Obesity is now considered the epidemic of the new millennium, whose main victims are children. Just last year, during this period, the World Health Organization launched the alarm talking about about 41 million children affected and identifying in sugary drinks and junk food the main causes of childhood obesity. So what role do snacks, poor dietary education, but also genetic predisposition play? Let’s go into it together in this article.

OVERWEIGHT AND IMC CALCULATION

Obesity is a disease characterized by an excess of adipose tissue, resulting in abnormal weight gain, which can generate several health problems. At an international level, the body mass index (imc), i.e. the ratio between weight and height, is used to identify this disease in adult patients, calculated by dividing the weight in kg by the square of the height in metres (BMI = kg/m2).

The issue is complicated with children and adolescents because the relationship between fat mass, weight and height changes physiologically over time and makes the diagnosis more difficult. However, paediatricians have suitable tools and assessment data for this type of measurement and are the specialists to refer to when talking about childhood obesity.

THE POSSIBLE DAMAGE OF CHILDHOOD OBESITY

Talking about an emergency is not an exaggeration. According to the 2014 data (sample of third class pupils of primary schools) of the Okkio Observatory on health coordinated by the Istituto Superiore di Sanità – Cnesps, in Italy:

  • 20.9% of children are overweight

  • 9.8% of obese children are obese
  • the highest prevalences are recorded in the southern and central regions

Not to mention that in 2 out of 3 cases an overweight child will become an obese adult, with consequences also for the health system, and this is not the only risk. Among the possible consequences of childhood obesity, in fact, we find:

  • problems with the respiratory system
  • accumulation of fat in the liver (steatosis)

  • osteo-articular pathologies
  • cardiovascular risk
  • increase in insulin, with possible evolution towards type 2 diabetes
  • problems with the gastrointestinal system
  • increased cholesterol and/or triglycerides and uric acid
  • psychological disorders (linked to embarrassment and shame, which can lead to isolation).

But where to look for the causes and how to intervene?

CHILDHOOD OBESITY: MULTIPLE CAUSES

The causes of childhood obesity are multifactorial and often interact with each other. In part it is a social problem, linked to a lack of nutritional education, but there is also an environmental factor, linked to lifestyles, so much so that the World Health Organization said that we live in an “obesogenic environment”, which leads people to overnourishment (evil). Without forgetting the “hereditary” component that goes back to family history. Let’s look in more detail at the different causes of childhood obesity.

FOOD AND DRINK

If it is true that “we are what we eat (so much so that there are “intelligent” foods that can protect us from many chronic diseases), it is not surprising that one of the most common causes of childhood obesity is nutrition. Snacks, sweetened drinks, fast food food and, in general, a poor dietary education of young people and their families, are the basis of the spread of this disease. The Okkio Observatory on Health in 2014 published some data on Italian eating habits revealing that:

  • 8% of children skip breakfast
  • 31% have an inadequate breakfast (i.e. unbalanced in terms of carbohydrates and proteins)
  • 52% have an abundant mid-morning snack
  • 25% of parents declare that their children do not consume fruit and/or vegetables on a daily basis
  • 41% of parents state that their children usually drink sugary and/or carbonated drinks.

SEAT

Another important risk factor, among the causes of childhood obesity, is the absence of physical activity in favour of a sedentary lifestyle. Also for this component the data speak clearly: many Italian children (and not only) do not practice sport or devote only 1 hour a week to motor activity. In addition, they spend many hours in front of video games and television (even during meals) and move very little on foot or by bicycle. Instead, sport is important at all ages and fundamental in children, not only to avoid fattening, but also to maintain a balance between lean mass (muscle tissue) and fat mass (adipose tissue).

FAMILY AFFAIRS

While environmental factors and lifestyles are among the main causes of childhood obesity, the “hereditary” aspect should not be underestimated. It means that a child with an obese parent (or both parents) has a greater risk of incurring the disease (about 25% of cases in Italy). In addition, for about ten years now there has also been talk of a possible genetic cause, or a predisposition to obesity, as evidenced in the study coordinated by the Italian Mario Falchi of King’s College in London, which links the disease to the lack of salivary amylase, a gene present in saliva necessary to metabolize starches.

After a close analysis of the causes of childhood obesity, we understand why prevention plays a very important role.

CHILDHOOD OBESITY AND PREVENTION

While about 4% of children in Europe are obese (and more than 30% are overweight), prevention is the most effective approach to tackling the problem, together with the promotion of healthy lifestyles, involving children, families and teachers.

In this regard, the Scotti Bersani Institute for Research and Scientific and Nutritional Information in Milan, in collaboration with the Italian Society of Paediatrics, has provided some important advice, especially for parents:

HEALTHY EATING HABITS FOR THE WHOLE FAMILY

  • have breakfast
  • eating as many meals as possible with the family
  • use small dishes and moderate portions
  • sharing food choices with children

  • avoid using food as a reward or punishment
  • avoid the prohibition of certain foods
  • avoid the use of sweetened beverages instead of water and with meals
  • avoid the use of fruit juices as a substitute for fruit

increase the use of fruit, vegetables, vegetables and legumes in the family’s usual diet (it is recommended to take 5 servings per day between fruit and vegetables and 3-4 times a week between legumes).

CONTROL THE USE OF TV BY CHILDREN

  • turn off the TV during meals
  • not allow TV in the children’s bedroom
  • limit TV time to no more than two hours per day
  • explain to children the real purpose of the advertisements (of snacks and other baby food)

INCREASE THE POSSIBILITIES OF PHYSICAL ACTIVITY FOR THE WHOLE FAMILY EVERY DAY

  • limit the use of computers and video games
  • increase the habit of walking together to reach school, gym, etc. instead of using the car
  • to allow the practice of sport activities pleasant and appreciated by the children, compatibly with the family’s economic resources.

As we have seen, among the most common causes of childhood obesity there are, mainly, bad family habits and sedentary lifestyle. These are factors on which it is possible to intervene by working on nutrition education and on the importance of health, in an educational pact that must involve doctors, families and schools. The Family Protection for Children policy, for example, allows, starting from a questionnaire, to structure a personalized program, supported by doctors who have an agreement with the company, that acts on diet and motor activity, thus investing in the prevention of overweight and obesity.

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