RUNNING HEAD: Literature Review: Childhood Obesity

Childhood Obesity Nick Falk October 31, 2013 University of Texas at El Paso

Literature Review: Childhood Obesity

Abstract: One of the fastest growing epidemics in our society is childhood obesity. As modern society steadily heads for an almost completely sedimentary lifestyle, as well as an increased availability of unhealthy foods, the percentage of obese children has skyrocketed. In this literature review, I will explore the various specific causes for the rise of childhood obesity. I will also list what is being done to stop the current obesity trend, as well as methods being implemented now to prevent any further spikes in this worldwide epidemic.

Literature Review: Childhood Obesity

Introduction: What is child obesity? Defined by the CDC, childhood obesity is a clear excess of body fat in children ages 2-20. Obesity is accurately measured according to the subjects BMI. The CDC marks obesity at a BMI level of greater than or equal to the 95th percentile. (CDC, 2010) Children in this percentile are known to develop potentially life-threatening conditions like diabetes, high-blood pressure, heart disease and cancer. The percentage of obese children has doubled from 7% in 1980 to 18% in 2010. (CDC, 2010) This staggering increase in just 30 years has been cause for great social concern. To fully understand the severity and complex implications of this issue, the following questions must be answered: 1. What are the causes of childhood obesity? 2. What are the health issues surrounding childhood obesity? 3. What is being done to prevent childhood obesity? 4. What is being done to reverse the effects of childhood obesity? This literature review will take an in-depth look at the complex issue of childhood obesity, as well as provide answers to allow full understanding of the implications of the epidemic.

Literature Review: Childhood Obesity What are the causes of childhood obesity? When analyzing the specific factors that cause a child to be obese, three major points must be dissected: the childs social environment, home environment, and lastly his/her genetic pre-disposition. Our society practices an almost completely sedimentary life-style; almost fully comprised of working indoors, relatively inactive for 50% of the active hours in a day (NIH 2012). While this lifestyle implication is largely an adult one, children are being raised in a social environment where healthy levels of physical activity are no longer a high priority. This general social disconnect is seeping its way into the building blocks of childrens perception of what is ok, and what is expected of them in the health aspect. Thus, children are also becoming sedimentary, opting for indoor computer gaming instead of active exercise gaming for entertainment. Another aspect linking social environment to child obesity is a general American culture of excess. Large food portions have become the norm in America, Americans are exposed to huge food portions in restaurants, fast food places, gas stations, movie theaters, supermarkets, and even at home.(NIH 2012) This is a dangerous practice, because often times the portions served in public eateries are large enough to feed two people successfully. Over extended an extended period of time, this culture of large portions becomes detrimental to childrens wellness; they intake far more calories than they use in daily activities, Eating large portions means too much energy IN. Over time, this will cause weight gain if it isn't balanced with physical activity.(NIH 2012) Society is also greatly influenced by the advertisements being produced in the media. Children are the easiest targets; bright colors and popular cartoon characters

Literature Review: Childhood Obesity included in the advertisements make sugary drinks and high calorie foods extremely appealing. To the child, these foods become must-haves, fully eliminating the appeal of healthy foods. These subliminal messages in advertisements can make it very difficult for parents to instill lasting healthy habits, as the only thing parents can be in control of, is the childs home environment. The home environment also plays a large role in the complex causes of childhood obesity. Children are molded mentally in the home structure; their knowledge of right and wrong is first learned in the home. Every habit the child has, like taking a bath every day, or doing their homework is also formed and reinforced in the home environment. Thus, it is only expected for their eating habits to also first be formed there. Studies have shown that children developing in a household marked at or below the poverty line, tend to have an increased chance of being obese "Sorensen and Lissau have shown a nine fold increased risk of obesity in children who were neglected. They have also documented a twofold to threefold increase in risk of obesity for children in dilapidated living conditions (Strauss, 2013) When the home is struggling to make ends meet the first aspect that takes a hit is the quality of the food being provided in there. Parents may be forced to resort to cheaper food options; cheaper often means far more processed fatty foods. The content of the foods parents are providing is meant to stave of hunger; nutrition value is not of high priority. Children that grow up in this environment develop sub par eating habits, with parents enabling the continuation of said practices, "Studies suggest that parental food preferences directly influence and shape those of their children. In a study by Oliveria and colleagues, they reported that parents who ate

