Childhood overweight and obesity have become the first non-infectious disease in history. This is a real epidemic affecting both industrialized and developing countries. The World Health Organization is currently prioritizing its prevention and management as a priority in the field of nutritional pathology.

Nearly 43 million children under five are overweight or obese. All are exposed to intensive marketing of products that are too rich in fat, sugar or salt.

Childhood overweight and obesity do not just affect the appearance of children; it has serious consequences for their health and well-being. People who are obese are more likely to suffer from health problems. Childhood overweight and obesity are also associated with psychosocial problems such as poor self-esteem and depression.

From a medical point of view, obesity is an “excess of fat leading to health disadvantages”. Certainly, you have already heard of gynoid or android obesity.

We talk about gynoid obesity when the excess fat is mainly in the thighs as is usually the case in women (“saddlebags”).

We talk about android obesity when fat deposits are mainly in the stomach (equivalent to abdominal obesity).

Although some people do not know it, there is a little difference between “overweight” and “obesity”.Overweight and Obesity

I – Childhood Overweight and Obesity

Definition. Overweight and obesity are defined as an abnormal or excessive accumulation of fat that poses a health risk.

*** Measuring Childhood Overweight and Obesity

Obesity is defined by a Body Mass Index (BMI) or Body Mass Index (BMI). BMI is calculated by dividing the person’s weight by the square of his height (Kg / m2). If this index is greater than or equal to 30, the individual is considered obese.

Not to mention the measurement of waist circumference

The measurement of the waist circumference makes it possible to identify an excess of fat at the level of the belly.

When waist circumference is greater than 90 cm in women (outside of pregnancy) or 100 cm in men, abdominal obesity is considered.

Abdominal obesity is associated with an increased risk of diabetes, hypertension, hypertriglyceridemia, and vascular disease.

Waist Measurement Method

– Take a meter of a seamstress

– Stand up, feet slightly apart, weight distributed on both legs

– Take the measurement by placing the meter at the level of the navel

– Do this measurement during a gentle exhalation.

*** How Does One Assess the Body Fat of an Adult / Youth?

Body fat is measured by calculating the Body Mass Index (BMI), which takes into account weight and height. It is obvious that a person weighing 100 kilos is not the same size if it measures 1,60m or 1,80m !!

– Calculate your BMI.

The value of the BMI makes it possible to determine a state, a reflection of “body size”: normal, childhood overweight and obesity. BMI = Weight in kilograms / (height in meters)2.

– Interpretation of the result:

BMI = between 18.5 and 25 (normal)

BMI = between 25 and 30 (overweight)

BMI = more than 30 (obesity).

Warning:

These values are valid neither in the child nor in the old subject (beyond 70 years).

Note:

It is difficult to develop a simple index that measures childhood overweight and obesity in children and adolescents as their body undergoes a number of physiological changes as they grow.

In a growing child, things are more complicated. To aid diagnosis, weight curves have been created to compare the BMI of a small child with that of children of the same age and gender.

Practice: The curves of corpulence can be downloaded from the website of the National Institute for Prevention and Health Education (INPES) here.

II – Causes of Childhood Overweight and Obesity

The main causes of the increase in childhood overweight and obesity are a change in diet with increased consumption of energy foods high in fats and sugars but low in vitamins, minerals and other healthy micro-nutrients, and a trend the decrease in physical activity.

In children as in adults, the development of obesity results from a prolonged positive energy balance (calorie or energy intake is greater than expenditure). The reasons are multiple and intricate, under the influence of complex nutritional, genetic, metabolic, psychological and social influences.

Nutrition plays an important role in the course of growth. The abundance of attractive foods, high in fat and fast sugars, boredom, emotional problems and/or school will cause a child to seek compensation in food, which can lead to a prolonged imbalance between contributions and expenses, and the childhood development of overweight.

Childhood overweight and obesity are associated with an increased risk of premature death and disability in adulthood. Several factors help explain childhood overweight and obesity.

1 – Genetic Factors

They have an undeniable role but are not the only ones responsible. A small number of genes would have a significant impact on body size and the percentage or regional distribution of body fat.

Overweight children over the age of 10 with at least one obese parent have an 80% chance of becoming obese in adulthood versus 10% risk if both parents are lean.

