Childhood obesity is steadily rising and is affecting the lives of many individuals in the United States. This issue has not only led to the increase of multiple-serious obesity-related comorbidities but also placed a strain on the healthcare system. According to the World Health Organization (2018), the incidence of childhood obesity has doubled in children. The most recent findings from the National Health and Nutrition Examination Survey report the relatively high prevalence of the disease among U.S. children, which was 18.5% between 2015 and 2016 (Centers for Disease Control and Prevention, 2018).
In general, the occurrence of obesity among preschool-aged children (2-5 years) was 13.9%; that of school-aged children (6-11 years) was 18.4%; and that of adolescents (12-19 years) was 20.6% (Centers for Disease Control and Prevention, 2021). Furthermore, there is a variation between genders; for instance, school-aged girls (20.9%) had a higher prevalence of obesity than school-aged boys (20.4%).
Effects of Obesity on the Health of School-Aged Children
Childhood obesity has a significant effect on the physical and psychological well-being of an individual. Psychologically, obese children have a negative body image that results in lower self-esteem. Furthermore, they are more likely to feel depressed and nervous about their condition; hence, adversely impacting their behavior. As a result, they might feel socially isolated from and stigmatized by their peers.
On the biological aspect, obese children are highly susceptible to high blood pressure, cardiovascular diseases, hypocholesteremia, asthma, body discomfort due to increased weight on joints and muscles, and insulin-resistant type 2 diabetes. These adverse physical and psychological effects impact the educational outcome. They affect the children’s cognitive functions and concentration, thus having a deleterious impact on academic performance.
Causes of Obesity in Children
The primary reason for obesity, including childhood obesity, is the imbalance of energy intake from food that is expended via physical activity. The physical issue is the most common etiological factor that has been yielded from research on childhood obesity (Brown et al., 2015). Nevertheless, it is essential to note that the excess weight is also caused by the interaction of a complex set of factors related to social, personal, and environmental influences. Personal traits and behavior can adversely affect a child’s sleep, weight, and mental health. Social and environmental impacts are centered on the home, school, community, and societal settings.
For example, friends and family can affect an individual’s dietary and lifestyle habits; education institutions are less supportive of physical activity and instead exert more emphasis on academic achievement; and societal factors including the media (e.g.) and community resources (e.g., parks), affect consumption and physical activity. As a result, the cause of obesity among children can be measured in terms of nutrition, physical activity, media usage, sleep hygiene, and mental health and mood.
Nutrition is essential for proper growth and development. According to Healthy People 2020, the data showed that the national goals for nutrition for children alteration had not yet been achieved (Health.gov, 2018). Food insecurity among U.S. households between 2008 and 2015 reduced from 14.6% to 12.7%; however, it still did not meet the 6% target (Health.gov, 2018). Also, between 2009 and 2012, there was no variation in the daily average vegetable consumption among individuals aged two years and above. This is because nutrition is also influenced by culture and socioeconomic status.
Culture affects the type of food that an individual consumes; some cultures place value on children being within normal weight ranges; however, this is not the case for the minority. Hispanic children (25.8%) had a higher prevalence than African-American (22.0%), Caucasian (14.1%), and Asian (11.0%) children. On the other hand, when it comes to socioeconomic status, children from low socio-economic backgrounds are more at risk as their parents do not have sufficient money to provide a balanced diet.
Physical activity in childhood is linked to physical and mental health. Students have three avenues through which they can engage their active self, and this consists of recess or lunch, physical education, and outside (before or after school). Considerable evidence indicates that a greater fraction of the children is not sufficiently active (Brown et al., 2015). This is primarily due to increased emphasis on educational achievement in schools and the use of electronic media. According to the 2018 Physical Activity Guidelines for Americans, school-aged children are required to be physically active for 60 minutes or more daily (Health.gov., 2018). A more significant fraction of the 60 minutes should be spent on moderate to vigorous aerobic activity, and vigorous exercise strengthening the muscles and bones at least three days a week. Furthermore, children are encouraged to participate in various developmental and age-appropriate activities that are enjoyable.
