Childhood Obesity

By: Farhana Nr
 Introduction

Overweight and obesity are defined as abnormal or

excessive fat accumulation that may impair health.
• CDC define childhood obesity as having a BMI at or
above the 95th percentile of a child's age group in
the CDC‘s sex-specific growth chart.
• WHO defines childhood obesity according to WHO
growth reference for school-age children and teens,
so a body mass index that is two standard
deviations above the average for a child's age group
and sex would be considered obese.
Children under 5 years of age:

• obesity is weight-for-height
greater than 3 standard
deviations above the WHO Child
Growth Standards median.

• overweight is weight-for-height
greater than 2 standard
deviations above WHO Child
Growth Standards median.
Children aged between 5–19
years

• obesity is greater than 2

standard deviations above the
WHO Growth Reference
median

• overweight is BMI-for-age
greater than 1 standard
deviation above the WHO
Growth Reference median.
A study shows that infants and toddlers are already getting
too many calories and eating inappropriate foods such as
pizza, soda, and French fries before their second birthday.
On survey of more than 3,000 infants and toddlers from 4
to 24 months old found that French fries are the most
commonly eaten vegetable for toddlers aged 15 to 24
months, and soda is being served to infants as young as 7
months old. (Dattilo, 2012)
 Magnitude of this problem -
Worldwide
• Globally, 1 in 5 children are obese.

• In 2016, an estimated 41 million children

under the age of 5 years were overweight
or obese, and over 340 million children
and adolescents aged 5-19 were
overweight or obese.
• In 2016 18% of girls and 19% of
boys were overweight. (WHO,2018)
The prevalence of overweight and obesity among children
and adolescents aged 5-19 has risen dramatically from just
11 million (4%) in 1975 to 124 million (18%) in 2016.
• Once considered a high-
income country problem,
overweight and obesity are
now on the rise in low- and
middle-income countries,
particularly in urban
settings.
• In Africa, the number of
overweight children under
5 has increased by nearly
50 per cent since 2000.
• Nearly half of the children
under 5 who were
overweight or obese in
2016 lived in Asia.
• Children in low- and middle-income countries are
exposed to food that is:
- high-fat, - high salt
- high-sugar, - energy densed
- micronutrient – poor food

which tend to be lower in cost but also lower in

nutrient quality. These dietary patterns, in conjunction
with lower levels of physical activity, result in sharp
increases in childhood obesity while undernutrition
issues remain unsolved.
 Magnitude of this problem -
Malaysia
• The prevalence of obesity in
children below 18 years was
11.9% (NHMS 2015).

• The total (direct and indirect)

costs of obesity of Malaysia are
the highest in ASEAN, accounting
for 10-19% of national healthcare
spending.

Source: Global nutrient report, 2018

Double burden of the disease
The fundamental cause of childhood obesity and
overweight is an energy imbalance between calories
consumed and calories expended.
Globally, there has been:
• an increased intake of energy-dense foods that are
high in fat and sugars but low in vitamins, minerals
and other healthy micronutrients; and
• an increase in physical inactivity due to the
increasingly sedentary nature of many forms of
recreational time, changing modes of
transportation, and increasing urbanization.
Prevention & Control Measures

WHO target, by year 2025:

No increase in childhood overweight

Achievement
Why this occurs?
A lot of the suggested plan are voluntary and not backed
up by regulation, renders them pointless,
This include on:
• to cut sugar by a fifth in the products children eat most
• to toughen curbs on advertising and discourage price
promotions of junk food
• replacing chocolate at checkouts with healthier fruit
snacks.
Manufacturers have been far keener to sponsor local
playgrounds than they are to stop selling unhealthy
products.
• Besides, the policy on implementing fat and sugar
taxes also showed futile result.
• Food labelling efforts were also shown to be
ineffective to curb childhood obesity.
• The cut of subsidy on sugar in Malaysia has been
shown to have ineffectual result too.
Commission on Ending Childhood Obesity (ECHO)
from WHO visited a secondary school in Auckland to
hear from young people about preventing childhood
obesity. The students suggested that:
• The number of fast food outlets in their community
should be reduced.
• Unhealthy foods and snacks should not be sold in
the school tuck shop.
• The price of foods and beverages are important to
them. The students suggested that taxing such
sugary drinks might encourage them and their
peers to buy healthier alternatives.
• All students should be provided with nutrition
literacy through the school’s curriculum.
Commission on Ending Childhood Obesity (ECHO)
from WHO visited a secondary school in Auckland to
hear from young people about preventing childhood
obesity.
• The number of fast food outlets in their community
should be reduced.
• Unhealthy foods and snacks should not be sold in
the school tuck shop.
• The price of foods and beverages are important to
them. The students suggested that taxing such
sugary drinks might encourage them and their
peers to buy healthier alternatives.
• All students should be provided with nutrition
literacy through the school’s curriculum.
Commission on Ending Childhood Obesity (ECHO)
from WHO visited a secondary school in Auckland to
hear from young people about preventing childhood
obesity.
• The number of fast food outlets in their community
should be reduced.
• Unhealthy foods and snacks should not be sold in
the school tuck shop.
• The price of foods and beverages are important to
them. The students suggested that taxing such
sugary drinks might encourage them and their
peers to buy healthier alternatives.
• All students should be provided with nutrition
literacy through the school’s curriculum.
 Measures taken in Malaysia
• Healthy School Canteen Management Guide,
enforced since 2018 plan to limit the accessibility and
availability of unhealthy food and drinks to school
children.
• Health Ministry director-general Datuk Dr Noor
Hisham Abdullah said efforts to
“healthify” school canteens began in 2016,
in collaboration with the Education
Ministry under the purview of the National
Plan of Action for Nutrition of Malaysia
2016-2025.
Current food and beverages that are
prohibited to be sold at school canteens:
Challenges faced by the control
programs in Malaysia

Lack of
enforcement
Association of School Canteen Operators president William
Huee says that despite the promises of better
enforcement, not much has been done by the Education
Ministry to curb the sales of unhealthy food within the
school compound. School koperasi (cooperative) and book
shops still selling junk food and there are also vending
machines dispensing soft drinks for school children.

(The Star, 2018)

vs
Recommendations for future
prevention and control
• Tray system of food selling at school canteen.

• And teachers will supervised type of food being sold.

 Recommendation of served food
• Serve fruit, vegetables or salad everyday.
• Emphasis on wholegrain foods in place of
refined carbohydrates.
• Emphasis on making water the drink of
choice.
• Limiting fruit juice portions to quarter
pints (150ml).
• Pastry, deep-fried, batter-coated or
breadcrumb-coated food sells just once a
week.
• Healthy sandwiches and high protein
food in place of nasi lemak, fried rice,
fried noodle.
The relevance:

• To promote healthy eating and provide healthy,

tasty and nutritious food and drink.

• To encourage right portion of food to be served and

eaten by students.
Thailand China
Japan South korea
Intervention overview
Strength Weakness
• It provides healthy food • The food can be pricier.
to young children. • Tedious work for food
• It educate young handler, thus, they
children about healthy might opt out.
food. • Burden for teachers to
• It educate young monitor the type of
children to eat right food served.
portion of food.
Summary
• School-aged children are leaders of tomorrow and
schools are the best platform to inculcate healthy
lifestyles including good eating habits.

• Schools provide the ideal setting to teach children

how to lead a healthy lifestyle with a nutritious
diet.

• Everybody plays an important role in fighting

obesity of all age.
Reference
• Dattilo A. M., Birch L., Krebs N. F>, Lake A., Taveras E.
M., Saavedra J.M. (2012). Need for early intervention in
the prevention of paediatric overweight: a review and
upcoming directions. Journal of Obesity.2012.
• Centers for Disease Control and Prevention(CDC) (n.d),
Clinical Growth Chart. Retrieved from:
https://www.cdc.gov/growthcharts/clinical_charts.htm
• Lounassalo I., Salin K., Kankaanpaa A., Hirvensalo M.,
Palomaki S., Tolvanen A., Yang X., and Tammelin T. H.
(2019). Distinct trajectories of physical activity and
related factors during the life course in the general
population: a systematic review. BMC Public Health. 19.
271
• Global nutrient report
• The Star (2018) Ensuring children chomp on
healthy treats. Retrieved from:
https://www.thestar.com.my/news/education/201
8/01/21/ensuring-children-chomp-on-healthy-
treats/
• World Health Organization (2018). Obesity and
overweight. Retrieved from:
https://www.who.int/news-room/fact-
sheets/detail/obesity-and-overweight
The end. Thank you