Global Perspectives on Childhood Obesity

Current Status, Consequences and Prevention

Debasis Bagchi

• Publisher: Academic Press
• Year: 2019
• eBook ISBN: 9780128128411
• Edition: 2
• Topic: Medicine
• Subtopic: Nutrition, Dietics & Bariatrics

Global Perspectives on Childhood Obesity: Current Status, Consequences and Prevention, Second Edition examines the current childhood obesity epidemic, outlines the consequences of this crisis, and develops strategies to forestall and prevent it. This book provides a thorough investigation of the causes of childhood obesity and, more importantly, offers specific prevention strategies that can be used by medical and mental health professionals, policymakers, community organizers, and individuals. New chapters on BMI and cardiovascular disease, exercise, neurotransmitters, neurocognition, nutrigenomics and combined prevention strategies are included, making this a solid introduction on the childhood obesity crisis.Researchers, practitioners, and advanced students in public health, health policy, and health economics, as well those working in medicine, pharmacy, nutrition, school health, physiology, and neuroscience related to obesity will find this to be a comprehensive resource.- Covers the multifaceted factors contributing to the rapidly growing childhood obesity epidemic- Includes new chapters on BMI and cardiovascular disease, exercise, neurotransmitters, self-regulation, and prevention strategies- Examines strategies for childhood obesity prevention and treatment, such as physical activity and exercise, personalized nutrition plans, and school and community involvement

Part I

Epidemiology and Prevalence

Chapter 1

Salient Features on Child Obesity from the Viewpoint of a Nutritionist

Bernard Waysfeld⁎; Dominique Adèle Cassuto^{† ⁎} Nutritionist and Psychiatrist, Obesity and Overweight Study Group, Paris, France
^† Hopital Pitié-Salpêtrière, Paris, France

Abstract

Child obesity is increasing at an alarming rate. The effects of different diets on weight reduction, such as low-fat, low-carbohydrate, high-protein, and low-glycemic index diets, have not been shown to have any superiority over other diets. A critical review of various factors demonstrates that preventing eating disorders may significantly contribute in the prevention of childhood obesity. Physical activity and a disciplined lifestyle may significantly contribute to controlling child obesity.

Keywords:

Child obesity; Genetics; Family; Cognitive restraint; Eating disorders; Relationship; Physical activity

The prevalence of child obesity has significantly increased in recent years [1, 2]. A specialist in nutrition would explain this evolution, and its epidemic quality, in dietary terms. However, there is no international consensus or study based on diet alone, and studies are not conclusive on the long-term effects on children's weight [3, 4]. Furthermore, the effects of different diets on weight reduction, such as low-fat, low-carbohydrate, high-protein, and low-glycemic index diets, have not been shown to have any superiority over other diets [4]. From the viewpoint of a nutritionist interested in the eating habits and difficulties of children, the question becomes, “What are the specific factors we need to observe, and what would be realistic in terms of intervention?” To answer this question, one needs to keep in mind the conundrum of preventing eating disorders without worsening obesity. In determining the etiological nature of the problem, one can develop targeted interventions according to age, time of onset, personal and family psychological background, and the degree of the child's obesity.

1.1 Genetic and Family Aspects

Nutritionists are convinced that family influences are not limited to genetic or epigenetic aspects [5–7]. However, professionals are aware of their importance in child obesity. (We shall not take into account genetic obesity in this chapter.) As Davidson has suggested, the child lives in an ecological nest box [5]. In the case of a child at risk of becoming overweight (including dietary, physical aspects, and sedentary behavior), the main characteristics can be explained by the influence of familial and school environment as well as a larger social environment (Fig. 1.1).

Fig. 1.1 Child ecological nest box. ⁎Among child risks factors, epigenetic consideration [7]. From Davidson KK, Birch LL. Childhood overweight: a contextual model and recommendations for future research. Obes Rev 2001;2:159–171.

There are consistent data to support that children have the ability to self-regulate the amount of food or energy consumed in unrestricted conditions. The energy needs of children differ from those of adults as a function of their gender and rate of growth, particularly during adolescence.

Birch and colleagues have performed studies revealing that children can adjust their energy intake, both in short-term single-meal protocols, and over 24-hour periods [8–10]. Children younger than 2 years may have some innate ability to self-regulate their intake by responding to internal cues for hunger and satiety. As children get older, these internal cues appear to be overridden by external factors, leading them to overeat in an environment that offers numerous opportunities to garner large portions of palatable food.

1.2 Influence of Family Life

Let us consider an example:

Mehdi, 12, has been referred by his school doctor as obese (187 pounds for 5.4 ft). He is the second in a family of four children. The eldest is very athletic and very thin, and the youngest are rather plump. Parents own a grocery store and come home late at night. The children are alone at dinnertime. The home is full of food, and children often come to look for dishes ready to be consumed in the store.

Everyone eats when and what he or she wants, often in his or her room watching television at the same time. This family is in danger. It does not seem possible to put Mehdi on a diet. However, one can try to help the family create a ritual of regular meals and planned menus.

Children's dietary patterns are central in the development of excess weight. Excess caloric intake will result in the storage of energy as fat [3, 4]. A preference for energy-dense foods may serve as a risk factor in becoming overweight if consumption of these foods leads to excessive fat and energy intake. Conversely, a preference for fruits and vegetables may serve as a protective factor. But the relationship between a preference for fruits and vegetables and a child's weight status has not yet been demonstrated [3].

The actual environment has been conceptualized as “obesogenic,” promoting excessive food intake and sedentary behavior in many individuals. Research in adults has shown that there is a wide degree of interindividual variability in tolerance of overfeeding. Some research implicates poor self-regulation training when a child is overweight. Children who are predisposed to obesity may be more susceptible to the effects of excessive energy intake than children with no familial history of obesity [11–13].

Moreover, there is evidence of an association between larger portions and greater energy intake. Some authors found a link between meal portion size and increased body weight in children. The degree to which children are usually exposed to large portions may be the key for understanding the implication of portion size in overweight children [14, 15]. Parents tend to judge portion size based on their belief about a child's appetite and are further influenced by the nutritional status of the given food [16]. It has been demonstrated that a reduction of portion size and eating rate is associated with Body Mass Index Standard Deviation Score (BMI-SDS) reduction in overweight and obese children and adolescents [17]. Parents play a central role in determining how much food is given, especially when they eat the same meals at the table with the whole family. All of these considerations can help clinicians understand the child obesity epidemic.

1.3 Importance of C...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• Contributors
• Preface
• Part I: Epidemiology and Prevalence
• Part II: Pathophysiology
• Part III: Psychological and Behavioral Factors
• Part IV: Consequences
• Part V: Prevention and Treatment
• Part VI: Commentary and Recommendations
• Part VII: Health Policies and Interventions
• Index