2 – Endocrine Factors

Hormonal, glandular disorders.

3 – Medical Factors

In the case of most noncommunicable diseases caused by obesity, the risks depend in part on the age at which obesity appeared and its duration.

Obesity is a major risk factor associated with the following diseases:

* Hypertension

* Noninsulin-dependent diabetes mellitus type II

* Cardiac diseases (especially heart disease and stroke)

* Greater risks for certain types of cancer (endometrium, breast, and colon).

* Increased levels of cholesterol and insulin

Obstructive sleep apnea

* Osteoarthritis

* Infertility

* Venous insufficiency

* Gastroesophageal reflux

* Urinary incontinence

* Asthma attacks

* Failure in glucose tolerance

* Problems with bones and joints

* Non-alcoholic fatty liver disease

* Kidney problems

* Polycystic ovary syndrome.

4 – Environmental Factors and Behavioral Changes

Junk food. With a diet too rich (high-fat food). Western populations tend to consume fewer calories and fewer fats as they grow steadily. This is explained by a change in lifestyle that is becoming more and more sedentary.

Lack of physical activity. There is a real imbalance between the intake of food and that spent.

The environment acts very early and plays a decisive role in the occurrence of childhood obesity. Early identification of factors that may promote childhood overweight and obesity allows for appropriate and effective prevention.

Children are particularly vulnerable to their environment because they have less control over it. They have little control over how they move and what to feed them. Children often have the same eating habits as their parents and the same physical activity habits – this is one of the reasons why obesity and obesity-related problems seem hereditary.

The problem with children, even more so than adults, is that they do not know how to measure the nutritional qualities of the foods they eat, or even how they consume them. As soon as they are old enough to open the cupboard of the kitchen and to seize a package of chocolate cakes alone, the risk of an uncontrolled and sometimes totally uncontrolled diet is very often a source of childhood overweight and obesity.

Growing up, it is often the following scenario: nibbling outside meals and in front of the television or the computer (for the older ones), sedentary life with its procession of modern comforts, the elevator instead of the stairs, the car instead of walking … And here is the child on the dangerous slope of obesity.

There are other environmental factors that come into play as well. Growing evidence suggests that the environment in the womb helps to program a child’s metabolism. Gestational diabetes exposure and maternal obesity, high birth weight, and intrauterine growth retardation, which is followed by rapid catch-up growth, are all associated with obesity later in life. In contrast, breastfeeding during childhood may reduce the risk of obesity. This is also the case with other health practices, such as getting enough sleep and eating when the appetite dictates.

III – Who to Contact in Case of Childhood Overweight or Obesity?

The attending physician. GPs and pediatricians are becoming more aware of the surveillance of childhood overweight and obesity.

Psychological doctors and school nurses. They can also help to review eating behaviors at home and the lifestyle of the child.

MCP services (maternal and child protection). They are particularly useful for low-income families, the first affected by childhood overweight and obesity.

When the doctor evaluates a child, he must make sure that he does not suffer from another problem, such as a genetic disorder, endocrine disease or neurological damage. Many medications, such as steroids and antidepressants, can also contribute to weight gain and make weight loss more difficult.

IV – Prevent the Epidemic of Childhood Overweight and Obesity

Childhood overweight and obesity, as well as the noncommunicable diseases that accompany them, are largely preventable.

Prevention is the best way to stop the childhood obesity epidemic. The goal of the fight against childhood overweight and obesity is to achieve an energy balance that can be maintained throughout the life of the individual.

Understanding what constitutes a healthy weight and knowing how to maintain that weight is a process that should begin during pregnancy and continue throughout life.

Healthy family habits include consuming foods that are more nutritious and lower in fat and sugar; have a regular breakfast do more physical activity; watch less television; to sleep sufficiently, and breastfeed. It is also important to respect children’s natural appetite for the amount of food they eat, especially when they are very young. Dieting and force-feeding do not respect the child’s natural signs of hunger and satiety and often result in higher calorie intake. A balanced diet with four meals a day, the snack allowing to wait until the evening meal.

1 – The Four (4) Rules to Lose Weight and Feel Better of the “Papillote” Method

Dr. Vincent Boggio from the University Hospital of Dijon has developed a method for parents and their overweight child.