Literature Review: Childhood Obesity diets high in saturated fats also had children that ate diets high in saturated fats."(Bishop 2005) Parents lead the course in the direction of the home environment; when parents have questionable eating habits, children follow by default. Genetic predisposition is also a determining factor and cause to childhood obesity. As medical advancement continues to show us, many of the physical ailments that plague modern society today, have been found to be bequeathed genetically. Our genetic composition is not something we can control, children are at times faced with an uphill battle, "-- they have inherited genes from their parents that make their bodies gain weight easily. This would have been a very good trait hundreds of years ago, when food was hard to find and people were very active. Today, though, this can work against people who have these genes." (NIH 2012) When children are already naturally predisposed to obesity, it is imperative that their eating habits and levels of physical activity are up to par to avoid the development of obesity, "Genetics is not the only cause of obesity. To become obese, children must also eat more calories than they need for growth and energy" (NIH 2012) While genetics is a very serious aspect of the several causes of childhood obesity, it is not an end-all determining factor. DNA per-dispositions can be held at bay with appropriate diet and physical activity in the child's life.

What are the health issues surrounding childhood obesity? Childhood obesity has taken center stage in American media. The staggering number of obese children in this country has skyrocketed in the past 30 years. The

Literature Review: Childhood Obesity alarm behind this considerable spike is the very serious health conditions that children are at risk of developing due to obesity. It is largely common knowledge that obese adults tend to have high blood pressure or diabetes; these are conditions not generally associated with children. Obese children, however, are also plagued with great risk of developing potentially life-threatening conditions. Obese children face severe health risks, Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease" (CDC 2013) 70% of children is a frightening number; the severity of obesity as a devastating epidemic ever more present. Cardiovascular health issues are not the only possibilities for obese children, psychological and bone structure issues are also a prevalent problems, "Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor selfesteem." (CDC 2013) The health issues surrounding childhood obesity are alarming; an astoundingly large number of this country's children and adolescents are plagued by this disease. The severity of this epidemic and its lasting effects on America's children has pushed the federal government and thousands of non-profit institutions to take action to prevent and reverse the advance of obesity.

What is being done to prevent childhood obesity? One in five children is overweight or obese by age 6. (Nemours, 2013) When faced with such a staggering statistic, government action has become essential in the

Literature Review: Childhood Obesity effective prevention of this epidemic. However, government action is not the only essential prevention method, often prevention of this epidemic starts at home. The government has created guidelines and programs in order to provide help for the parent. As this epidemic rose in severity, the amount of resources available did as well, starting with government initiative. The main factor in preventing childhood obesity starts at home. Parents can follow many guidelines that have been provided by well-known medical facilities, such as the CDC. Some guidelines, created by the Nemours Childcare Center and sponsored by the CDC, provide many options in which a parent can prevent their child from becoming obese. This foundation focuses on five main goals that can provide a healthy lifestyle for a child. Their specified goals include: providing one to two hours of physical activity a day, limiting the amount of screen time a child has, providing fruits and vegetables, in children above the age of two limiting the amount of juice they have and mainly providing water, and providing breast milk for infants. (Nemours, 2013) These goals are an easy step-by-step guide for parents to responsibly affect their childrens lifestyle. "Physical activity also helps children reduce their risk of feeling stressed or depressed and developing obesity-related illnesses (type 2 diabetes, high blood pressure, and unhealthy cholesterol levels)." (Nemours, 2013) These guidelines, although enacted and created by the Nemours Foundation, were enacted specifically for the purpose of creating healthy habits within the home.

