The issue of childhood obesity is becoming one of the most important global public health issues for the 21st century. This is because of the sedentary lifestyles that have been adopted by many people thereby increasing the risk of children developing obesity (Han, Lawlor & Kimm, 2010). This paper will discuss the issue of childhood obesity in the UK and focus on London.
Obesity in children is a condition whereby there is an imbalance in energy expenditure resulting in the accumulation of excess body fat deposited abnormally and subcutaneously (Farooqi and O’Rahilly 2006). Obesity is usually determined from a child’s Body Mass Index, BMI, and it’s an acceptable way of determining obesity in children. The height to weight ratio of a child represents his BMI (Deurenberg et al., 1991). Children of different ages have varying BMI but generally, a child with a BMI greater than the 85th percentile is considered overweight, and those with a BMI greater than or equal to the 95th percentile are obese (Ogden et al., 2012) Obesity in children has recently received much attention in public health as it is currently affecting children all over the world. The health risk of childhood obesity makes affected children prone to life-threatening health conditions such as cardiovascular disease and diabetes mellitus. In addition, obese children have the tendency of growing up into obese adults who exhibit all complications associated with obesity (Kopelman and Peter, 2005).
The rationale of this study is based on the fact that obesity affects the physical and mental health of children in different parts of the world (Lobstein, Baur & Uauy, 2004). This has created a global public health burden. This is because once the children become overweight, it becomes very difficult for the healthcare professionals to manage the other physical and psychological problems that these children may experience (Lobstein, Baur & Uauy, 2004). In addition, childhood obesity leads to different psychological and physiological problems in the children. Due to stereotyping and stigmatization, children suffering from obesity always have a low self image of themselves, they may have low self confidence and may suffer depression even after this young age (Franklin et al. 2006). If these risks are not managed early on in the life of the children, then they are likely to increase as the child advances in age.
There are many factors attributed to childhood obesity with the major two being genetic causes and environmental causes. It has been documented that genetic factors contribute to 30% of a child being predisposed to obesity while the remaining 60% is attributed to environmental factors. Researchers have found that children of this generation spend less time in play and more time watching television (Weinstock, 2013). The socioeconomic status of a family has also been known to contribute to the onset of obesity in some children. It has been found that children from low socioeconomic status are usually prone to being obese or overweight (McBride, 2010).
The aim of this study is therefore to determine the prevalence rates of obesity in London and device ways in which the prevalence of obesity can be reduced.
From the 2009/2010 data released on childhood obesity in London, it can be seen that London has high prevalence rates of childhood obesity. The data shows that for children aged between 4-5 years, the risk for obesity is 11.6% while the risk is 21.8% for children aged between 10-11 years (Greater London Authority, 2011). The prevalence rates are higher in the most deprived areas. London is one of the areas that have the highest health inequalities in the UK. The prevalence rate was highest among children of the minority ethnic groups including Black Caribbean, Bangladeshi and Black Africans (Greater London Authority, 2011). However, there is no strong link between ethnicity and obesity. The link that exists in this case is the deprivation that exists in London.
Obese children may develop health problems which may vary from child to child. These health implications such as high circulating cholesterol levels involved in lining and forming plaques which disrupt the normal flow of blood through the arteries, high blood pressure, high blood glucose levels associated with the metabolic syndrome are common in obese children and may be severe in obese adults who were obese children (Ebbeling et al., 2002).High blood glucose levels seen in obese children and adolescents are currently of worldwide concerns as traditionally, these conditions were only associated with adults but now is very prevalent in 2 years to 15 years worldwide (Reinehr and Wabitsch, 2011).
Obesity is on the increase in both developed and developing countries. In the year 2010, it was estimated that 42 million children aged between 0-5 years are either overweight or obese. When the prevalence of obesity is estimated worldwide, the United States is in the lead followed by the UK and Australia with the UK being the most prevalent in the European Union (CDC, 2011).Countries outside the United Kingdom generally use three primary references namely the International Obesity Task Force (IOTF) thresholds, the World Health Organization Growth Reference and the Centers for Disease Control (CDC) growth reference (CDC, 2011) and prevalence of the childhood obesity in some European countries is documented in Table 1.
