Childhood obesity: what are the causes and risks in childhood

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Obesity is a real disease and can lead to severe disabilities; this is why it is necessary to adopt a correct lifestyle from an early age to safeguard health.

There is no moment more awaited by children than a snack : a break for sharing, relaxation and delicious food. Too bad that very often these snacks turn out to be very unbalanced from a nutritional point of view and it is the duty of parents or caregivers to propose healthy foods, at school and at home. 

Childhood obesity: definition

Defining obesity in children is more complex than in adults. This is because in adulthood the excess weight is calculated from the BMI or BMI value (Body Mass Index), that is the relationship between weight and height (BMI = weight in kg / height in meters, squared). This has not always been the case over time, but the scientific community has now accepted this value as universal and it is a parameter considered everywhere.
Today it is agreed that a person is overweight if his BMI / BMI is above 25, while he is obese when the BMI is above 30.

For children however this parameter is not sufficient to determine the presence of overweight or obesity. The subjects who are still developing, therefore all children and adolescent boys, increase fat mass according to age and the ratio between weight and height changes over time , with differences between males and females . Consequently, it becomes limiting to measure excess weight in minors with the BMI only: there is no single value that determines overweight and obesity in children .

However, the WHO (World Health Organization) has tried to draw up guidelines in order to have an idea of ​​the patient’s situation, referring to some BMI points on the centile curves that all pediatricians use . These points were made from a Cole study in 2000 and have been adapted over the years.

From birth, a newborn is monitored in its growth by looking at these percentile curves and evaluating its genetics , as well as sex (for example, a child with very tall parents will potentially have a higher percentile than normal, but being a characteristic of family ‘is absolutely normal in his specific case). From the point of view of weight, on the other hand, if a figure higher than 85% is detected, the child is considered overweight and if it goes beyond the 95-97% percentile it is in a state of obesity .

Diffusion of the phenomenon

Unfortunately, although these tables are updated from year to year, precisely to report the most realistic data possible on the growth of children, there are not rare cases in which the little patient is categorized as overweight or obese.

The ‘ childhood obesity is a problem in all respects and has a great social impact. In Europe it is a public health problem and our country is at the top of the charts : it is estimated that about one in four children is affected by obesity . About 42% of boys are overweight with 21% obesity, and in girls the figure changes little because it is about a good38% to be overweight with 14% being obese girls. The worrying trend increases from year to year , mainly the fault of incorrect lifestyles already in developmental age.

Statistics should make us think: a child who is overweight will be led to be so even in adulthood and furthermore these extra pounds can be associated with serious orthopedic, psychic, metabolic and cardiovascular pathologies .
This is why it is always recommended to approach a healthy lifestyle from an early age ; it serves to keep fit and in these cases it is the main ally to reduce obesity.

The triggering causes

Obesity in pediatric age is determined by genetic and environmental factors , by an incorrect diet and by a sedentary lifestyle . These things can interact with each other, accentuating the problem.

Among these listed, the genetic heritage is the most important cause : if one or both parents are obese, it is a high risk factor for the child.
L ‘ obesity will show itself when it detects a positive energy balance protracted : that is, you introduce more calories than you consume, very often due to an incorrect diet and a low use of these calories through a sedentary lifestyle.
Among the most harmful and widespread eating habits in children is the tendency to eat very often outside the home , preferring fast-food foods and calorie snacks, accompanied by drinks with high percentages of sugar.

To give you an idea, it is sufficient to take 100 kcal / day more than necessary to obtain an increase of 4.5 kg of weight per year. Provided that these calories are not ‘burned’ with healthy physical activity.

Remain rare cases in which obesity binds to hormonal alterations such as hypothyroidism and adrenal disfunzoini or forprolonged treatment of drugs such as cortisone (about 2%), therefore the triggering causes are to be found within the family.

Problems associated with being overweight

Obesity in childhood is associated with various problems, including:

  • accumulation of fat in the liver (causing fatty liver);
  • increase in insulin with possible evolution towards type 2 diabetes , thus affecting the endocrine system;
  • increased cholesterol , triglycerides and uric acid;
  • rise in blood pressure and attack of the cardiovascular system, resulting in an increase in mortality in adulthood directly linked to problems of obesity in adolescents and in boys between 14 and 19 years (this is the most serious and important risk factor);
  • orthopedic and skeletal problems ;
  • respiratory ailments ;
  • psychological disorders .