Literature Review: Childhood Obesity With Childhood obesity rising over the past decade, programs from the government have followed suit. In 2010 Michelle Obama initiated the Lets Move! campaign due to the rise in childhood obesity. "The physical and emotional health of an entire generation and the economic health and security of our nation is at stake." (Obama, 2010) The main goal of this organization is to solve the problem of obesity within a generation, in order to provide a healthier start in these childrens lives. These government organizations have multiple prevention methods to include: enabling parents, caregivers, providing healthy food in schools, improving access to healthy and affordable foods, and increasing physical activity. Actions enforced and enacted by the government to prevent childhood obesity have recently been shown to reverse the effects of this epidemic. What is being done to reverse the effects of childhood obesity? Obesity rates among preschoolers are improving, but there is more work to be done to continue this downward trend. (CDC, 2013) As of August 2013, nineteen of forty-three states have shown a slight decrease in obesity among preschoolers. However, three of forty-three have increase, and twenty-one of forty-three remained unchanged. (CDC, 2013) What is being done to reverse the effects of childhood obesity? The government is taking this epidemic very seriously, and has made a valiant effort in reversing the effects of childhood obesity. The first target areas have been the states; the government has funded the implementation of programs that promote healthy eating and physical activity. As stated above in the prevention paragraph, campaigns such as the First Ladys Lets Move! Campaign and the

Literature Review: Childhood Obesity childcare centers such as the Nemours Childcare Center, provide training and resources for parents childcare centers and communities. The former initiatives have been proven to help reverse the effects of childhood obesity. Parents have also begun to take initiative on this epidemic working to reverse its effects. In a survey recently conducted by Nicolas Falk, one can see that the number of times a family goes out to eat during the week is fairly low. (Figure 1) Most families only go out to eat one to two times a week, while according to the United Press International in 2011 the average U.S. adult eats 4.8 meals per week in restaurant (Dietsch, 2011) This steady decline has shown to reverse the effects of childhood obesity. More often, parents are making time to provide healthy home cooked meals for their children. All of these actions have helped to reverse the effects of childhood obesity; while it has not worked in all forty-three states examined, it has worked in nineteen. Conclusion: Understanding the implications of this epidemic through the answers of questions of definition, and understanding, provides the best comprehension for the reader. Defining obesity as clear excess in body fat, and children between the ages of

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Literature Review: Childhood Obesity two and twenty, one can understand the definition of childhood obesity, as well as see the many health risks associated with the epidemic at hand. These health risks can prove to endanger a childs life, making prevention and reversal imperative. Prevention and reversal have come in many forms to include: government implemented and funded programs, parental support. The combination of these social efforts has been proven to reverse the effects of childhood obesity.

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Literature Review: Childhood Obesity References Dietsch, K. (2011, September 19). Americans eat out about 5 times a week. Retrieved from http://www.upi.com/Health_News/2011/09/19/ Lets Move! (n.d). About lets move!. Retrieved from http://www.letsmove.gov/about Kaneshiro, N. (2012, August 1). Causes and risks for obesity - children. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000383.ht m Center for Disease Control (2013, July 12) Childhood Obesity Facts retrieved from http://www.cdc.gov/healthyyouth/obesity/facts.htm Strauss, R. (2013, june 1). Influence of the home environment on the development of obesity in children. Retrieved from http://pediatrics.aappublications.org/content/103/6/e85.full National Heart lung and Blood Insitute (2013, March 12). What Causes Overweight and Obesity? Retrieved from http://www.nhlbi.nih.gov/health/topics/obe/causes.htm Bishop, J. (2005, August 1). Childhood obesity. Retrieved from http://aspe.hhs.gov/health/reports/child_obesity/index.cfm Center for Disease Control (2013, August 3) Progress on Childhood Obesity Retrieved from http://www.cdc.gov/vitalsigns/childhoodobesity/ Obama, M. (2010, March 10). First lady column on physical acitvity. Retrieved from http://www.letsmove.gov/first-lady-column-physical-activity Nemours Foundation. (2013, June 13) Early Childhood Obesity Prevention, Retrieved from http://www.healthykidshealthyfuture.org/welcome.html

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