Running head: CHILDHOOD OBESITY

Problems with Childhood Obesity

Aaron Phillips &
Jennifer Cartwright
Ferris State University

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Abstract

Childhood obesity is a growing concern in the United States and around the world. Changes in
eating habits, decreased exercise, and environmental factors reflect societys growing trends in
childhood obesity. This paper explores risk factors, exercise recommendations, what has
influenced changes in eating habits, environmental influences and the nursing role. Nurses can
help parents and children by providing nutritional advice, advising on a weight management
program, offer strategies for decreasing caloric intake and increasing physical activity.

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Problems with Childhood Obesity

Childhood obesity is a growing problem in the United States and around the world. The
World Health Organization (WHO, 2004) considers childhood obesity an epidemic and a critical
health priority. Obesity in children affects more than 35 million children (under 5) around the
world (WHO, 2004). In the United States, child and adolescent obesity affect more than 12.5
million (17%) children between the ages of 219 (CDC, 2011). The growing rate of obesity
among children is a concern that warrants attention. Since 1980 obesity among children and
adolescents has almost tripled (CDC, 2011). Changes in eating habits, decreased exercise, and
environmental factors directly reflect societies growing trend toward childhood obesity.
Risk Factors
Body mass index (BMI) is the most common tool used to measure child obesity.
According to the CDC, BMI is calculated by using the childs height and weight. BMI is not a
direct measurement of body fat, but it is a reasonable indicator of body fatness for most children
and teens (CDC, 2011). A childs weight status is calculated differently than an adult. A
childs age and sex is used to classify them into a percentile used to determine weight status and
changes as they age. According to the CDC:

Overweight is defined as a BMI at or above the 85th percentile and lower than the
95th percentile for children of the same age and sex.

Obesity is defined as a BMI at or above the 95th percentile for children of the
same age and sex.

There are many consequences related to childhood obesity. According to WHO (2004),
children that are obese are more likely to be obese than adults and are at greater risks for

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developing noncommunicable diseases (NCDs) such as cardiovascular disease and diabetes at a

younger age. According to the CDC (2011) consequences of child obesity are:

High blood pressure and high cholesterol, which are risk factors for
cardiovascular disease (CVD). In one study, 70% of obese children had at least
one CVD risk factor, and 39% had two or more.

Increased risk of impaired glucose tolerance, insulin resistance and type 2

diabetes.

Breathing problems, such as sleep apnea, and asthma.

Joint problems and musculoskeletal discomfort.

Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).

Obese children and adolescents have a greater risk of social and psychological
problems, such as discrimination and poor self-esteem, which can continue into
adulthood.

Childhood obesity also places children at much greater risk for developing psychological
problems. Obese and overweight children are more likely to face peer rejection, develop selfimage problems, social isolation, anxiety, and depression (Christian, 2011). As a result of these
risk factors, obese children are at a much greater risk for developing self-esteem problems that
lead to decreased quality of life (Christian, 2011).
Exercise
Exercise has a direct effect on childhood obesity. Todays youth are spending less time
outdoors and more time inside watching TV, surfing the internet, and playing video games.
According to the CDC (2011), children ages 8 18 spend about 7.5 hours using electronic media
such as TV, computers, video games, and cell phones. Children and adolescents are

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recommended to exercise 60 minutes or more a day according to the 2008 Physical Activity
Guidelines for Americans (U.S. Department of Health and Human Services, 2008). According
to the CDC (2011), many children fall well short of 60 minutes of recommended daily activity.
The majority of the recommended daily activity should be aerobic exercise. The CDC
states, Vigorous-intensity activities should be incorporated, including those that strengthen
muscle and bone*, at least 3 times per week (2011). These activities can include sports, chores,
recreation, or planned exercise with family or school. Daily exercise is a necessity for reducing
childhood obesity. Although exercise is a vital component, it is only one link in solving the
problem of childhood obesity.
Healthy Eating
Recent dietary guidelines for Americans recommend plenty of grain products, vegetables
and fruits; moderate amounts of sugar and salt; and 30% or less of calories from fat and less than
10% of calories from saturated fat. Along with these recommendations school lunches must
provide at least 1/3 of the daily recommended dietary allowances for protein, iron, calcium and
vitamin A & C (USDA/FNS, 2013). New federal rules also set calorie maximums. For
kindergarten through fifth grades, students are allowed 650 calories a meal. In sixth through
eighth grades, the number rises to 700 calories. High school students get 850 calories per meal
(Callahan, Shoemaker-DeBree, Shrift, 2013). For schools that are following the new
recommendations a students lunch includes a choice of entre supplying protein and grain, up to
three vegetable sides, one fruit side dish and milk. Also available daily is a cold vegetable and
fruit bar (Chartwells, 2013).
In 2010, Congress reauthorized the Healthy Hunger- Free Kids Act. This Act helps
improve nutrition and focuses on reducing childhood obesity, increases access, increases