Country Age Prevalence in boys Prevalence in girls
Belgium 10-12 16.9 13.5
Greece 10-12 44.4 37.7
Hungary 10-12 27.7 22.6
Netherlands 10-12 16.8 15.4
Norway 10-12 15.1 13.8
Slovenia 10-12 31.7 22.5
Table1: Prevalence of childhood obesity in some European countries using the IOTF reference. (IASO, 2012). From the table, it can be concluded that childhood obesity is of concern in both boys and girls from European countries.
A general trend in the prevalence of obesity in England between 1995 and 2004 demonstrated that obesity was highly prevalent in children and adolescents of age 2-15 years. The prevalence, however, was found to decline from 2004 onwards. It has been found that the correlation between the degrees of fatness in children with their corresponding body mass indices varies substantially with age. In Britain, currently, a growth reference (UK90) is utilized to differentiate between obesity and overweight in children and adolescence (HSE, 2013). In England, the National Child Measurement Programme (NCMP) established an annual programme whereby the height and weights of school children are measured. For the academic year 2013/2014, 9.5% of children aged between 4 years and 5 years were obese While 13.1% were overweight (NCMP,2013). In the same year, 14.4% of children aged between10 years and11 years were overweight, while 19.1% were found to be obese. Another study conducted by the health Survey for England (HSE) in 2012 revealed that 28% of children aged between 2 years and 15 years were either overweight or obese (HSE, 2013). It has also been established that childhood obesity is prevalent in England, Scotland and Wales, Fig1.
Fig1: Percentage prevalence of childhood (2-15 years) overweight and obesity in England, Scotland and obesity in 2012 (The Health and Social Care Information Centre, 2008). The study indicated that the prevalence of childhood obesity was on the increase in the UK.
A closer look into childhood obesity in London showed that indeed overweight and obesity were issues that were associated with children aged between 4-15 years and needed rapid attention as was the case in Scotland, Wales other European countries and globally (The Health and Social Care Information Centre, 2008). The prevalence of childhood obesity in London during the 2009/10 academic year showed that children of age 4-5 years (11.6%) and 10-11 years (21.8%) were at risk of being obese. This implies they were overweight and if control measures were not implemented these children would develop obesity. A critical analysis of the gender specific prevalence of obesity in boys and girls indicated that the number of young girls aged 4-5 years in academic years 2006/07 and 2008/09 with obesity stayed constant (11.9%) but has taken an increase in subsequent years (12.2%). With regards to the prevalence of boys the reverse occurred as in 2006/07 academic years the prevalence was 12.3% and then increased to 12.7% in the academic year 2009/10, Table 2, (The London findings of NCMP, 2010).
Gender 4-5years 10-11 years
Males 12.3 24.0
Females 10.9 19.5
All 11.6 21.8
Table 2: Percentage prevalence of childhood obesity in London, 2009/10 academic year (The London findings of NCMP, 2010).The prevalence of obesity in young adolescence is higher than in pre-school children in London.
The causes of obesity in children were found to be no different to the causes of obesity globally, in other parts of England, Scotland and Wales as previously described. These causes include overfeeding and excessive snacking provided by parents and guardians and low activity rates of children due to the introduction of video games, to name a few (London Health Observatory, 2010). The outcomes of these occurrences are overweight children who develop into obese children and adolescents and gradually develop life-threatening conditions such as Type 2 diabetes and high blood pressure (Young Londoners’ Survey, 2009). In the long, a large proportion of money that could be utilised in other sectors of development has to be pumped into the health sector to manage and support obese children and adults. This support could be both short and long term. It is estimated that an obese child residing in London will utilize £31.00 a year and £611.00 a year if they grow into obese adults (HM Government report, 2007).
