The prevalence and severity of people suffering from obesity has increased markedly worldwide. The WHO declared obesity a “crisis of epidemic proportion”. Obesity became prevalent public health problem that presents significant risk factor for increased morbidity and mortality worldwide. It is linked with hyperlipidemia, type 2 diabetes mellitus, hypertension, atherosclerosis, cardiovascular diseases, and cardiorespiratory conditions. Childhood obesity has psychosocial and physical effects during childhood. It is considered predictive for obesity later in life. About 70 % of obese children and adolescents grow up to become obese adults.
The high rates of obesity accompanied by upward
shifts in body-fat distributions among this particular population cannot be
attributed solely to genetic factors as argued by others. Environmental factors
and lifestyle preferences have also a major role in increasing the prevalence
of obesity worldwide among children and only 1% or less of childhood obesity
cases is directly caused by genetic disorder. Particularly, school age
children, who are usually entrenched in sedentary daily routines consisting of
sitting at home, sitting in school, and sitting in front of a television or a
computer monitor for most of their waking hours. Environmental influences on
overweight and obesity are primarily related to food intake and physical
activity behaviours. In the industrialised nations, there is an overall abundance
of palatable, calorie-dense food advocated by aggressive and sophisticated food
marketing in the mass media, supermarkets and restaurants. Large portions of
fast food served outside the home make it easy for children to consume more
empty calories convenient and ready meals, which contain excessive amounts of
fats, salts and sugars (FSS).
Global scale of obesity; ‘Globesity’
There is an important need to quantify the scale of the problem, for three reasons; to establish its prevalence in different parts of the world, to monitor the trends in prevalence over time, and to test the effectiveness of interventions introduced to address the problem. Global estimates show about 400 million adults (age 15+) suffering obesity to date with at least 20 million children under the age of 5 years are overweight. WHO further projects that by 2015, approximately 2.3 billion adults will be overweight and more than 700 million will be obese. A number of recent studies have indicated that the prevalence of obesity has substantially increased among children and adolescents. It has also been shown that obesity is one of the most common nutritional disorders affecting these age groups. Although the highest prevalence rates, for overweight and obesity among children, have been found in developed countries, its prevalence has also been found to be increasing in developing countries especially in Eastern Europe and the Middle East. Due to its long-term adverse effects, the prevention and management of childhood obesity has been recognized as a public health priority in many countries, especially those in economic and nutritional transition.
When the typical daily routine is so strongly biased towards promoting and perpetuating overweight and obesity, very high levels of knowledge, motivation, personal behavioural management skill, and lifestyle flexibility are required for an overweight or obesity-prone individual to avoid becoming overweight, or progressing to moderate or severe obesity.
Health behaviour change
During the past twenty years, there has been an increase in public, private and professional interest in preventing overweight and obesity through changes in individual behaviours, such as weight reduction, increased exercise, and dietary change. The increased interest in behavioural determinants of health and disease has drawn attention to the importance of health behaviour change. ‘Behavioural medicine’ is a field introduced to study relationships between health and behaviour, and apply behavioural change methods to enhance health.
Various research programs have been established to identify and test the most effective methods for achieving individual behavioural change. Health promotion has been identified as one of those aspects of behaviour modification which are known to have an impact on health. While estimates of the relative contribution of lifestyle factors to health problems vary, it is clear that many of the public health problems of our time have a significant individual decision-making behavioural component. Childhood obesity has been attributed to bad dietary behaviour, resulting inconsistent knowledge and attitude. Social reasons play the major role in this attitude, as children enjoy being with their peers. Economic factors are also important as they affect the choice of individuals. Decision makers need greater awareness of the education and promotion opportunities for improving health behaviours and health states of our children. Health education, communication and promotion are recognised as valuable public health interventions, vitally important in addressing health changes. Experimental behavioural science has developed systems to help persons change own health behaviour that are more effective than traditional health education.
Nutritional guidelines to prevent and or manage overweight and obesity
Eat a variety of fruits and vegetables every day. ( 5 servings – they are naturally low in fat and high in vitamins and minerals)
Eat a variety of grain products ( 6 a day)
Increase intake of monounsaturated fat, Omega 3 fatty acids and soluble fiber which helps to lower blood cholesterol levels and reduce the risk of heart disease.
Choose nonfat or low-fat products.
Limit foods high in saturated fat, trans fat and cholesterol
Use lean meats- choose chicken, fish, turkey and lean cuts of beef.
Switch to fat-free milk- gradually reduce the fat content of the milk you drink.
Choose fats with 2 gms or less of saturated fats per serving
Eat less than 6 gms of salt a day
Balance the number of calories you eat with the number of calories you use each day.
Maintain a level of physical activity that keeps you fit and matches the number of calories you eat.
Restrict the intake of energy-dense, micronutrient-poor foods such as packaged snacks;
Restrict the intake of sugars-sweetened soft drinks; and
Detect and respond appropriately to children at risk at an early age.
Additional measures include modifying the environment to enhance physical activity in schools and communities, creating more opportunities for family interaction, such as eating family meals and limiting the exposure of young children to heavy marketing of energy-dense, micronutrient-poor foods, and providing the necessary information and skills to make healthy food choices.