Factors that Play the Most Significant Role in Determining the Prevalence of Childhood Obesity

Children obesity is a serious problem with several health and social consequences that frequently persist into adulthood. To effectively control the obesity epidemic among children and adolescents, implementation of prevention programs and understanding of treatment for youngsters is important. Childhood obesity affects both children and teenagers; in the US about 5-25 percent of children and adolescents are obese (Ogden, Caroll & Flegal 2008). Just like in adults, the prevalence of obesity in children and teenagers varies by ethnic group; about 7% of White and Black children are obese, and the percentages are even higher among Hispanics where 12% of the boys and 19% of girls are obese (Miller, Rosenbloom & Silverstein 2004). Studies have indicated that obesity among children is on the increase; a national children and youth fitness study indicates that children aged 6-9 years have thicker skin folds than their counterparts in the 1960s (Olds et al. 2009). Similarly, other research findings indicate a rise in the prevalence of obesity among 6-11 year olds by 54% in the same time frame (Hedley et al. 2004).

Obesity is a health condition characterized by having excess weight as compared to the expected weight based on an individual’s age and weight. Obesity manifests itself primarily via an accumulation of excessive body fats especially around the waist and stomach, a phenomenon that may adversely affect the health of the individual (Brogan & Hevey, 2008). Obesity in children has become a major determinant of morbidity and mortality in many areas of the world. Most importantly, its association with diseases such as type II diabetes, hypertension, cardiovascular diseases, musculoskeletal and psychological disorders and several types of cancer has heightened the need for initiatives that address obesity in childhood (Ahrens et al. 2006). For example, the relative risk of contracting type II diabetes among obese children later in life was estimated to be in the order of 6.74 in males and 12.41 in females in one study (Guh et al. 2009). For hypertension, such estimates were 1.84 in males and 2.42 in females while estimates for contacting coronary artery disease, the estimates were 1.72 in males and 3.10 in females (Guh et al. 2009). Further, the study estimated  that obesity in children conferred a 4.20 and 1.96  relative risk in males and females respectively, of contracting osteoarthritis later in life,  with estimates for the risk of contracting kidney cancer being 1.82 in males and 2.64 females (Guh et al. 2009).

The prevalence of obesity among children has increased dramatically in the last few decades, with rising trends in almost all developed countries in spite of prevention efforts advanced at various institutions (Hedley et al. 2004; Pratt et al. 2008). Primary prevention efforts in adults are mostly disappointing (Snell, Adam & Duncan 2007) and there is emerging indication that the manifestation of obesity and its co-morbidities starts from early childhood onwards (Flynn et al. 2006). Therefore, there has been growing interests to better understand the factors leading to the increase of the prevalence rates of childhood obesity in most parts of the world (Hedley et al. 2004). Additionally, despite the recent evidence that this trend may be leveling off in some developed countries like US, Australia and some European countries (Ogden et al. 2008; Olds et al. 2009), the level remains unacceptably high. Further, the obesity-related hospital discharges in youth (6-17 years) increased from 1979-1981 to 1997-1999; discharges of diabetes nearly doubled from 1.43 to 2.36%, gallbladder diseases tripled from 0.18 to 0.59% and sleep apnea increased fivefold from 0.14 to 0.75 (Wang & Dietz, 2002).

The definition of obesity in children is typically based on percentile curves of the body mass index (BMI) and therefore, it might be argued that the rising trend in obesity is more an artifact than a real problem. For this reason, it is necessary to investigate whether children who have been classified as obese will also be classified as obese later in life. Several longitudinal studies have shown that half of obese children in school age continued to be obese during adulthood and this occurrence has been observed in pre-school children (Vogels et al 2006). Additionally, the treatment costs of obesity and its co-morbidities are a growing concern. According to Wolf and Colditz (1998), the total economic cost attributable to obesity in the US was estimated at 99 billion USD in the year 1995. About 52 billion USD of this amount were direct medical costs. Although knowledge about economic costs of obesity in children is scarce, it has been estimated that annual hospital costs in the US increased threefold from 35 million USD in 1979-1981 to 127 million in 1997-1999 (Wang and Dietz, 2002). As obesity develops early in life, it is important to understand the causes, mechanisms and risk factors leading to this disorder in children.

Research has shown that, similar to other conditions, obesity in children develops from a combination of factors. The most significant are unhealthy eating habits, leading sedentary lifestyles, genetic predisposition, medical conditions, influence of the home environment and psychological issues such as low self-esteem (Stamakis, Wardle & Cole 2009). The effects of dietary habits are quite significant in the development of childhood obesity. High intake of high calorie food, sugar-laden drinks and calorie-dense snacks is a major contributing factor to childhood obesity. However, this is aggravated by co-occurrence of other factors such as physical inactivity and a sedentary lifestyle.  In a research of 200 children in a period of two years, French et al. (2001) indicated the likelihood of contracting obesity to increase1.6 times for each extra soft drink consumed per day. Additionally, eating of fast foods is very common among children and youngsters thus increasing the probability of developing obesity (French et al. 2006). Sedentary lifestyles among children are a significant cause of obesity. In a study done on 122 children over a one-month period, Epeistein et al. (2008) noted that obese children were 40% less active at school and 70% on weekends as opposed to non-obese children.

Genetic predisposition coupled to medical conditions also contribute a considerable part in the development of obesity in children. Genes controlling appetite and calorie metabolism determine the likelihood of childhood obesity; others contribute to rapid weight gain (Yang, Kelly & He 2007). Medical conditions that have been shown to contribute to obesity include Cushing’s syndrome and hypothyroidism (). Home environment and other developmental factors are also argued to contribute to the increasing cases of obesity among children. This, for instance, arises out of the observation that a family’s meal greatly influences children’s food choices. In a research about household eating, Videon and Manning (2003) indicated that children who consumed family meals more, tended to be less obese as those who ate out more often. On the contrary, children who are brought up by grandparents and busy mothers who had little time to have a family meal together with their children had a higher likelihood of having obesity (Videon & Manning 2003). Developmental factors include such factors as duration of breast-feeding and birth weight. Psychological factors include factors such as low self-esteem that has is argued to contribute to feelings of stress and depression and higher risk of developing eating disorders such as binge eating (Goodman & Whitaker 2002).

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