Controlling Child Obesity
Child obesity is a condition that requires major attention because it predisposes the child to the risks of premature illness. Illnesses including cardiovascular, pulmonary and psychosocial conditions as well as the increased chance of premature death as an adult. At this point, there is not a completely effective method for treating child obesity. Researchers continue to search for the genetic, physiological and environmental factors to properly address the situation. Unfortunately, child obesity remains persistent in developed countries and continues to be increasing in developing countries, despite the increase of obesity research and interventions done in the past decades.
Childhood obesity is a complex and multifactorial condition, the repercussion is more than how many calories are consumed by the child. There are a few factors to consider, the type of food the child is consuming, how frequent is the children eating, what types of genetic makeup are involved, even gut microflora diversity. Children with obesity also have more risk factors for heart disease than their normal-weight peers. Risk factors include high blood pressure and high cholesterol. "In a sample of 5- to 17-year-olds, almost 60% of children who were overweight had at least one risk factor for cardiovascular disease, and 25% had two or more risk factors." (Brody)
Childhood obesity rates continue to rise every year. "More than 80 percent of all children and adolescents with type 2 diabetes are overweight, and about 40 percent are clinically obese." (Brody). "More than 75% of children with type 2 diabetes have a close relative who has diabetes type 2" (Gebel). The single biggest cause of type 2 diabetes in children is extra weight. "In the U.S., nearly 1 out of every 3 children is overweight". (Gebel) Once a child gets too heavy, she or he is twice as likely to get diabetes. There are certain things that contribute to extra weight or obesity, unhealthy eating, lack of activity, family genetics, bad eating habits, a hormone imbalance or other medical condition.
There are some symptoms that can show after time. For example, hunger or thirst even after eating, dry mouth, frequent use of the bathroom, fatigue, blurred vision, heavy breathing, numbness or tingling in the hands or feet and slow healing of sores or cuts. The first step is to get your child to the doctor. The doctor can tell if the child is overweight based on his or her age, weight, and height. A blood test will be required to see if the child has diabetes or prediabetes. If it determined the child has diabetes, it may take a few extra steps to find out if it's type 1 or type 2. Until then, insulin may be prescribed to control the diabetes. Once the results confirm the child has type 2 diabetes, the doctor will recommend making some lifestyle changes. Another recommendation that can be made by the doctor would be a medication called metformin. Metformin and insulin are the only two blood sugar-lowering medicines approved for kids younger than age 18, but others are being studied. The doctor will monitor the child's diabetes every three months requesting for a hemoglobin A1c test to be done every three months. A hemoglobin A1c test measures the average blood sugar levels over that period.
Parents and loved ones can help prevent or delay type 2 diabetes by developing a plan not only for the child but the whole family. Children, especially teens, may have a difficult time making changes to prevent or manage type 2 diabetes. As parents, caregivers or as a support member, we need to talk to the child honestly about what changes need to he done to manage their diabetes. By adding a daily physical activity, dinking more water and fewer sugary drinks. Making favorite food healthier, eating more fruits and vegetables and controlling their meal portions. Being physically active lowers the risk for type 2 diabetes because it helps the body use insulin better, decreasing insulin resistance. Physical activity improves health in lots of other ways, from controlling blood pressure to boosting mental health. Reaching out to a diabetes educator, doctor, dietitian, or other diabetes professional for more ideas on how to help your child become healthier can be helpful, not only for a parent but for the child as well. By working together, the parent, the child, and the diabetes health care team can be sure the child remains healthy for years to come.
High blood pressure is more common in youth with obesity. "A study showed about 1 in 25 children from the ages of 12 to 19 suffer from high blood pressure, and 1 in 10 have elevated blood pressure." (Gill)
Atherosclerosis is a type of heart disease to describe the buildup of fat and cholesterol-filled plaques inside arteries. Blood clots and heart attacks occur when buildup increases, and arteries become stiffened and narrowed. It typically takes many years for atherosclerosis to develop. It's unusual for children or teenagers to suffer from it. However, obesity, diabetes, high blood pressure, and other health issues put children at higher risk. Doctors recommend screening for high cholesterol and high blood pressure in children who have risk factors like family history of heart disease or diabetes and are overweight or obese.
