Childhood Obesity: An overview
- Kaylee
- Jun 16, 2019
- 5 min read
Updated: Jul 2, 2019
Introduction
There are many factors that influence a person's health. Obesity has become a huge issue around the world and especially in North America. Childhood obesity is an even larger issue, as it affects the future population and is linked to many health problems. The most important to note is that "childhood obesity tracks to adulthood and is associated with increased risk of cardiometabolic disease and premature mortality" (Reilly & Kelly, 2011).
Childhood obesity can be linked back to biological concerns within the family and especially parental obesity. It can be linked to behavioural issues and specific social interations. These combined can be linked to exposure through gestation, childhood, adolescence and eventually adulthood. As the image above shows, a lack of physical exercise is a large contributer to childhood obesity - but the factors that go into this can be biological, behavioural or social. This can also be said for what the child is eating.
In the field of medical radiation technology, 'as low as reasonably achieveable (ALARA)' radiation dose and diagnostic quality images are the priority. When obese patients are being imaged, it is a fine line between achieving diagnostic quality images and keeping patient dose low. In some morbid obese cases, diagnostic quality images are not achieveable at all even with increased doses. There is also a fine line with injection of contrast agents, especially in patients with reduced kidney function. Obese patients generally need a higher volume of contrast but tend to have reduced kidney function (due to diabetes, or other comorbidities). There needs to be a specific volume of contrast based on patient size for it to highlight well on the CT scan, but the patient's kidney function should not be reduced further. Aside from the specific effects to a medical radiation technologist, the increase in diseases linked to obesity put a further strain on the Canadian Health System.
A Multilevel Perspective
From a multilevel perspective, childhood obesity as a whole can be linked to many factors. Over-eating, or eating the wrong foods, are not the only causes of childhood obesity - and that stigma must end.
The life course epidemiology approach"examines biological, behavioral, and social pathways that link exposures during gestation, childhood, adolescence, and adult life, and across generations, to influence health and health inequalities in later life." (Ben-Shlomo, Mishra & Kuh, 2015)
The critical period model refers to a time "when an exposure acting during a specific (sensitive) period has lasting or lifelong effect on the structure or physical functioning of organs, tissues and body systems, which are not modified in any way by later experience, and which results in disease later" (Kuh & Ben-Shlomo, 2004). Prolonged childhood obesity as whole has an impact on this critical period, as childhood obesity is linked to several adult diseases. "Hyperlipidemia, hypertension, and abnormal glucose tolerance occur with increased frequency in obese children and adolescents" (Dietz, 1998). It is important that parents and caregivers are educated on how to keep their children healthy.
The home environment is a very important link to childhood obesity. A parent/caregiver can influence their child without even noticing it. Over-eating due to incorrect portion sizing, not eating balanced foods, and inactivity are all factors. "The home environment is a critical factor in the development of childhood obesity" (Strauss & Knight, 1999). This healthy environment is made by parents and caregivers, and without it, children will overeat and underexercise, leading to obesity - which then can lead to many other issues for children such as bullying.
Socioeconomic status is also a factor linked to obesity among men, women and children. Put simply, it is much cheaper to eat 'unhealthy' than it is to eat clean, organic, farm fresh foods. Families with higher income are proven to have less likelihood of obesity (Strauss & Knight, 1999)
The table below from Strauss and Knight's 1999 study shows socioeconic factors and their cumulative incidence percentage compared to a reference group.
The same study completed by Strauss and Knight in 1999 concludes "that children raised in environments with high levels of cognitive stimulation have the lowest rates of developing obesity independent of socioeconomic factors, race, maternal marital status, or maternal BMI." They recommend that future parents encourage more stimulating home environments as a solution to childhood obesity.
Using a social-ecological model, health care professionals must focus on enhancing support from media sources, strengthening community context, and bolstering personal and parental self-management to combat childhood obesity. The video below from England demonstrates how anyone can help to combat childhood obesity through the entire life-cycle. The video is directed at health-care professionals, but can be used by anyone to learn.
