health concerns among children which were once considered to be the lifestyle disorders of adults only. Thus, the prevention of childhood obesity with a focus on increased physical activity and lifestyle management at an early age is of utmost importance.
Current technologies and cultural habits have successfully managed to reduce the physical activities of everyday life of children along with changing food habits by providing cheap and accessible sources of high sugar, high-calorie drinks, and food. Now if we solely rely on individual “self-control” to change our food habits to become healthy, it will not be effective. The outside environment as a whole needs to contribute to making sure that change has been established and a child adapts healthy eating habits and an active lifestyle.
Prevention of Childhood obesity
Prevention is the key to controlling obesity among children and it can be more rewarding as it provides better chances to avoid long-term complications. It can be subdivided into three levels:
- Primordial Prevention – deals with keeping a healthy weight and BMI throughout childhood and into teens
- Primary Prevention – Prevent overweight children from becoming obese
- Secondary Prevention – directed towards the treatment of obesity, to reduce the risk factors of lifestyle disorders and reverse obesity and overweight if possible
If we put it into the lens, the prevention doesn’t start in infancy or it doesn’t stop at puberty, all three stages of prevention can be put into practice sequentially from the pre-infancy period to adolescence:
- Perinatal – includes adequate nutrition for the mother with optimum maternal weight gain, controlled blood sugar levels, postpartum weight loss with an active lifestyle, and the right nutrition
- Infancy – exclusive breastfeeding for 6 months followed by the inclusion of solid foods, providing balanced nutrition, and avoiding unhealthy calorie-dense snacks. Close monitoring of weight gain is recommended here
- Preschool – providing nutritional guidelines to parents and children to develop healthy eating practices, followed by monitoring the rate of weight gain to prevent early adiposity
- Childhood – monitoring weight gain and height, thus preventing prepubertal adiposity. Provide nutritional counseling to children and emphasize physical activities
- Adolescence – Prevention or management of weight gain after a growth spurt, maintaining healthy eating habits, and positive reinforcement on the significance of an active lifestyle
Physical activity becomes an important aspect of the prevention and management of childhood obesity. As per the American Academy of Pediatrics, preschool children require unstructured activities like outdoor play or games whereas school-going children and adolescents require at least 60 minutes of total physical activities which require 30 mins of structured activities like sports or supervised exercise routine.
Structured recommendations have been provided by numerous scientific societies that focus on preventing or management of childhood obesity. They are divided into two major stages, one for infants and pre-school children and the other for school-going children and adolescents.
Recommendations for the prevention of overweight and obesity in infants and pre-school children
| Nutrition | Physical Activity and Sports | Media Consumption |
|---|---|---|
| Family should eat together | For 3-5 years old children – 60 mins of structured physical activities | No TV in children’s bedroom |
| Introduction to healthy and new food choices | School Age – minimum of 60 mins of moderate to intense physical activities | Limit access to media and in a general reduction of screen time spent |
| No distraction from the TV while eating food | Promoting access to the indoor and outdoor exercise area | For children under 3 years – 0 Hours |
| Inclusion of water or unsweetened beverages; fresh juice without added sugar | Acquisition of basic motor skills as a basis for future physical activities | For 3-6 years – 30 mins maximum |
| Inclusion of fruits and vegetables, grains, potatoes | Education of parents and guardians on the significance of physical activities | |
| Limited intake of sugar and sweets |
Recommendations for the prevention of overweight and obesity in early and middle school years
| Nutrition | Physical Activity and Sports | Media Consumption |
|---|---|---|
| Varied balanced diet | 90 minutes of moderate to intense physical activity | No TV in children’s bedroom |
| Ample inclusion of water or unsweetened beverages; fresh juice without added sugar | Minimum of 12000 steps in a day | Limit access to media and in a general reduction of screen time spent |
| Ample inclusion of fruits and vegetables, grains, potatoes | Limit sedentary activity to a maximum of 2h/day | For children 7 – 11 years – 60 mins maximum |
| Elimination of sweetened drinks | For children 12 years and older – 120 mins maximum | |
| Controlling portion size and creation of healthy balanced meals | ||
| Limited intake of sugar and sweets |
The intervention for preventing and managing childhood obesity is mainly focused on limiting the intake of sugar and high-calorie snacks with higher consumption of vegetables and a fruit-based diet. This also includes a calcium-rich high-fiber diet with balanced micronutrients and home-cooked meals with smaller portion sizes. Also, decreasing the duration of “screen time”, especially television, and increasing physical activities are important for preventing childhood obesity.
Reference list
- Pandita, A., Sharma, D., pandita, Pawar, S., kaul and Tariq, M. (2016). Childhood obesity: Prevention is better than cure. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, [online] 9, pp.83–89.
- Weihrauch-Blüher, S., Kromeyer-Hauschild, K., Graf, C., Widhalm, K., Korsten-Reck, U., Jödicke, B., Markert, J., Müller, M.J., Moss, A., Wabitsch, M. and Wiegand, S. (2018). Current Guidelines for Obesity Prevention in Childhood and Adolescence. Obesity Facts, [online] 11(3), pp.263–276.