(1) Do not refill yourself.

(2) Eat only during meals.

(3) Walk 30 minutes a day.

(4) Never be alone at home.

These 4 rules are simple and must be respected to the letter. No difference is allowed. Do not try to “limit” or “avoid”, but strictly follow all 4 instructions, and routinely every day. The child must be helped by his parents, but must also understand the rules and the impossibility of derogating from them. In return, no food is prohibited or conversely imposed.

2 – Some Tips for Eating Healthy and Balanced

* Avoid skipping meals, especially breakfast.

* Try to include foods from three or four food groups (bread and cereals, fruits and vegetables, meat and alternatives, milk and dairy products) in each meal. Plan meals and snacks to include a variety of nutritious and tasty foods.

* Limit portion size of snacks (maximum 1 to 2 snacks a day.) Choose fresh fruit and yogurt or cheese, muffin or cereal and milk, half a sandwich, crackers, and cheese.

* Let the child savor his favorite foods in moderation without feeling guilty. Choose low-calorie snacks (maximum 1 to 2 snacks a week).

* Avoid eating anything other than fruit after dinner so that the child is hungry at breakfast.

* Choose drinks without sugar. Avoid regular soft drinks, juice, fruit drinks and regularly scented waters. Any sweet drink should be considered solid food.

* In parallel, monitor the intake of omega-6, which is consumed in excess, compared to omega-3. This imbalance seems to be one of the factors explaining the increase in childhood overweight and obesity. It is enough simply to reduce the consumption of the principal vectors: sunflower oils and grape seeds, but especially industrial preparations and commercial cakes.

3 – Encourage Physical Activity of the Child

Childhood overweight and obesity can come from a poor diet but also a lack of physical activity. For this reason, it is important to check that the child does not spend too much time watching television or video games.

Walking is the most natural activity of the child. He must, therefore, accumulate a minimum of 30 minutes of walking per day. In parallel, he can watch TV or play games on the computer, at the discretion of his parents, of course.

Physical activity is just as important as calorie intake. Children (and adults too) need to be more active, not only to control their weight but for their overall health and well-being.

– Encourage the child to perform vigorous physical activity for 20 to 30 minutes, four to five times a week (after consultation with the pediatrician.)

– Choose a variety of activities that the child likes to practice.

– Choose activities that can be practiced near the house, such as walking, cycling, dancing or playing outdoors.

– Limit television, video games, and computer games to 1 or 2 hours a day. Most doctors recommend less than two hours a day. If necessary, take the TV out of the child’s room to limit use. A study shows that children who have a TV in their bedroom watch nearly five hours of TV more than those who do not.

– Set a good example – be active with the child.

Several parental principles should be applied to correct eating and physical activity behaviors.

Diet, physical activity and behavioral changes are most effective when the whole family is involved.

*** Find Reasons to Congratulate the Child on His Behavior

– Offer rewards for positive behavioral changes. Never offer food as a reward.

– Establish fixed times for meals and snacks.

– Determine what foods are available and when. Let the child decide whether to eat or not.

– Offer only healthy choices.

– Remove the temptations.

– Give the example.

– To be constant.

In conclusion, parents and children are involved and together they will gain weight loss and enjoy new well-being.

4 – The Reduction of Childhood Overweight and Obesity Will Require a Global Effort

Addressing the child obesity epidemic requires sustained political commitment and the collaboration of many public and private stakeholders.

Governments, international partners, civil society, NGOs and the private sector have vital roles to play in creating healthy environments and ensuring that healthy food options for children and adolescents are affordable and easily accessible.

* Develop comprehensive health education programs that address topics such as healthy living and healthy eating, including physical education classes.

* Develop community initiatives such as nutrition education in grocery stores and restaurants, creating community gardens and walking trails, and improving neighborhood safety.

* Plan land use planning and transportation to encourage active transportation such as walking and cycling, instead of reliance on automobiles.

* Adopt tax options such as property taxes that discourage sprawl and a “discouragement tax” on foods with high heat content and low nutrient content.

* Regulate the advertising surrounding junk food and other high calorific foods and the marketing of these foods.

* Provide better income support for low-income families, which will reduce food insecurity and encourage healthier choices.