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program monitoring and integrity of the program (Whitehouse, 2010). The Healthy Hunger-Free
Kids Act focuses on reducing childhood obesity by giving the USDA the authority to set
nutritional standards, expands access to drinking water in schools, and provides additional
funding to schools that meet updated nutritional standards.
In the United States, more than 98% of the television food ads seen by children and 89%
of those seen by adolescents are for products high in fat, sugar, and/or sodium. The most
common food products advertised in most countries include confectionary, sweetened cereals,
fast food, savory snacks, and soft drinks (Harris, Pomerant, Lobstein, & Brownell, 2009).
According to the New York Times (2011), the federal government proposes new guidelines that
could push the food industry to overhaul how it advertises cereal, soda pop, snacks, restaurant
meals, and other foods to children.
The guidelines, released by the Federal Trade Commission, encompass a broad range of
marketing efforts, including television and print ads, Web sites, online games that act as
camouflaged advertisements, social media, product placements in movies, the use of
movie characters in cross-promotions and fast-food childrens meals. The inclusion of
digital media, such as product-based games, represents one of the governments strongest
efforts so far to address the extension of childrens advertising into the online
world, which childrens health advocates say is a growing problem (Neumann, 2011).
These guidelines are not mandatory but are highly recommended by the Federal Trade
Commission.
With the busy life styles that families have these days, many say they do not have time to
sit down and eat a healthy meal with their family. The alternate option is to have a meal from a
fast food restaurant. Forty percent of young children ask to go to McDonalds every week. Fifteen

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percent of preschoolers ask every day. 84% of parents say they've taken their kids for fast food at
least once in the past week (Tracy, 2010). With thousands of meal combinations that are
available within the multiple food chains there are only twelve that meet nutritional guidelines
for the 15% of preschoolers that ask every day to have fast food. Within the last couple years the
fast food chains have begun to offer healthier choices for kids meals. Looking at Wendys,
McDonalds, Subway and Burger King kids meals all come with apple slices. Some get a choice
of French fries or apple slices and in others the meal comes with both.
Environmental Influences
Many communities are built in ways that make it difficult or unsafe to be physically
active. For some families, getting to parks and recreation centers may be difficult, and public
transportation may not be available. For many children, safe routes for walking or biking to
school or play may not exist. Half of the children in the United States do not have a park,
community center, and sidewalk in their neighborhood (CDC, 2012). There are four different
types of strategies to increase physical activity that is supported by The Guide to Community
Preventive Services, Center for Disease Guide to Strategies for Increasing Physical Activity in
the Community, The Surgeon Generals Vision for a Healthy and Fit Nation, and The National
Physical Activity Plan. The four strategies are: 1) Create or enhance access to places for physical
activity; 2) Enhance physical education and activity in schools and physical activity in child care
settings; 3) Support urban design, land use, and transportation policies; and 4) Develop and
maintain a public health workforce competent in physical activity (CDC, 2010).
Some people have less access to stores and supermarkets that sell healthy, affordable
foods such as fruits and vegetables especially in rural, minority, and lower-income
neighborhoods. Supermarket access is associated with a reduced risk for obesity. Choosing

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healthy foods is difficult for parents who live in areas with an overabundance of food retailers
that tend to sell less healthy food, such as convenience stores and fast food restaurants (CDC,
2012). The Institute of Medicine in 2005 recommended that we have improved access to and
affordability of fruits and vegetables for low- income population and increase availability and
affordability of healthful foods and beverages at supermarkets, grocery stores, and farmers
markets located within walking distance of the communities they serve (Berkowitz & Borchard,
2009).
Nursing Role
A nurses approach to take towards the prevention of childhood obesity should consider a
whole range of critical factors. Nurses need to assess the level and type of prevention most
appropriate for the child, family, culture and socio-economic status, and environment. Nurses
also need access to tools that can guide them in planning and evaluating programs. The
appropriateness of any promotion or protection strategy is most effective when introduced at the
community level. Nurses in community based or public health settings may be the best
positioned healthcare professional to take action on the prevention of childhood obesity
(Berkowitz & Borchard, 2009).
Conclusion
Childhood obesity is an epidemic around the world. There are many consequences related
to childhood obesity. Hypertension, hyperlipidemia, diabetes, breathing problems, joint
problems, social and psychological problems are some of the consequences youth can encounter
due to obesity. Todays youth are spending less time on physical activity and more time
watching television, playing video games, etc. There have been recent dietary guideline changes
and recommendations for school lunches. The federal government has also proposed new

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guidelines on how food industries advertise food such as high- sugar cereal, soda pop, snacks,
and restaurant meals. Fast food restaurants have become very popular with familys busy
schedules. Some fast food restaurants have added fruit to their kids meals. Other influences that
have been studied and found to contribute to childhood obesity are: limited access to healthy,
affordable foods, and communities not built for safety, easy to access area to be physically
active.

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References

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