Obesity is defined as the excessive accumulation of fat and is predominantly caused when there is an energy imbalance between calorie consumption and calorie expenditure. Childhood obesity is becoming an increasing concern worldwide, and Australia alone recognizes that 1 in 4 children are either overweight or obese.
For Australians aged between 4 and 17 years, obesity is a very concerning condition as once gained it is favourably harder to be liberated from. Short-term effects on children can mean a decrease in their psychological well-being (stigmatisation and poor self-esteem) as well as physical deteriorations such as sleep apnea, breathlessness and cardiovascular disease. With an increase risk of adult obesity being associated with childhood obesity there are numerous long-term effects that can ultimately hinder the life expectancy of individuals including the development of serious diseases.
In order to combat the worldwide epidemic of childhood obesity it is imperative that the issue is addressed in its early stages. The main preventative measures to be implemented include increasing physical exercise, dietary knowledge and decreasing sedentary behaviours.
Measuring obesity
Body Mass Index (BMI) is a common and useful measurement of body fat that helps individuals understand the difference between being overweight and obese. The system can be used to calculate a person's BMI by dividing their weight (in kilograms) by the square of their height (in meters). According to the World Health Organization (2015) a BMI greater than or equal to 25 kg/m2 in adults is overweight and greater than or equal to 30 kg/m2 regards individuals as obese.
Using the BMI method, however, to measure a child's excess weight can encounter regular issues. BMI is used to decipher an individual's excess body weight but not their excess body fat. In this way the measurements taken from a child who is at different stages of their sexual maturation compared to another may alter the reliability of the data. Other issues that may affect the results surrounding this method for children and adolescents includes their age, sex, ethnicity muscle and bone mass, their height as well as their sexual maturation levels.
Using the percentile ranking to determine whether or not a child or adolescent between 2–20 years old is overweight or obese inherits the same techniques as a BMI except the interpretation of the data collected is varied. Information gathered using the percentile ranking takes into consideration the child's age and sex, recognising that the amount of body fat regularly changes with age and sex. The BMI-for-age highlights the values among children of the same sex and age and categorises overweight adolescents as being between the 80th percentile and less than the 95th percentile. Obese children are classified as being equal to or greater than the 95th percentile.
Although calculating an individual's BMI is the most recommended indicator it doesn't distinguish the risk of disease. Regular monitoring of fat distribution, genetics and fitness levels should be maintained to assess the likelihood of disease. Alternative ways in which an individual can have their weight assessed, other than a BMI test, includes measuring the circumference of their waist or using the skin fold test.
History
As early evolution has it, prehistoric ancestors in the form of hunter/gathers maintained the mentality that food supplies were unpredicted and their next meal was unknown. In this way, ancestors would eat whenever possible and efficiently store the energy absorbed as fat to use when resources were scarce. Since then, the environment in which we live in, has evolved rapidly with food supplies readily and effortlessly available. Consequently, the approach to conservation of energy from food has now been transformed into overeating and under-activity, generating a recipe of chronic disease and premature death.
Childhood obesity has been a consistent health burden throughout the entirety of Australia's history with close regard placed on genetics and an energy imbalance between calorie consumption and expenditure. Between 1985 and 1995 the number of obese children increased dramatically from both perspectives of boys (10.7% to 20.5%) and girls (11.8% to 21.1%) aged 7–15 and 5–17 in the two respective year brackets. In the 10 years that followed, until 2008, figures continued to rise from 21% to 25% resulting in a similar percentile for both males and females. In the 2011/12 Australian Bureau of Statistics- Australian Health Survey, statistics reiterated the lack of substantial preventative methods, highlighting a 1% increase and therefore a total of 26% of children aged between 5–17 years as being either overweight or obese.
World comparisons
Childhood obesity is a worldwide epidemic that, in 2009, affected 155 million (1 in 10) 5–17 year olds. In regards to The International Association for the Study of Obesity, figures collected in 2013 highlight that Greece held the highest values for both overweight and obese boys and girls (44% and 38% respectively). Twenty four percent of Australian girls, according to the Organisation for Economic Co-operation and Development (OECD), were considered obese, ranking in at 10th out of 40 countries.
Both Spain and Canada reported the same statistical findings of 24%. In regards to obese and overweight boys, Australia is ranked 18th, showing an identical figure of 22% to that of the United Kingdom. The lowest ratings of obesity were displayed by Indonesia showing values of 11% and 8% respectively for boys and girls. In 2013, the World Health Organization estimated that over 42 million children under the age of five were obese with 31 million of these living in developing countries.
