An alarming spike: the global crisis of childhood overweight and obesity

In Southern Europe, such as Greece, Italy and Spain, 10-15% of children are obese, while obesity rates in Eastern European countries are slightly lower but are rapidly increasing and may soon rival southern Europe. There is. Globally, Asia has almost half of all overweight children under the age of five, and Africa has a quarter of such children. In Latin America, approximately 20% of children under the age of 20 are overweight. Many developing countries face the dual challenges of overweight/obesity and malnutrition among children.

The harmful effects of this epidemic are already evident, particularly in childhood hypertension and type 2 diabetes. Researchers at Florida Atlantic University's Schmidt School of Medicine sound the alarm in a commentary published in 2016, discussing both the challenges and potential solutions. Maternal and child health magazine.

“Childhood overweight and obesity has reached epidemic levels in the United States and is becoming a global pandemic. These conditions cause hypertension, type 2 diabetes, and dyslipidemia and contribute to metabolic syndrome. In adults, these problems significantly increase the risk of metabolic syndrome—heart attacks, stroke, liver disease, obstructive sleep apnea, arthritis, and certain cancers—many of which are now more common. It's occurring at a younger age,” said lead author Charles H. Hennekens, MD, the inaugural Sir Richard Dole Professor of Medicine and Prevention. Medicine, FAU Schmidt School of Medicine. “Through collaborative clinical and public health efforts, we can address these alarming trends and work towards a healthier future for children and families around the world.”

In their commentary, the authors report on the main causes of this epidemic, including high body mass index (BMI), which increases the risk of many serious health problems. In the United States, preschoolers are considered overweight if their BMI is above the 85th percentile. Research shows that these children have a significantly higher risk of becoming overweight during adolescence compared to children in the 50th percentile of BMI. This highlights the misconception that children simply “outgrow” the problem of being overweight.

Additionally, the authors suggest that healthcare providers and public health workers should promote daily physical activity in children, which is important for increasing metabolic rate, lowering body mass index, and reducing future risk of coronary heart disease. He points out that they are facing major challenges.

“Many children are not meeting recommended activity guidelines due to reduced physical education in schools and excessive time spent using electronic devices. This sedentary behavior is linked to poor eating, poor sleep, “It contributes to overweight and obesity through decreased physical activity and decreased physical activity,” said Panagiota “Iota”. Dr. Kitsantas, co-author, professor and chair of the Department of Population Health and Social Medicine, FAU Schmidt School of Medicine. “Encouraging organized, fun activities rather than competitive activities will help children achieve the level of physical activity they need.”

The authors also caution that while increasing levels of daily physical activity is necessary, it alone is not sufficient to significantly impact childhood overweight and obesity rates. Along with the consumption of ultra-processed foods, the increase in sugar-rich foods is also a major cause.

“Nearly 70 percent of the average U.S.-based child's diet consists of ultra-processed foods,” Hennekens said. “Furthermore, consumption of ultra-processed foods by children under 24 months of age is increasing worldwide, leading to decreased immunological defenses as well as increased likelihood of developing obesity.”

The authors say further research is needed to determine exactly which components of ultra-processed foods contribute to weight gain in children. However, they warn that diets high in ultra-processed foods are associated with higher rates of overweight and obesity, and schools are a major source of these foods.

“Evidence shows that strengthening nutritional standards in school meals may reduce obesity, especially among low-income children,” Kisantas said. “Despite the challenges external influences pose to children, we are committed to eliminating ultra-processed foods from our menus and promoting healthier alternatives, alongside educational programs on healthy eating. We recommend the adoption of a school lunch policy.”

Some of the challenges highlighted in the commentary include the use of social media and advertising, such as sharing unhealthy food posts and being aware when exposed to many unhealthy food brands. This has a huge impact on children's food choices and behavior.

“Despite recommendations from the World Health Organization and public health authorities to restrict food sales to children, very few countries have implemented such measures,” Hennekens said. “The effectiveness of existing regulations in today's media environment is uncertain, creating an opportunity for health care providers and public health workers to educate families about the impact of this advertising.”

The authors explain that addressing the growing childhood obesity epidemic requires a multifaceted approach. In 2023, the American Academy of Pediatrics endorsed the WHO guidelines and issued its own recommendations for managing overweight and obesity in children. These guidelines encourage healthcare providers and public health workers to address social determinants of health and use motivational interviewing to modify nutritional and activity behaviors to achieve individualized patient goals. We advise you to consider drug therapy or surgery.

However, the authors state that while there are approved drug treatments available, maternal-fetal health care providers should employ therapeutic lifestyle changes before prescribing pharmacological options. Masu.

“While the ultimate goal is to prevent overweight, obesity and metabolic syndrome in children, we should not, in the words of Voltaire, 'make the perfect the enemy of the good,'” Hennekens said.

In conclusion, the authors urge us to utilize all available resources to at least stabilize rising childhood obesity rates and related health problems. Ignoring these challenges could lead to an unprecedented global epidemic of childhood and adolescent obesity, as seen in the United States, with serious implications for future health.

“Medical and public health professionals must collaborate across disciplines to address these issues with patients, families, communities, and policy makers. A united effort will help reverse these alarming trends. , will help ensure a healthier future for children around the world,” said Kisantas.

Other co-authors are Dawn Harris Shearing, MD; Allison H. Ferris, MD, associate professor and chair of the FAU Schmidt School of Medicine. Alicia Caceres, fourth-year pre-medical student at Tufts University School of Medicine. Katerina Benson, third year pre-med student at FAU. Alexandra Rubenstein, second-year medical student at Tufts University School of Medicine. Sarah K. Wood, M.D., Director of the Harvard Macy Institute at Harvard Medical School, former interim dean and professor and chair of the Department of Maternal and Child Health at FAU's Schmidt School of Medicine.