According to the National Sleep Foundation, 2% to 3% of children of all ages suffer from sleep apnea. ( Cormier ) This sleep disorder can cause serious health problems for children. Symptoms may include loud snoring, long pauses in breathing while sleeping, excessive sweating at night because of the strain of trying to breath, waking up with headaches and daytime sleepiness, irritability, hyperactivity, and difficulties in concentrating. Parents or caregivers are suggested to schedule an appointment to get their child tested. Doctors evaluate the child's condition during an overnight sleep study. Polysomnogram is a type of test using sensors applied to the child's body to record brain wave activity, as well as snoring, oxygen levels, muscle activity, heart rate, and breathing patterns. Unlike a polysomnogram test, an oximetry test can be completed in the child's home since it is used if the doctor believes the child has obstructive sleep apnea. An overnight recording of oxygen levels might help make the diagnosis. Unfortunately, an oximetry test at times fails, which then a polysomnogram is required. Doctors might use a test called electrocardiogram, if they need to determine if the child suffers from an underlying heart condition. Electrocardiogram are sensor patches with wires attached to the child to measure the electrical impulses given off by your child's heart. Doctors may use this test to determine if your child has an underlying heart condition. There are couple treatment options a doctor can use to treat a child. Medications, which include nasal steroids, unless a child sufferer from allergies then montelukast will be used. Dental devices or mouthpieces are also recommended to treat sleep apnea. An oral appliance is used to move the child's bottom jaw and tongue forward to keep the child's upper airway open. (Mayo Clinic Staff) "Mayo Clinic dental specialists have experience developing oral appliances to treat sleep apnea. Only some children benefit from such devices." (mayo clinic staff) A form of therapy called positive airway pressure can also be a treatment for sleep apnea. Small machines are used to gently blow air to a child's nose using a mask. Children can also use a mask that covers their nose and mouth. The purpose of the machine is to send air pressure into the back of the child's throat to keep the child's airways open. "The child might get referred to a pediatric nose, ear and throat specialist to discuss the removal of the tonsils and adenoids. An adenotonsillectomy might improve sleep apnea by opening the airways. Depending on your child's condition, upper airway surgery might be recommended." (Mayo Clinic Staff)
Obese children are at increased risk for developing asthma, which is already one of the most common chronic diseases among children. "In the United States, asthma is a leading cause of hospitalization, emergency department visits, and missed school. Despite the high degree of heritability, external factors such as air pollution, immune sensitization, nutrition, and obesity can affect asthma." (Pongdee) Obese children with asthma generally should receive the same guidelines-based management as lean children. However, interventions that encourage daily physical activity, weight loss, normalization of nutrient levels, and monitoring of common obesity-related sequelae should be considered by healthcare providers managing obese children with difficult-to-control asthma. "We care about this issue because asthma affects approximately 6.5 million children - about 1 in 10 - in the United States,". "It's a chronic childhood disorder and if it increases the risk of obesity, we can advise parents and physicians on how to treat it and intervene to help young children grow up to enjoy healthy, adult lives." (Chatz) Unfortunately, there is no cure for asthma. Uncontrolled asthma in children can result in permanent lung damage. (Pongdee) But for most children, asthma can be controlled with appropriate treatment and management. "The Centers for Disease Control and Prevention (CDC) and U.S. Department of Agriculture strongly recommend that children adhere to a balanced diet generally low in saturated fats and with half their meal plate consisting of fruits and vegetables. However, many children and families struggle to achieve these recommendations. In addition to supporting our primary care and public health colleagues and reminding asthma patients about these key health initiatives, we as asthma specialists should be aware of the impact diet and weight status may be playing in innate asthma severity and the response to therapy." (Gill) "There is evidence that suggests that maintaining key antioxidant at normal levels may be helpful in maintaining asthma control. Children with asthma and low antioxidant blood levels appear to have reduced symptom control. When intervention trials have been undertaken supplementing one vitamin alone, the results have been disappointing. However, encouraging patients with poor symptom control to commit to a healthier diet replete with the current recommendations for vitamins A, C, E, and selenium may be helpful for asthma control." (" Griffin)
Currently the data are "encouraging for the potential future use of vitamin D supplementation as an adjuvant therapy for persistent asthma." (Griffin) Though more investigation is needed, basic research suggests that vitamin D may be important in viral defense, reduction of virally induced airway inflammation, and response to steroid therapy. (Griffin, Kumar) "Many children with asthma have low vitamin D. For the many children with difficult-to-control persistent asthma, clinicians should consider hypovitaminosis D as a potential factor. The best dietary sources of vitamin D are fatty fish, fish liver oil, and fortified foods such as milk, orange juice, yogurt, and breakfast cereal." (Zhang, Hauk)
Children with obesity can be bullied and teased more than their normal weight peers. They are also more likely to suffer from social isolation, depression, and lower self-esteem. The effects of this can last into adulthood.