These are very serious complications that if contracted already in childhood can have repercussions even in adulthood, compromising the well-being of life . As you can see, there are few systems that obesity does not affect, not to mention the psychological aspects that afflict teenagers or pre-adolescents: chubby children are often the object of derision from their peers and this does not help with feelings of shame. for their own body which they most likely already have. If we notice that our child or teenager is overweight, it is best to take action and change something in lifestyle.

How to prevent obesity in children

To avoid the onset of the diseases we have listed above, the best way is certainly to prevent . If the baby tends to gain weight, intervene promptly . Of course you will have to review your eating habits and moments dedicated to physical activity , but there are no pre-established rules. Therefore you can customize the suggestions we are about to give you by adopting small tricks for your family. If specifically your son / daughter suffers from obesity, never let your guard down because the risk of going back is always possible.

Here are some practical advice that is promoted by the Italian Ministry of Health:

  • as far as food and diet are concerned , it accustoms the child to take regular meals , avoiding that he eats after hours . The suggested number is 3, which is a generous but substantial breakfast and a moderate lunch plus dinner with the presence of vegetables. Spend the day with two snacks , one in the morning and one in the afternoon. Snacks must still be based on nutritious foods, but no junk food . This will help him not to have holes between meals;
  • excessive snacking should be avoided . Do not give him snacks that are too high in sugar or high in calories (pay particular attention to snacks, ice cream, fruit juices and carbonated drinks). Instead, opt for fruit-based snacks or yogurt ;
  • cut down on cured meats, fried foods, and seasonings . Even sugary foods with meals have to be limited. The protein is usually taken in a balanced, not excessive, thus alternating the consumption of meat, eggs and cheese (never nsieme the same meal). These indications must be followed by the whole family , because children start from an early age to imitate their parents in everything, even in their habits at the table;
  • if the child seems full, do not insist : sometimes the desire to make the mother happy is greater than the hunger you have at that moment. Better not to unleash a distorted relationship with food;
  • fight a sedentary lifestyle by accustoming the child to playing outside, outdoors . Physical activity outdoors is important both to help him grow properly from a physical point of view and to burn excess calories;
  • respects the rhythms of sleep and wake up in order not to establish incorrect habits such as night feeding
  • limits the use of electronic devices to about 2 hours maximum per day. Among these we consider both television and computers and videogames; free time is nice to spend in the company of friends or outdoors! Under 2 years of age, watching TV in general is not recommended.

When to contact the pediatrician

When excess fat is already evident and obesity has now become pathological (ie with a BMI higher than the 95th percentile or 85th), it is always better to consult a specialist.
The family pediatrician or dietician will have to be the first point of reference for this type of problem, especially when as a parent you have already made the changes mentioned in the previous paragraph, and efforts have not been sufficient to improve the situation.

The pediatrician will intervene not only on the health level, but also on the behavioral one, indicating collaborators and ad hoc paths, based on the individual situation. Initially, a careful medical history will be required that identifies whether the child is suffering from obesity or overweight and what kind, essential or secondary, and only then will the case history be deepened with any blood tests that confirm the diagnosis.

Subsequently, different approaches are possible , but to obtain lasting results over time it will be necessary to carry out a nutritional, physical and psychological rehabilitation path , which involves the child first, but also the whole family . The therapy can be set by starting a routine that includes constant physical activity or set small goals that will be monitored through a food diary .

In the event that even the advice of a pediatrician and dietician are not sufficient, it may be necessary to resort to taking medications.

Medicines to combat childhood obesity

To date, pharmacological therapy is the last resort , because it has been studied how re-education to good nutrition and sports activity is more than indicated. It is clear that the decisive factor remains the will of the little patient to change things and to reach the end of the path, as well as the involvement of the members of the family to which he belongs.

There are no more targeted drugs than others that counteract obesity in childhood, except for fibers that would help reduce the sense of hunger and slow down the absorption of nutrients.

For the most serious cases of childhood obesity it is possible to resort to bariatric surgery ; but here too it should be noted that the long-term effects of these interventions have not been documented in children. Without forgetting that important side effects such as intestinal obstruction, pulmonary embolism or malabsorption are always possible , which do not guarantee a safe recovery.

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