Free Literature Review On Childhood Obesity
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Childhood obesity is one of the most challenging conditions faced by healthcare professionals of all over the World. Global occurrence of childhood obesity has increased sufficiently during the past three decades (Han, Lawlor & Kimm, 2010.) According to data of the National Health and Nutrition Examination Survey, the obesity rate in children increased dramatically. While in 1960s the rate of obesity was 4.2 per cent of children aged 6 to 11 years (4.6 per cent – for the age group between 12 and 19 year old), in 2008, 19.6 of 6 to 11 kids and 18.1 per cent of 12 to 19 year old children were obese (Marks, 2013.)
There’s a significant body of research on the subject of childhood obesity accumulated up to date. The numerous studies explain reasons, risk factors, complications, prevention methods and ways to manage obesity in children. This paper is aimed at summarizing briefly existing body of knowledge on childhood obesity in a form of review of literature on the subject.
Children are considered obese when they have body mass index that exceeds BMI of 95 per cent of their peers (Roth, 2012.) In the consensus statement of 65 health professionals from nine countries including USA, approved in 2004, except the obesity threshold, there’s also the definition of clinical overweight. According to this consensus statement, children with body mass index exceeding 85% of their peers of the same age and gender are considered clinically overweighed (Bauchner, 2005.)
One of the most comprehensive publications is “Childhood obesity” by Han, Lawlor & Kimm (2010). In their review, the authors address epidemiology of obesity in different countries of the world, emphasizing the various classification methods for obesity. The review of obesity drivers, both genetic and non-genetic, is rather cursory, but gives a main idea of key predictors. The question of differential diagnosis and complications is covered in detail, especially, multiple adverse effects obesity imposes on cardiovascular, musculoskeletal, endocrine, gastrointestinal and other body systems. The authors dedicate specific attention to prevention of obesity in children in youth “at individual, household, institutional, community, and health-care levels” (Han, Lawlor & Kimm, 2010.) The scholars mention possible methods of non-pharmacological, pharmacological and surgical treatment, identifying the need for further research necessary in the field. In general, this study is descriptive and summarizes the basic information the healthcare professionals should know about identifying, preventing and addressing obesity in children and youth.
The study “The Science Of Childhood Obesity” by Jonathan Bor (2010) is also dedicated to understanding of childhood obesity, its epidemiology, pathophysiology, role of genetics and environmental factors such as food environment in predicting excessive weight in minors. Bor (2010) gives a brief overview of recent innovations in pharmacological treatment of obesity. At the same time, the author emphasizes the role of social acceptance of overeating and states, that this cultural aspect should be changed.
Another integral work, focused mostly on prevention and cultural factors and attitudes helping to fight obesity as large-scaled social threat, is “Childhood Obesity: The New Tobacco” by Jonathan Klein and William Dietz (2010.) In their paper, the authors compare the public movement against childhood obesity epidemic with social movement against tobacco, emphasizing the scale of the problem and risk level imposed by obesity. According to Klein and Dietz, to address the childhood obesity successfully, the society should reframe its attitude to obesity phenomenon and to implement “policy and environmental changes in multiple settings and sectors” (2010). Obesity in younger generations should be seen as a threat; the attitudes and perceptions in people’s minds should be changed with the help of policymakers, healthcare system and media. The authors call for raising a broad movement for childhood obesity prevention, leveraging experience of past social movements against tobacco, HIV/AIDS, etc.
There’s a significant body of knowledge about factors predicting obesity in childhood and older ages. For example, Flores and Lin (2013) in their research “Factors predicting severe childhood obesity in kindergarteners” study the risk factors causing obesity in children. Using multivariable regression and also recursive partitioning analysis (RPA), the authors define and classify the key parental, prenatal, infant, and early childhood factors, predicting severe obesity. For example, the following factors indicate the elevated risk of a child’s obesity in kindergarten: a child being overweighed in early childhood; mother’s obesity before pregnancy; maternal gestational diabetes; maternal age at birth of first child; weight at birth; eating habits; drinking sugary beverages, tea or coffee, etc. The study by Flores and Lin (2013) gives an analysis of multiple factors increasing the probability of severe obesity in childhood, and, despite its limitations, has important implications for the practice. For example, monitoring of body mass index in 9-month children can reveal their predisposition to obesity and allows plan parental education and necessary intervention.
The study of Nielsen et al. (2015) “The Influence of Familial Predisposition to Cardiovascular Complications upon Childhood Obesity Treatment” researched whether a familial obesity predisposition and obesity-related cardiovascular complications were associated with the degree of childhood obesity. The study findings confirmed the initial hypothesis of the scholars: obese children with a familial predisposition to diabetes 2 type displayed a higher degree of obesity; also the scholars have found that “girls with familial obesity responded better to treatment.” The information about family predispositions was not accurate, because it was based on study’s participants’ questionnaires data. The size of the families was not taken into consideration. But the study has significant implications for paediatric practice; also, it has identified a large field for further research.
