Childhood Obesity

There has been an increase in the rates of overweight and obesity amongst adults and children, both in Australia and globally.

The Australian Bureau of Statistics, in the Australian Health Survey, states that in 2011-2012, 25.1% of children aged 2–17 years were overweight or obese (based on Body Mass Index).

Childhood obesity is associated with a range of serious health problems such as obstructive sleep apnoea, increased risk of cardiovascular disease, type 2 diabetes, and certain cancers, as well as psychosocial problems including depression, social isolation, and low self-esteem. In addition, childhood obesity is a strong predictor of adult obesity and carries a substantial economic burden.

What is Obesity?

Obesity is defined as a complex disorder involving an excessive amount of body fat. It is usually measured by Body Mass Index (BMI), which is calculated by dividing a person’s weight in kilograms by their height in metres squared.

Causes of Childhood Obesity

• Genetics. Body composition and predisposition to obesity have been shown to be hereditary.
• Mode of delivery. Birth by caesarean section is associated with increased risk of both overweight and obesity in children, possibly due to the lack of exposure to maternal gut microbiota for children who are not delivered vaginally.
• Maternal BMI. Body mass Index of the parents pre-pregnancy - particularly that of the mother - increases the risk of childhood obesity. 
• Maternal smoking. Smoking during pregnancy increase the risk of overweight of her offspring.
• Dietary intake. Eating high-calorie foods, such as fast foods, soft drinks and desserts on a regular basis, can easily lead to weight gain.
• Physical activity. Low levels of physical activity play an important role in childhood obesity. Exercise contributes to expenditure of energy and research suggests that it also has an impact on energy intake.

​Sedentary behaviour. Sedentary behaviour describes sitting or lying down while awake. Research has shown that over the past 20 years, Australian children have become more sedentary.

More children are being driven to school, rather than walking or riding their bikes, as well as spending more time on the Internet, social media, and electronic games.

• Media exposure. Excessive screen time (watching television or playing video games) as well as eating while watching television, is associated with less energy expenditure, sedentary behaviour, exposure to food advertising – all leading to greater caloric intake and overweight.
• Lack of sleep. Poor sleep is associated with obesity.
• Poor peer food choices. Children are influenced by their peer food choices.
• Summer holidays. Research suggests that children gain more weight during the summer vacation, possibly due to changed diet and physical activity patterns.

What Parents/Caregivers can do?

Childhood is the period of time where unhealthy behaviours begin to establish. Parents/caregivers involvement is a crucial component of obesity prevention.

• Be a role model. Promote positive health behaviour at home by adopting a healthy lifestyle for yourself. For example, increase your own fruit and vegetable consumption, decrease or eliminate sweetened beverage consumption, increase physical activity, and watch less television.
   

Expose your child to healthy food. Limit your child's consumption of sugar-sweetened food and beverages, offer water at meal time, and provide plenty of fruits and vegetables, and healthy snacks.

• Serve age-appropriate portion sizes.
   
• Do not focus on the weight.  Instead, focus on healthy lifestyle.
   
• Encourage outdoor play/physical activity. Toddlers and pre-schoolers should be physically active every day for at least three hours, spread throughout the day, according to The Australian Government Department of Health.
   
• Enforce appropriate sleep practices.
   
• Limit screen time. The Australian Government Department of Health recommends that children younger than 2 years of age should not spend any time watching television or using other electronic media, while for children 2 to 5 years of age, sitting and watching television and using other electronic media should be limited to less than one hour per day. Children aged 5-12 years should limit use of electronic media to no more than two hours a day.

Tips for reducing screen time for all children (The Australian Government Department of Health):

• Make meal time your family time and turn off the TV.
• Turn the TV off after the program has finished.
• Set limits and have rules around screen time.
• Make your kids’ bedrooms TV and computer free.
• Play music or listen to stories on CDs instead.

Talk to your health care provider. If you feel that your child is gaining weight, your health care provider can refer you to a qualified dietitian or nutritionist for a weight-reduction diet.

Knowledge is power! Educate yourself about nutritional basics and healthy foods for children. Join a Facebook group, find a website that promotes health and wellbeing, or visit your nearest community health centre.

 

References

Australian Bureau of Statistics 2013, Australian Health Survey: Updated Results, 2011-12, ABS, retrieved November 14, 2016,

Australian Department of Health 2014, Australia’s Physical Activity and Sedentary Guidelines for Australians. Department of Health, retrieved November 14, 2016,

Australian Government Australian National Preventive Health Agency 2014, Evidence brief -Obesity: sedentary behaviours and health, ANPHA, retrieved November 14, 2016, < https://sydney.edu.au>

Crowle, J., & Turner, E. (2010). Childhood Obesity: An Economic Perspective - Staff Working Paper.

Fearnbach, S. N., Masterson, T. D., Schlechter, H. A., et al., (2016). Impact of imposed exercise on energy intake in children at risk for overweight. Nutrition Journal, 15(1), 92. http://doi.org/10.1186/s12937-016-0206-5

Harrison, K., Bost, K. K., Mcbride, B. A., et al. (2011). Toward a Developmental Conceptualization of Contributors to Overweight and Obesity in Childhood: The Six-Cs Model. Child development perspectives, 5 (1), 50-58

Hopkins, L. C., Fristad, M., Goodway, J. D., et al., (2016). Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months. BMC Public Health, 16(1), 1122. http://doi.org/10.1186/s12889-016-3765-7

Mayo Clinic 2015, Childhood obesity, retrieved November 14, 2016,

Rath, S. R., Marsh, J. A., Newnham, J. P., et al., (2016). Parental pre-pregnancy BMI is a dominant early-life risk factor influencing BMI of offspring in adulthood. Obesity Science & Practice, 2(1), 48–57. http://doi.org/10.1002/osp4.28

Rutayisire, E., Wu, X., Huang, K., et al., (2016). Caesarean section may increase the risk of both overweight and obesity in preschool children. BMC Pregnancy and Childbirth, 16(1), 338. http://doi.org/10.1186/s12884-016-1131-5

Skjåkødegård, H. F., Danielsen, Y. S., Morken, M., et al., (2016). Study Protocol: A randomized controlled trial evaluating the effect of family-based behavioral treatment of childhood and adolescent obesity-The FABO-study. BMC Public Health, 16(1), 1106. http://doi.org/10.1186/s12889-016-3755-9

World Health Organisation 2016, Report of the commission on ending childhood obesity, WHO, retrieved November 14, 2016, < http://apps.who.int>