Causes
The causes of childhood obesity can be based on both a combination of individual choices and socio-environmental adaptions with genetic factors playing an important role also.
Genetics Genetics, according to the Australian Health Survey plays a primary role in determining obesity. In 2011/2012 it was recorded that 90% of the Australian population had inherited their obese tendencies due to the epigenetic modifications of their mothers during pregnancy. Interchanging closely with the genetic factor, the environment and individual temptations are also highlighted as contributing causes to the worldwide epidemic. The genetic configuration influences the tendencies to become overweight, and diet and physical activity determines to what extent those tendencies are elaborated.
Diet and parental influence
Parents, guardians and teachers all play a key role in the mentality that children have towards certain types of foods as they develop. The first five years of a child's life, when developing a familiarisation with solids, can ultimately have a negative influence on the foods that they give preference to in the future. "Treat" food consumption, which is a well- intentioned technique used by parents to reward their children, contributes to between 23- 24% of an individual's total daily energy intake (aged between 2–16 years old).
With no more than 20% being recommended daily, it is visibly clear that adults may not be allowing their children to develop an intrinsic motivation for healthy foods, 'rewarding' them with energy dense snacks such as potato chips, muffins, lollies, and popcorn from the theatre. A large popcorn at Hoyts', Australia's largest cinema chain, contains more than 700 calories, and is the most popular item on their menu. According to the Australian Dietary Guidelines 2013 a child aged between 4–8 years old should consume 1 ½ serves of fruit and 4 ½ serves of vegetable daily with individuals aged 9 and above recommended to consume "2 and 5".
Parents can help to positively influence their child's diet by being an active role model and eating a wide variety of fruits and vegetables themselves. Encouraging children to eat a variety of different nutritional snacks and making fruits and vegetables visually appealing through changing their shapes can also help to entice and excite children about fruit and vegetable consumption.
Societal influences In order for an individual (children) to remain healthy, there must be a balance between the amount of calories consumed and the amount of calories expend (through physical activity). Socio-environmental factors that disrupt this energy consumption/ expenditure balance include changes to the economy (food costs), an increased dependency on cars and sedentary behaviours and an increased marketing of poor nutritional foods.
Media and advertising Advertising is a common aspect of today's society and is strategically conducted and presented and conducted to persuade consumers to respond in a particular way. Approximately 30% of advertisements conducted during children's television viewing hours in Australia are directed on food intending to influence children towards unhealthy food products. Companies such as McDonald's, in particular, have specifically created and designed their advertisements and commercials so that they are appealing and enticing to children. Through the use of bright alluring colours, the introduction of the Happy Meal, the strategic use of playgrounds and the Ronald McDonald character, it is evident that children are the main target audience (Super Size Me).Morgan Spurlock- "Super Size Me" Documentary (2004)
In a similar way, Australian sporting teams are often sponsored by companies who market unhealthy food products to children and young adults. Recent reports show that during a high-profile cricket match, the KFC (Kentucky Fried Chicken) logo was clearly visible for 61% of playing time and XXXX beer logo clearly visible for 75% of playing time in a similar event. As a country dominated by sporting heroes, with a strong child based audience during televised times, the inclusion of unhealthy foods and alcohol sponsorship may indicate to children that even their most idolised sporting heroes support such unhealthy products.
Some children find it hard to grasp the concept of unhealthy products in the same way they have internalised the negative effects of smoking. Advertisements in Australia for tobacco smoking reflect the negative outcomes associated, through the use of graphic and gruesome images. Unhealthy food, in comparison, is not portrayed in the same light, despite the equality of consequences. Instead, commercials, billboards and television advertisements portray fast food and energy dense products with attractive colours and happy/ energetic staff members, persuading children to believe that high calorie junk food promotes a positive and rewarding experience.
Social Media As technology and social media become more advanced and accessible, so does the increase in children utilising these content-sharing platforms. Randomised-controlled trials considered the link between social media and childhood obesity; where they believed eating whilst viewing social media, effects of influencers and advertising on social media impacts childhood obesity. Children are exposed to energy-dense food content such as meal ideas and specific food items which can shape young consumers' social norms about where, how and what food to eat on social media. Children under the age of 12 lack advertising literacy, their knowledge and understanding of advertising is not fully developed alongside their cognitive abilities. Studies have shown young people often idolise influencers, these influencers become role models to their young audience. Children may lack the knowledge to understand the reason behind their favourite influencers promoting a particular brand. Social media can be a channel for content creators to advertise energy-dense food products which shapes children's attitudes toward 'healthy' foods.