Obesity in children is a serious health issue in the United States, contributing to such conditions as heart disease, stroke and type 2 diabetes. As parents, teacher, caregivers, and community members, we all need to take some responsibility when taking care of children. There are many ways we can join and prevent obesity and support healthy growth in children. Developing a healthy eating habits and providing the children with a variety of colorful fruits and vegetables, whole grains, lean meats, and low-fat dairy products to receive the recommended daily intake of essential foods. Serving reasonable sized food portions, replacing high-calorie snacks with fruits and vegetables, limiting sugar-sweetened beverages and increasing water intake. Another way we can help is by limiting their time in front of electronic devices and encouraging active play is also important. It has been recommended to have our children have some sort of physical activity every day for at least 60 minutes. A good night sleep is also recommended to control child obesity. Like many other things, it is easier said than done, but supporting and encouraging children to live a healthier lifestyle goes a long way. Unfortunately, convincing our kids to step away from the computer, video games and television and substitute with a physical activity can be a daily struggle.
The United States government serves several vital functions in a national public health crisis, such as the childhood obesity epidemic. The federal government is responsible to establish national priorities and objectives on national issues. "They provide funds to states to strengthen their capacity for services to achieve adequate minimum health services and achieve national health objectives." (cdc) They have the responsibility to address public health crises including the childhood obesity epidemic through ensuring enough capacity to provide essential public health services; responding when a health threat is apparent across the entire country, region, or may states. Aiding when the responses are beyond the jurisdiction of individual states. Helping formulate the public health goals state. The state responsibilities include conducting health assessments based on statewide data, ensuring an adequate statutory base for health activities in the state, establish health objectives, delegate responsibilities, and hold local governments accountable. (cdc) Promoting children's healthy lifestyle will require not only the parents and caregivers of the child, but the involvement of government officials, which includes the mayors and commissioners or other leaders of counties, cities, or townships. The cities public health, public works, parks and recreation, economic development is also involved in the healthy lifestyle of the child. Community involvement is vital for childhood obesity prevention efforts. Members of an engaged community help identify local assets and improve implementation plans. As obesity prevention actions are implemented in the communities, they need to be evaluated in order to provide vital information whether the implemented programs are working or not working.
Over the course of the past several years nonprofits have worked to tackle this issue from a variety of perspectives. AmpleHarvest.org is a unique nationwide resource that is eliminating the waste of food. (Oppenheime) They focus on being a reduction in hunger and malnutrition as week as improving the environment. AmpleHarvest can accomplish their mission partnering with 42 million Americans who grow food in home/community gardens to donate their excess harvest to one of 8,642 registered local food pantries spread across all 50 states. AmpleHarvest.org aims to make sure their clients have the option of fresh food rather than packaged food with added salt and sugar. Fresh healthy food helps reduce the risk of health illness such as diabetes. high blood pressure and child obesity. (Oppenheime)
Alliance for a Healthier Generation Inc. is another example of a nonprofit organization to help decrease child obesity. Their Mission is to reduce the prevalence of childhood obesity and to empower kids nationwide to make healthy lifestyle choices. (Ni)
The United States Department of Agriculture (USDA) administers WIC at national and regional levels. WIC is a federal program that promotes healthy eating and nutrition education for infants and children up to age 5, and low-income women who are pregnant, postpartum, or breastfeeding. "WIC now serves 53 percent of all infants in the United States. The program's implementation of a new food package that includes more fruits, vegetables, and whole grains also has had an impact on WIC households across the country". (Concannon)
The Supplemental Nutritional Assistance Program (SNAP) also is making changes designed to combat obesity. "SNAP serves 47 million people each month, nearly half of whom are children. Part of the recent increase in numbers served reflects economic problems, but states also have made efforts to provide access for eligible families. The program now serves about 79 percent of those who are eligible in the United States, compared with just 50 percent in the relatively recent past."(USDA) N ot only does SNAP provide nutritional food for our children, they also have an education component, funded at about $400 million annually.
