 2014). Factors like “maternal weight, gestational weight gain, glycemic control, smoking and alcohol use during pregnancy” are associated with childhood obesity. These all refer to early childhood. Childhood habits are influenced by parents, siblings and relatives at home. Maternal smoking and obesity are risk factors for childhood overweight. Excess energy and body fat can lead to diabetes and is one of the main primary health concerns in childhood populations.
Risk factors in childhood obesity include maternal lifestyle and habits during and after pregnancy (Bammann et al. 2014). Bammann et al.’s (2014) study found that maternal lifestyle during pregnancy is associated with childhood obesity. They measured the BMI of mothers involved in the study and found that parental BMI was associated with childhood obesity. Maternal BMI could be an indicator that “obese genes” were transferred from mother to child (Bammann et al. 2014). These factors were investigated and affirmed by other empirical studies.
Childhood obesity can be clinically diagnosed before complications of vascular diseases (Siegrist et al. 2014). This can be done by tracing (diagnosing) atherosclerosis wherein doctors examine the retinal vessel diameter by means of a “fundus” camera which detects signs of obesity in small brain vessels. Thinning of retinal arteriolar and widening of retinal venules were found to be signs of high-blood pressure and cerebral infarction. Obesity due to physical inactivity in adults was also found to be associated with venular dilatation. Venular diameters were present in adults with type-2 diabetes. However, there were inconclusive findings on examining the arteriolar diameters.
Childhood obesity and related health problems have increased because of lack of health workers to implement the health programs (Nursing Children and Young People 2014). This is particularly true in the UK. The number of children’s nurses has considerably dropped in 2013 to 2014 despite government efforts to train nurses. In England, health practitioners have been asking for a national emergency task force to deal with the growing problem of obesity. The government must invest more by adding more training places and recruiting more children’s nurses.
Lifestyle and eating habits cause obesity and diabetes (Kendall, Amin, and Clayton 2014). Lifestyle and environmental factors cause obesity and diabetes. Diabetes is associated with atherosclerosis which is a precursor of cardiovascular diseases. Diabetes is caused by the inadequacy of B-cell mass to produce insulin, leading to a concentration of glucose in the blood. Outcomes include physical and psychological problems resulting into lower self-esteem, eating disorders, including respiratory problems, orthopedic problems, and cardiovascular disease. Childhood obesity can lead to type 2 diabetes (T2D), or metabolic sicknesses, and what is known as insulin-resistance syndrome (IRS) (Kendall et al. 2014). Type-2 diabetes was once common in adults, but recent findings found it is prevalent among children.
Lifestyle and eating habits cause obesity and diabetes (Kendall et al. 2014). Lifestyle intervention accompanied with drug treatment is effective in reducing obesity. Some randomized controlled trials found that lifestyle intervention is one key preventive measure for type-2 diabetes (T2D). This must be supplemented with the drug metformin which can reduce weight, but this is for obese adults with still no symptoms of diabetes and for children. Metformin has been recommended and found effective for adults who are progressing to have T2D and showing higher blood glucose. They used this in the UK through a program of the National Institute for Health and Care Excellence (NICE) (Kendall et al. 2014). Children should be targeted for early intervention of T2D.
Lifestyle and eating habits cause obesity and diabetes (Kendall et al. 2014). Likewise, obesity and diabetes are preventable through lifestyle changes. This has to be coupled with the taking of the drug metformin, which acts on the liver and reduces gluconeogenesis and increase peptide levels in obese adults, diabetic or not. Numerous metformin studies have been made in the UK which resulted in some conclusions that metformin had reduced the risk of diabetes to 32 percent and some 36 percent for “all-cause mortality” (Kendall et al. 2014:15). Studies in the United States on the drug metformin found that it was useful in reducing obesity and T2D. It becomes more effective if it is done with lifestyle intervention. There are however adverse effects of metformin that include gastrointestinal problems (diarrhea, nausea, and so on). Some studies found that metformin can also prevent ovarian cancer and even Alzheimer’s disease.
Prevention and Treatment
Health care professionals can address childhood obesity through the primary care setting (Gorin et al. 2014). Children have regular visits with their health care providers, thus, the primary care office has the opportunity of addressing obesity in young children. However, problems occur because of lack of cooperation between health care providers and the parents. In a study by O’Brien et al. (Gorin et al. 2014), obesity was recorded in only 53 percent of charts, while diet and physical activity was documented in only 29 percent and 15 percent of charts. Pediatricians reported only 55 percent of children had their BMIs measured. Parents were not aware of their child’s weight and had no proper communication with the pediatricians regarding their child’s weight status (Gorin et al. 2014).
Parents should guide the children’s “social, economic and environmental” activities to facilitate a healthy lifestyle (Penn and Kerr 2014:3). Obesity is caused by more energy intake and less energy output. Health problems exacerbate in children who depend their daily life decisions from adults. Parents, guardians and nearest acquaintances can influence children’s lifestyles; family problems and break-up can impact on children’s behavior. Economic deprivation is another factor since children of poor families tend to buy unhealthy food and practice unhealthy lifestyles.
Diet programs, physical education and exercise for school-aged children can help reduce childhood obesity (Young et al. 2014). A Cochrane study recommended that intervention can be given through programs in schools focusing on diet and exercise involving children and parents. Health practitioners and researchers recommended regular physical activity to control and prevent diseases and obesity in children. Prevention of weight gain has been instituted in the United States through the program “Healthy Kids, Healthy Futures” (Penn and Kerr 2014). The role of the nurse is crucial as she/he has to deal with the child and family. Intervention necessitates change from one spectrum to the other, from parenting guidance and expertise to local government policies and strategies.
Family cooperation is very important in the prevention and treatment of childhood obesity (Farley and Dowell 2014). While this is an important factor in dealing with childhood obesity, Farley and Dowell (2014) found that this is difficult for nurses and government health practitioners. In Bristol, general practitioners who ran an obesity intervention program encountered problems in recruiting families to participate. They sent request letters to 300 families and got only 19 responses. Some researchers explained this phenomenon, saying that parents deny that they have overweight children and they do not want to discuss about the issue. Communication between parents and children is important to facilitate good interaction and exchange of information on health and behavioral problems.
Conclusion
Childhood obesity is a major health problem but it can be avoided and treated through early intervention and lifestyle change, coupled with drug therapy.
This research dealt on the subject of childhood obesity and its association with adult obesity. The causes, symptoms and outcomes for both may be similar. Obesity is closely associated with diabetes, and the outcomes are cardiovascular diseases, hypertension, and psychological or mental health problems.
The literature search provided facts and data on childhood obesity and how this can be dealt with effectively. Lifestyle, genetic factors and environment are some of the strongest causes of childhood obesity. Parents contribute to childhood obesity, but they can use their self-efficacy to help control their children’s obesity. Parents should be persistent in teaching their children about eating health food.
Socioeconomic status is another factor that contributes to obesity, because children of poor families tend to buy unhealthy food. The presence of fast food chains adjacent to schools and universities influence their eating habits. Programs in public schools should promote physical education.
The causes have to be addressed that can take the form of prevention such as physical activity and eating health foods. Metformin can be used to reduce obesity, but this has to be coupled with lifestyle change. The simple solution is to reverse the lifestyle of obese children so that their quality of life will improve.
References
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