A psychosocial approach to childhood obesity should take into consideration the social-ecological model. A combination of these two models shows a very in depth multilevel approach to childhood obesity. "The potential strain on the body because of stressors is particularly important to consider for children, who are still developing biologically, cognitively and socially" (Gundersen, Mahatmya, Garasky & Lohman, 2011). It is becoming more and more well known that mental health is correlated with low-income families, which then connects to increased stressors in both adults and children. The psychosocial categories in household level include events and conditions such as "parental divorce, poor parental marital quality, poor parental mental health, chronic physical health conditions of family members, domestic violence, child abuse and general relationship strain amongst family members." (Gundersen et al, 2011). On an individual level, risky behaviours and poor mental health should also be considered. "These physical health reactions to stressors have also been linked to weight gain in children via direct metabolic changes and maladaptive coping behaviours, such as lack of exercise and over‐eating" (GUNDERSEN ET AL)
Interestingly enough, the most recent documents on the Government of Canada's website regarding the issue of childhood obesity date back to 2012. Ontario specific plans and documents all date back to 2011-2013.
A full detailed plan for Canada from 2012 can be found here:
Ontario's plan from 2013 can be found here:
It is important to note, however, that Canada did finally update the Food Guide this year.
References
Ben-Shlomo, Y., Mishra, G., & Kuh, D. (2014). Life Course Epidemiology. Handbook of Epidemiology,1521-1549. doi:10.1007/978-0-387-09834-0_56
Chandola, T., & Marmot, M. (2005). Social Epidemiology. Handbook of Epidemiology,893-916. doi:10.1007/978-3-540-26577-1_23
Cohen, S., Janicki-Deverts, D., Chen, E., & Matthews, K. A. (2010). Childhood socioeconomic status and adult health. Annals of the New York Academy of Sciences,1186(1), 37-55. doi:10.1111/j.1749-6632.2009.05334.x
Dietz, W. H. (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101(3 Pt 2), 518–25. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12224658
Glymour, M. M. (2014). Policies as Tools for Research and Translation in Social Epidemiology. Social Epidemiology,452-477. doi:10.1093/med/9780195377903.003.0012
Gundersen, C., Mahatmya, D., Garasky, S., & Lohman, B. (2011). Linking psychosocial stressors and childhood obesity. Obesity Reviews,12(5). doi:10.1111/j.1467-789x.2010.00813.x
Jacob, C. M., Baird, J., Barker, M., Cooper, C., & Hanson, M. (2017). The Importance of a Life Course Approach to Health: Chronic Disease Risk from Preconception through Adolescence and Adulthood. World Health Organization. Retrieved from https://www.who.int/life-course/publications/life-course-approach-to-health.pdf.
Kuh, D., & Ben-Shlomo, Y. (2004). Introduction. A Life Course Approach to Chronic Disease Epidemiology,3-14. doi:10.1093/acprof:oso/9780198578154.003.0001
Liberatos, P., Link, B. G., & Kelsey, J. L. (1988). The Measurement Of Social Class In Epidemiology. Epidemiologic Reviews,10(1), 87-121. doi:10.1093/oxfordjournals.epirev.a036030
Mcbride, K. A., Ogbo, F., & Page, A. (2019). Epidemiology. Handbook of Research Methods in Health Social Sciences,559-579. doi:10.1007/978-981-10-5251-4_91
Meara, E. R., Richards, S., & Cutler, D. M. (2008). The Gap Gets Bigger: Changes In Mortality And Life Expectancy, By Education, 1981–2000. Health Affairs,27(2), 350-360. doi:10.1377/hlthaff.27.2.350
Osypuk, T. L., Kehm, R., & Misra, D. P. (2015). Where We Used to Live: Validating Retrospective Measures of Childhood Neighborhood Context for Life Course Epidemiologic
Studies. Plos One,10(4). doi:10.1371/journal.pone.0124635
Phillips, C. M. (2017). Metabolically healthy obesity across the life course: epidemiology, determinants, and implications. Annals of the New York Academy of Sciences, 1391(1), 85–100. https://0-doi-org.aupac.lib.athabascau.ca/10.1111/nyas.13230
Pollock, J. (2009). Methods in Social Epidemiology. Journal of Public Health,31(2), 303-304. doi:10.1093/pubmed/fdp023
Public Health Agency of Canada. (2018, February 21). Government of Canada. Retrieved from https://www.canada.ca/en/public-health/services/publications/healthy-living/obesity-excess-weight-rates-canadian-children.html
Reilly, J.J. & J. Kelly. 2011. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int. J. Obes. (Lond.) 35: 891–898.
Sobal, J., & Stunkard, A. J. (1989). Socioeconomic Status and Obesity: A Review of the Literature. Psychological Bulletin. doi:10.1037/0033-2909.105.2.260
Comments