8 months ago

Childhood Obesity 

Obesity is defined as an abnormal or excessive accumulation of body fat that can be harmful to a person’s health. It is classified as a chronic disease that can lead to numerous pathologies such as diabetes, hypertension, heart disease and many more. Over 17% of children in france are overweight, of which 5% are obese. 

How is obesity determined in children?

It is particularly difficult to identify wether children are overweight or obese with the naked eye. BMI tests (waist circumference or body weight curve) are used to determine how overweight a child is. BMI is calculated by dividing the weight in kilos, divided by the height in metres squared. However, the interpretation of these results will be different. For instance, a 10 year old child with a BMI of 23 kg/m2 determines the child is overweight.

BMI in children is categorised into 3 phases: 

  1. Between 0 and 12 months : BMI increases due to weight gain in infants.
  2. Between 1 and 6 years : the child becomes thinner, therefore the BMI decreases.
  3. From 6 years to adulthood : Increase in BMI due to a rebound in adiposity

In addition to BMI, the body shape curve is also used to determine how overweight a child is. This is based on the height, weight, age and sex of the child. This curve should be monitored by a doctor at least twice a year to ensure that there isn’t a sudden increase in the child’s weight. 

Some small but essential advice: the 1st 1000 days of a child’s life are crucial, which is why it is essential to track children’s weight in order to prevent obesity!

What does adiposity rebound correspond to?

Once children reach the age of 6, adiposity rebound may start and can be observed on the body weight curve of the child. During this period, a very small percentage of the child’s total mass is fat, and this instance is when children will start to gain more fat mass. If this phenomena occurs before the normal age, we would now have an early adiposity rebound, and the concerned children could be predispositioned to develop obesity or to becoming overweight, due to an abnormally high intake of food at an early age. 

Determinants linked to obesity/overweight in children 

Obesity is usually caused by an increase in food intake and/or a decrease in energy expenditure. For the past several years, we have seen the average energy expenditure in children decrease. This is strongly correlated to the abundance of games on consoles and computers, as well as the introduction of mobile phones. Children release less energy whilst interacting with these electronics and also tend to snack whilst doing so. 

In addition to consuming excess calories, a sedentary lifestyle, genetics, and other factors can also influence weight gain and obesity, such as psychological factors, socio economic difficulties, lack of sleep etc. Pregnancy can also play a role, as mothers tend to gain weight during this stressful period, as well as the father! Poor nutrition, gestational diabetes and smoking during this period can also have an impact on the child’s health. 

Are you aware of the different parenting styles and how they affect eating habits?

There are several different parenting styles: 

  • Authoritarian style: children are expected to obey parental demands, without discussion. There is limited affection within the family. In the area of nutrition the child has no ability to regulate their own intake of food. They are forced to finish their plates, or eat what they are given to eat, which impairs the knowledge of their own preferences and metabolism.
  • Neglectful style: children are free to act as they please, education is neglected and have little to no rules. As far as food is concerned, in general few fruits and vegetables are eaten, and lots of snacking is permitted.
  • Democratic style: General rules are set by the parents, as well as a framework for life. The children are still allowed to live, and benefit from an emotionally supportive environment. This is the most recommended parenting style, and usually favours a healthy diet. fruits , vegetables and other produce known to have good nutritional value: a balanced diet.
  • Permissive style: Parents educate their children and provide an abundance of affection and freedom. In terms of diet, children who are raised with this parenting style tend to eat little food of good nutritional quality.

In addition to the impact on the child’s diet, the parenting style influences children’s personalities. It is a key determinant of school performance, social relationships, psychology, self confidence and their whole lifestyles. 

What are the consequences on the child’s health?

Some of the consequences of being overweight and obesity in children are negligible, however others have shown to have a huge impact on mental and physical wellbeing and behaviour of the child. 

Firstly, elevated health risks are a main concern as they can appear in childhood and follow through to adulthood. These include sleep disturbances, shortness of breath, asthma, high blood pressure, insulin resistance leading to diabetes, high cholesterol, heart abnormalities and more. 

The impact on the child’s mental health often goes unnoticed, but should not be ignored as it can lead to mental health issues, low self esteem, anxiety and teasing and bullying. 

How can you reduce a child’s weight? 

  After a child is diagnosed as being overweight or obese by a doctor or dietician, dieting may not be the solution to achieve weight loss. Weight maintenance is sufficient to reduce the weight curve and BMI of children, as they are still growing. Eating behaviours brought on by parents’ influence is one of the major issues in weight stabilisation for children. Parents must take responsibility and teach their kids and themselves better eating habits by focusing on balanced diets and also by doing more physical activities. This is essential for children’s physical and mental wellbeing.

Lorine TRAMEAU
Nutritional Engineer at Nutrimis