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200 7.2 Childhood Obesity
●● social discrimination, such as bullying, ●● active engagement of the children in nutrition
victimization and social exclusion that can lead education.
to low self-esteem, lower quality of life and lower
academic achievement Secondary school children make more of their own
lifestyle decisions and the responsibility for
●● orthopaedic and musculoskeletal problems preventing obesity is a shared responsibility
●● increased risk of insulin resistance and type 2 between themselves and their parents and carers.
However, the lifestyle habits and preferences of
diabetes secondary school children, particularly around
●● higher incidence of atherosclerosis food and physical activity, will have been largely
●● increased risk of cardiovascular disease learned by parental role modelling when they were
●● non-alcoholic fatty liver disease younger. Environmental factors and marketing
●● kidney disease will also influence lifestyle choices of adolescents.
●● several cancers.
Food and drinks
Obese adolescents may also develop one or more of
the following: Adopting the principles of nutritious balanced diets
as discussed in Chapter 1.2 is a key part of obesity
●● sleep apnoea prevention. Although most infants and preschool
●● hypertension and dyslipidaemia – found in children tend to regulate their energy intakes to their
needs, some young children do not regulate their
80 per cent energy intake well and some derive considerable
●● type 2 diabetes pleasure from sweet, high-energy foods. From 5 years
●● gallstones children tend to eat to social cues and easily override
●● encopresis their feelings of satiety. Portion control becomes
●● steato-hepatitis important for children who do not regulate their
●● gastro-oesophageal reflux. intake according to their feelings of satiety.
An overweight child has a 40–70 per cent chance of However, providing food is an emotional issue
becoming an obese adult. The older an overweight for parents and many show their love through
child is, the more likely they will remain overweight giving food. Research has found that more parents
or obese as an adult. are concerned about their young children being
underweight than overweight (Pagnini et al. 2007).
Preventing Obesity Some parents:
Preschool and primary school children are ●● coerce children to finish up larger portions than
dependent on parents and carers for their food and the child wants to eat
opportunities for physical activity, so it is the
parents and carers who must take responsibility for ●● give high-energy, low-nutrient foods as treats,
a healthy family lifestyle. A recent systematic rewards or for comfort.
review found the following factors should be
included in interventions (Bond et al. 2011): Small amounts of foods high in fat and sugar are
acceptable but children often eat these foods to
●● cultural sensitivity excess – particularly sweetened drinks and high-fat
●● sustained moderate to vigorous exercise snack foods such as crisps. The rise in obesity is
●● active engagement of the parents in the parallel to the increase in consumption of
sweetened drinks by children. Restricting these
programme and as role models of healthy living foods and drinks in today’s environment requires
discipline, as children naturally prefer energy-
dense foods (Cooke 2004).