The President's Council is a federal advisory committee supported by the Office of Disease Prevention and Health Promotion that works to increase sports participation among youth of all backgrounds and abilities and to promote healthy and active lifestyles for all Americans. President Obama formed a White House task force in 2010 that brought federal departments and agencies together to develop an action plan for solving the problem of childhood obesity within a generation. The Healthy, Hunger-Free Kids Act of 2010, enacted with the support of First Lady Michelle Obama, also has been making a difference in the lives of students across the country. Enrollment in the School Breakfast Program has increased, as has the percentage of free and reduced-priced meals being served to students. Under the Healthy, Hunger-Free Kids Act, students are provided fruits and vegetables every day of the week. Another program former first lady Michelle Obama was so proud of was Let's Move. Let's Move was not only focus on the physical activities, but also the healthy meals.
From the National Football League to the National Basketball Association, professional athletes and sports organizations have realized the positive influence they have when it comes to encouraging kids to have physical activity. 'nPlay is pro athlete movement for childhood obesity. "A government tax exempt 501(c)3 organization, 'nPLAY's primary focus is to financially support physical education and activity programs in low income areas which statistically suffer the highest rates of childhood obesity in the United States." (Sideman)
Therefore, child obesity is a condition that requires major attention to save our children from premature illness. Although, there is not a completely effective method for treating child obesity. We as parents, caregivers, friend, and everyone involved trying to fight obesity is now knowledgeable in all the different ways we can help children. From the food we provide to the physical activity we engage ourselves with them. We must realize children are not responsible for their illness. We need to look at ourselves and ask ourselves, have I done everything in my power to help? As researchers continue to search for the genetic, physiological and environmental factors to properly address the situation, we must do everything in our power to help one another defeat child obesity. Together we are stronger.
Works Cited
Renne A, Alli., MD. "Obesity in Children" WebMD, 8 September 2018
Jane E. Brody "The Fight Against Obesity Begins Early" the NewYork times
Erika Gebel, PhD "More Kids Than Ever Have Type 2 Diabetes" November 2012
Thanai Pongdee, MD "Childhood Asthma" American Academy of Allergy, Asthma & Immunology
Karen Gill, MD "Types of Heart Disease in Children"-Journal of the International Association for the Study of Obesity, 30 Sep 1992
Courtney Cormier "Sleep Apnea in Children" August 6, 2019
United States Department of Agriculture "NIFA Helps Build a Better Future for Our Children" August 24, 2015
Gail Sideman "Pro Athletes Help Fight Childhood Obesity"
Bruney TS. "Childhood Obesity: Effects of Micronutrients, Supplements, Genetics, and Oxidative Stress" September 2011
Searing DA. Zhang Y. Murphy JR. Hauk PJ. Goleva E. Leung DY. "Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use" May2010
Griffin MD. Xing N. Kumar R. "Vitamin D and its analogs as regulators of immune activation and antigen presentation" March 2003
Brehm JM. Celedon JC. Soto-Quiros MD "Serum vitamin D levels and markers of severity of childhood asthma" Feb. 1o0, 2009
Thanai Pongdee, MD, FAAAAI American Academy of Allergy Asthma & Immunology
Parker L, Burns AC and Sanchez E "Local Government Actions to Prevent Childhood Obesity" September 1, 2009