Childhood obesity is associated with inadequate sleep, which is a modifiable risk factor. Short sleep duration is common, with only 20% of adolescents getting their optimal nine hours of sleep on school nights and a third of 2-3-year-olds sleeping less than the recommended course (Morrissey, Taveras, Allender & Strugnell, 2020). Sleep deprivation is associated with several metabolic changes that affect body function and behavior. This results from dysregulation in the secretion of the growth hormone, prolactin, thyroid hormone, insulin, and cortisol. Some are greatly secreted during the night, while the secretion of others is induced by nocturnal sleep. Recently, with increased electronic media usage, a majority of school children suffer from sleep deprivation.
It was initially identified to be linked to childhood obesity in the 1980s, and ever since, there is growing evidence that continues to support it. Television viewing is the medium on which most American school-aged children spent the greatest amount of time. It is estimated that they spend an average of three hours per day watching television, and this screen time is compounded to five hours when they use computers and play video games. Several studies have suggested that media usage duration increases the body fat percentage; hence, increasing the risk of obesity (Sahoo et al., 2015; Sanyaolu, Okorie, Qi, Locke & Rehman, 2019). The mechanisms that have been proposed for this phenomenon are reduced physical activity that reduces the burning of calories, and food advertising that causes increased energy intake.
Solutions in Place to Address Childhood Obesity
Overweight and obesity in early childhood have a higher probability of continuing all through adolescence into adulthood. Therefore, intervening in childhood is essential to prevent the persistence of obesity into adulthood. It is crucial for educational, practice, and policy-based interventions to be formulated and should envelop all cultures, health coverage systems, and socio-economic levels. Stakeholders that can participate in activities that aim to reduce childhood obesity include children, parents, schools, and the local and federal government. Educational needs comprise improving the awareness of nutritional guidelines by inculcating them into the curriculum and encouraging physical activity through PE.
Regarding healthier food access, schools that did not provide calorically sweetened beverages to students increased by 9.3% from 2006 to 2014 (Williams & Greene, 2018). Similarly, data from the School Health Policies and Program Study (SHPPS) indicated an increase in teaching nutrition and dietary behavior at elementary and middle school levels from 68.9% to 70.6% from 2016 to 2017 (Williams & Greene, 2018). Additionally, in middle schools, it increased from 75.1% to 76.9%, while in high schools, it decreased from 85.9% to 84.6% within the same duration.
Nevertheless, although there are several preventive measures in place, some have not been enforced due to research limitations, which is the expense of long-term studies (Lambrinou et al., 2019). There are signs of growing partnership among stakeholders. However, the remaining barriers are in the marketing, food, and entertainment industries, together with pervasive social and cultural influences. Moreover, resistance arising from economic pressure and the underlying tension between government versus parent or individual rights and freedom of choice might occur when reinforcing related interventions. It is recommended that this gap be addressed to ensure a wholesome intervention.
Addressing Childhood Obesity in School Settings
The foundation of a healthy life is laid in childhood. Beyond the home life, it is only the time spent in school that provides children with an immersive experience. Therefore, this suggests that schools provide the most appropriate avenue through which issues of obesity can be intervened. This approach requires the active involvement of teachers and school health educators. One way through which these institutions can tackle this is by inculcating healthy living in the curriculum (Lambrinou et al., 2019). Health educators should teach students about evidence-based nutrition, including the causes, effects, and ways of preventing obesity.
These nutritional and physical activity lessons should be integrated into the curriculum and be placed at the core of physical education, classroom subjects, and after-school programs. Along with teaching evidence-based nutrition, physical education should include high-quality and regular activity. Schools can also promote healthy living outside the classroom by making available healthy food choices, for instance, in the cafeteria to eradicate the marketing of unhealthy foods (Lambrinou et al., 2019). In addition, there should be health and wellness programs for the faculty and staff to boost their morale regarding student-focused programs.
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