In summary, both the government and community are affected by obesity and as number rise indicate a possible future threat to the economy, Fig 2.
Fig 2, The vicious cycle of childhood obesity. Factors contributing to the development of childhood obesity have to be addressed as they have a knock on effect on the quality of the lifestyles of affected individuals and the decision policymakers subsequent take.
In the above discussion, data from a number of different sources have been analysed. I think all data should be adequately standardised excluding all outlets for precise conclusions to be made. I would also take into consideration the degree to which child confidential details are given when questionnaires are being administered. In addition, for all studies to be adequately approved ethically I think all data has been handled confidentially, consent obtained from parents and children being studied and the objective of the study clearly explained to the children and parents of the child before enrolling the children in the study. If any rewards are to be given for participation, all subjects must be made aware at the beginning of the study. Furthermore, care has to be taken when analysing data of different populations for comparisons as in the case of England, Scotland and Wales. Moreover, when comparing data from different gender, care has to be taken with regards to how the two genders develop especially during adolescence (The London findings of NCMP, 2010).
In the studies discussed, the investigations were designed to incorporate the adequate number of subjects. This would ensure any significant differences to be observed when the data is analysed.
In my opinion,
There are different ways in which the prevalence of childhood obesity in the UK can be reduced. A number of preventive measures, including lifestyle and dietary change may reduce the rate at which children and adolescents develop obesity. In my opinion, London policy makers have to address the issue of childhood and adolescent obesity as it’s affecting the lives of many children and influencing how they grow and take up jobs to contribute to developing and maintaining the economy of the city. As already discussed, policies have been initiated to curb childhood obesity, but these have to be constantly advised to ensure they are actually reducing the rate of childhood obesity. The policies must focus on eliminating the socio-economic barriers that may limit the access to healthcare by some members of the population. From the data presented, it has been seen that obesity is most prevalent in regions that are occupied by the low-income earners.
Evaluating this, has brought to my attention a number of factors which contribute to childhood obesity. Firstly, the socioeconomic environment in which a child finds him or herself determine many things including whether they end up obese or not as cheap food and low education levels of the inhabitants influence the decisions and the upbringing of the children in these areas (McBride, 2010) (Ebbeling et al., 2002). In these areas, there are increasing the burden on health facilities. Thus, the quality of health care is also affected. This factor has to be thoroughly explained to the inhabitants of London who currently find themselves in low economic boroughs. They can then voice out their concerns to their representatives of policy makers, and then hopefully changes can be made in their community. These changes can include the reduction of the number of fast food outlets where high caloric food is sold. These places can be replaced with outlet lets that promote the sale of healthy foods like fruit and vegetables.
Secondly, I have been made aware of the impact genetics may have on a child developing obesity as studies have shown that genes influence the rate of development of obesity (Farooqi and O’Rahilly 2006). With regards to genetics, I think education at health care centres, schools, universities and other public places have to spell critically out the role of genetics in association with the environment has on a child developing obesity. Furthermore, events either organized on a competitive basis or for leisure can be organised for both children and their parents to engage in physical activities. These events can be charity runs, swims, walks, hill walking or hiking. Community funds can be raised and utilized to provide more playgrounds or resources for children to play with and engage with to be more active. Furthermore, dietary advice and menu planning information can be made known to parents to encourage them to feed their families on healthy diets.
In summary, childhood obesity is a public health. The government should therefore device strategies of reducing this burden for future sustainability. Factors such as genetic, environmental, socioeconomic issues need to be addressed as to reduce risks and burden on government funds. Tackling obesity in children is a priority on the political agenda. The Government has targeted to prevent the increase in the under 11s by 2010 as a policy to address obesity in children including the whole residents. Initiatives to halt this include the Healthy Start (a Healthy Schools Programme), Schools Tool Kit and school physical activities, by Department for Education and Skills (DfES).
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