Childhood obesity and overweight are one of the most alarming public health challenges in the 21st century. It is no longer news that obesity is not only a thing of the developed countries but a common phenomenon across the different social strata in the low and middle income countries as well. However, obesity is now a common upsurge among children as well. Over the last three-decade overweight and obesity has demonstrated a time trend of a rapidly growing epidemic.

What is obesity and overweight in Children

To ascertain whether a child is overweight or obese is by either calculating the child’s body mass index (BMI), checking the BMI- for- age value or plotting the Child’s BMI on a BMI-for-age percentile graph because the internationally acceptable measure and cut-offs for overweight and obesity in children were developed by the World Health Organization (WHO), the Centre for Diseases Control and Prevention (CDC), and the International Obesity Task Force using percentiles and BMI.

To calculate the body mass index, BMI= Weight/(Height)2 (weight in Kg and height in metres) while the percentile can be calculated by plotting the child’s BMI on the BMI-for-age percentile graph (see the graph below)

According to the World Health Organization (WHO) criteria for children and adolescents (ages 5 – 19 years) limits of ≥ 1 SD and ≥ 2 SD defines overweight and obesity respectively. The CDC defines overweight as percentile between the 85th – 94th percentiles and Obesity as percentile > 95th percentiles while the International Obesity Task Force defined overweight and obesity as percentile curve passing through body mass index (BMI) of 25 kg/m2 and 30 kg/m2 at age 18years respectively.

FACTORS THAT CONTRIBUTES TO CHILDHOOD OVERWEIGHT AND OBESITY

1. Gender/ Gender roles: In Sub Saharan Africa(SSA) increase in overweight or obesity is recorded among the females and a possible explanation can be as a result of the different roles played by each gender as well as the cultural perception of overweight or obesity as an admirable trait in females.

2. Poor physical activity: Physical inactivity of children is associated with overweight and obesity. Most children now majorly engage in indoor activities for example: internet, video games and television viewing and this does not allow for energy balance as the energy accumulated is not expended.

Causes of Inactivity in Children

a. Laudable emphasis on academic excellence at the expense of extra-curricular activities has crippled physical activities in homes and schools

b. Urbanization/ industrialization of communities which has led to the lack of open play space in communities and schools

c. Pandemic: Pandemic situations such as COVID-19 led to lockdown for months this in itself has the potential to increase children’s weight gain. Check: COVID-19 restrictions: Potential for increased obesity in children.

3. Poor Diet: The noticeable shift from the consumption of healthy traditional foods to the high- calorie, sugary and saturated fat filled westernised foods also contributed to the increase in the prevalence of overweight and obesity among children. The diets are filled with refined carbohydrates, saturated fats, highly sweetened carbonated beverages with low polyunsaturated fatty acids and fibres contents. This has the potential to predispose children to metabolic syndrome, type 2 diabetes, obesity and various coronary artery diseases.

4. Socio-economic status: Children of high socio-economic level are more prone to overweight and obesity compared to those of low socio-economic level in Sub Saharan Africa (SSA) probably due to increased sedentary lifestyles and increased accessibility to high-calorie diets which are more affordable to children of high socioeconomic levels.

5. Maternal factors: Diverse maternal factors/ conditions play a significant role in the development of childhood overweight and obesity in SSA. Overweight or obese mothers has a higher tendency of giving birth to an overweight/obese child.

Maternal educational level has also been seen to be a contributory factor in that, children whose mothers have no formal or primary education has been shown to have a higher chance of being overweight or obese possibly due to their poor knowledge on high-caloric diets.

THE DANGERS OF OVERWEIGHT AND OBESITY IN CHILDREN

Overweight and obesity are the major risk factors for childhood non-communicable diseases especially cardiovascular diseases as well as early and accelerated atherosclerosis, obstructive sleep apnea, atherogenic dyslipidaemia, metabolic syndrome, hypertension and type 2 diabetes mellitus. It has the potential of causing a long lasting problem in adulthood if not properly managed in childhood. It can result into cardiovascular, metabolic, malignant, psychological difficulties as well as premature death

Conclusion

Interventions in homes, schools, communities and the nation at large to curb the burden of childhood overweight and obesity in sub-Saharan Africa should focus on modifying the gender roles, encouraging physical activity, consumption of healthy diets and improving maternal (female) education. Furthermore, the ministry of education should be encouraged to incorporate a compulsory physical activity and healthy diets module in school curriculum.

REFERENCES
Berenson GS., et al. “Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogulasa Heart Study”. The New England Journal of Medicine 338.23 (1998):1650-1656.

Berenson GS., et al. “Atherosclerosis of the aorta and coronaryarteries and cardiovascular risk-factors in persons aged 6 to 30 years and studied at necropsy (The Bogalusa Heart Study)”. American Journal of Cardiology 70.9 (1992): 851-858.

Berenson GS., et al. “Obesity and cardiovascular risk in children”. Annals of the New York Academy of Sciences 699 (1993): 93-103.

Butte NF., et al. “Evaluation of the feasibility of international growth standards for school-aged children and adolescents”. Journal of Nutrition 137.1 (2007): 153-157.

Cole TJ., et al. “Establishing a standard definition for child overweight and obesity worldwide: international survey”. BMJ 320 (2000): 1240-1243.

Cowan P., et al. “Cardiovascular Risk Factors Increase with Obesity Severity in African American Youth with and without type 2 Diabetes (T2DM)”. The American Journal of the Medical Sciences 331.2 (2006): 61-62.

Flegal KM., et al. “High adiposity and high body mass indexfor-age in US children and adolescents overall and by raceethnic group”. The American Journal of Clinical Nutrition 91.4 (2010):1020-1026.

Freedman DS., et al. “The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study”. Pediatrics 103.6-1 (1999):1175-1182.

Fruhstorfer BH., et al. “Socio-economic status and overweight or obesity among school-age children in sub-Saharan Africa – a systematic review”. Clinical Obesity 6.1 (2016): 19-32.

Wellens RI., et al. “Relationships between the Body Mass Index and body composition”. Obesity Research 4.1 (1996): 35-44.

WHO [homepage on the Internet] Child growth standard (2006).

WHO. World Health Statistics (2017).

 

This Post Has 7 Comments

  1. Anonymous

    Wow, eye opening write up

  2. Tanimowo Adegboyega

    Nice write up

  3. Tanimowo Aramide

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  5. Tanimowo Adeoye Joseph

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