A significant number of publications are dedicated to consequences and complications of childhood obesity. The study of Stephen Daniels (2006) “The Consequences of Childhood Overweight and Obesity” is dedicated to general systematic overview of adverse health outcomes in children such as cardiovascular problems (high blood pressure, atherosclerosis, left ventricular hypertrophy, etc.); metabolic disorders; pulmonary complications, gastrointestinal disorders, skeletal abnormalities, etc. The author emphasizes, that many diseases and conditions were considered as those associated mainly with adulthood. But in fact, with higher prevalence of obesity-related metabolic disorders, such diseases as diabetes type 2 can be found in children and adolescents. For example, “type 2 diabetes now is appearing in children as young as eight years old” (Daniels, 2006.) The author doesn’t limit his study with adverse effects obesity has on physical health, but also provides an overview of psychosocial and economic issues caused by the problem of obesity.
The study of Franks et al. (2010) “Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death” addresses the specific effects of obesity on the children’s developing cardiovascular system and studies impact of childhood risk factors for cardiovascular conditions, such as obesity, on premature mortality in adult age. The authors found that obesity in obesity-related disorders such as glucose intolerance and hypertension “were strongly associated with increased rates of premature death from endogenous causes” (Franks et al., 2010.) The study has its limitations, for example, the correlation between high body mass index in childhood and mortality rate can be affected by numerous unmeasured lifestyle factors. The key value of this study is it proved that obesity in childhood has long-term effects on health. According to Franks et al. (2010), even if preventing obesity in early age does not decrease the risk of premature death, increased physical activity and diet modification will have long-term health benefits.
Speaking about publications regarding prevention of childhood obesity, it’s necessary to mention the work “Preventing Childhood Obesity: What Works” by Birch and Ventura (2009.) This is a systematic overview of approaches and best practices in preventing obesity in children. The author analyses the factors impacting the child’s weight (behaviour-related, parenting, feeding; community and demographic factors) and gives critique of the most popular school-based prevention programs. The authors state that as 25% of pre-schoolers are already overweight, it’s necessary to focus on risk assessment and intervention before school age. Birch and Ventura emphasize an importance of pre-school period for building eating culture in children and propose environment-based behaviour-targeted interventions to prevent obesity. The findings and recommendations of this study are useful for healthcare professionals and also for parents, focused on building healthy future for their kids.
The current brief overview of publications evidenced the sufficient body of knowledge on the subject of childhood obesity. The studies cover epidemiology and pathogenesis of obesity, analyse in detail the genetic and environmental risk factors predicting obesity, including family-related factors. There’s a significant body of research on consequences and complications of childhood obesity, including long-term health-related, psychosocial and economic outcomes. The scholars also study existing and propose new approaches in prevention and treatment of obesity. The further evidence-based research is required studying response of different child populations on various methods of interventions (non-pharmacological, pharmacological and surgical) and their combination. Many scholars agree that large scale social campaigns and programs are needed to initiate a shift in a culture of nutrition and to prevent obesity.
Bauchner, H. (2005). Childhood obesity: An international consensus. Journal Watch.Cardiology, doi:http://dx.doi.org/10.1056/JC200505200000006
Birch, L. L., & Ventura, A. K. (2009). Preventing childhood obesity: What works? International Journal of Obesity, 33, S74-81. doi:http://dx.doi.org/10.1038/ijo.2009.22
Bor, J. (2010). The science of childhood obesity. Health Affairs, 29(3), 393-7. Retrieved from http://search.proquest.com/docview/204624160?accountid=12779
Daniels, S. R. (2006). The consequences of childhood overweight and obesity. The Future of Children, 16(1) Retrieved from http://search.proquest.com/docview/1519298841?accountid=12779
Flores, G., & Lin, H. (2013). Factors predicting severe childhood obesity in kindergarteners. International Journal of Obesity, 37(1), 31-9. doi:http://dx.doi.org/10.1038/ijo.2012.168
Franks, P. W., PhD., Hanson, Robert L,M.D., M.P.H., Knowler, William C,M.D., DrP.H., Sievers, M. L., M.D., Bennett, Peter H,M.B., F.R.C.P., & Looker, Helen C,M.B., B.S. (2010). Childhood obesity, other cardiovascular risk factors, and premature death. The New England Journal of Medicine, 362(6), 485-93. doi:http://dx.doi.org/10.1056/NEJMoa0904130
Han, J. C., Lawlor, D. A., & Kimm, S. Y. S. (2010). Childhood obesity. The Lancet, 375(9727), 1737-48. Retrieved from http://search.proquest.com/docview/288318173?accountid=12779.
Klein, J. D., & Dietz, W. (2010). Childhood obesity: The new tobacco. Health Affairs, 29(3), 388-92. Retrieved from http://search.proquest.com/docview/204632033?accountid=12779
Marks, Sh. (2013). The History of Obesity in Children. Livestrong.com. Retrieved from http://www.livestrong.com/article/364363-the-history-of-obesity-in-children/
Nielsen, L. A., Bøjsøe, C., Kloppenborg, J. T., Trier, C., Gamborg, M., & Holm, J. (2015). The influence of familial predisposition to cardiovascular complications upon childhood obesity treatment. PLoS One, 10(3) doi:http://dx.doi.org/10.1371/journal.pone.0120177
Roth, E. (2012). Childhood Obesity. Healthline.com. Retrieved from http://www.healthline.com/health/weight-loss/weight-problems-in-children#Overview1
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