Child Obesity – An Old Foe in the New Era

Opinion piece by: Edwin Hlangwani

Department of Biotechnology and Food Technology, University of Johannesburg

In all his wisdom the ancient Greek physician, Hippocrates, immortalized, “Let food be thy medicine, and let?medicine be thy food.” Today, food is less of a medicine and more of a drug. Recent statistics from the World Health Organization (WHO) overemphasize this fact. According to the report, over 340 million children and adolescents aged 5 – 19 were?obese in 2016, and 39 million children under the age of 5 were overweight or obese in 2020.

Obesity, which is an excessive amount of body fat sufficient to impair health, is attributed to imbalances between energy consumption and expenditure. Adopted lifestyle and dietary preferences, and recently the rise of technology misuse lead to excess energy (positive energy balance). Other child obesity risk factors include sedentary behavior and physical activity. However, these risk factors are moderated by genetics (ghrelin secretion, leptin and insulin sensitivity), gender, age, parenting styles and parents’ work-related demands, demographics, stress, socioeconomic disparities, cultural practices, and existing public policies. Within this context, child obesity is a critical health challenge that continues to plague nations across the world. Child obesity is associated with several health issues, including type-2 diabetes, metabolic syndrome, hepatic steatosis, glucose intolerance and insulin resistance, respiratory illnesses, impaired balance, cardiovascular disease, cholelithiasis, menstrual abnormalities, and sleep apnea.

Child obesity has also been linked to psychosocial conditions such as depression and anxiety, aggression, conduct and peer troubles, physical and verbal abuse, eating-related pathology, and body dysmorphia.

Given the substantial healthcare costs, child obesity is an economic burden to public health institutions. Recently, the long-term social consequences of obesity have also been brought to light. Children who struggle with obesity are often socially stigmatized (i.e., teased and bullied) which can lead to low self-esteem and social isolation. Despite being often overlooked, it is clear that child obesity is a global health challenge that needs urgent attention. In this case, “prevention is better than cure” is the most appropriate approach.

First, there needs to be a deliberate effort from the government, the private sector and families to promote healthy lifestyles to children. Through community engagement, physical activity and healthy eating initiatives in the form of local sports clubs, sporting events and tournaments, outdoor activities, park funfairs, support groups for families struggling with weight management, and community gardens must be encouraged. Since children learn best by observing and impersonating adult behaviour, this will require participatory commitment from parents. Physical education—a subject scarcely available at public schools in developing countries must be at the forefront of teaching and learning at schools. In line with this strategy, nutritional education programs must be implemented focused on reading and understanding food labels, the importance of balanced diets, healthy eating habits (making healthier food choices),?and portion control. This must go beyond educational programs, but be a precursor to the incorporation of healthy food options into the feeding ecosystems of schools. Plant and high-protein insect-based options are now understood to be practical alternatives to ultra-processed, high-calorie, low-nutrient foods currently served at school cafeterias.

Lastly, holistic wellness programs such as mental health support, counselling services, and regular health check-ups must be integrated into the school curriculum. This strategy will only be effective when followed by strict policy regulations on food marketing targeting children. The promotion of healthy food options at vending machines, school cafeterias, and convenience stores must be incentivised through subsidies and tax breaks. Relevent government authorities should enforce policies that limit the advertising of high-fructose, high-calorie foods to protect children from persuasive marketing tactics. This is because promotion and frequent exposure to healthy foods within a supportive and encouraging environment are important for fostering positive associations and counteract initial aversions, leading to the development of healthy eating habits. Achieving these positive associations can be further reinforced by appropriately employing technology. Promoting educational mobile applications and games that encourage physical movement can be powerful tools.

The success of the Pokémon GO mobile game and the Wii home video game console is evidence that technologies such as augmented and virtual reality can be effective tools for stimulating interest in physical health. These games can be supplemented by health and fitness tracking apps such as Apple Health, Fitbit, MyFitnessPal and FatSecret to show an individual’s progress in comparison with peers, fostering ‘healthy’ competition. The final actionable solution to address child obesity is to empower families by providing resources—community nutrition workshops, free or subsidised cooking classes, etc., and support—subsidised subscriptions to farm fresh produce delivery services, support groups and peer networks, and awareness campaigns for parents to create a healthy home environment.

Parental involvement is crucial in shaping a child’s habits, and lifestyle choices, with family mealtime structures an important feature which suggests that families who eat together eat healthy balanced diets. However, to fully benefit from these strategies solutions must be tailored to fit the target population’s sociodemographic background, ethnicity, and cultural needs. From this perspective, it must be noted that combating child obesity will be an uphill battle and not just a short duel. Much remains to be done, and perhaps, once again food will be our medicine, and our medicine, food.

Supporting sources

World Health Organisation (WHO). (2021). Obesity and overweight. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight [Accessed on 15 January 2024].

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences.?Journal of Family Medicine and Primary Care,?4(2), 187-192.

Kumari, S., Shukla, S., & Acharya, S. (2022). Childhood Obesity: Prevalence and Prevention in Modern Society.?Cureus,?14(11), e31640.