Factors Effecting Childhood Obesity and Interventions

¶ … Childhood Obesity and Interventions

There is a strong relationship between childhood obesity and exposure to environmental factors -- most notably socio-economic status. There are exposures that trigger both positive and negative outcomes, and these have to be discussed along with the possible interventions that can be undertaken. Low socio-economic status (SES) has been associated with a large number of problematic outcomes where health is concerned, including obesity and related issues in childhood (Kallem, et al., 2013). Despite this correlation, though, there are plenty of children with low SES who grow up slim and apparently health, so it is clear that environment is not the only factor (Kallem, et al., 2013). The objective of the study by Kallem, et al. (2013) was to examine the "shift-and-persist" strategy and how (or if) it was what was protecting low SES children from obesity in some cases. This strategy involves how a person deals with stressors in the sense that the person reframes them into something positive while ensuring that positive and optimistic thoughts for the future continue (Kallem, et al., 2013).

While this is not a theory that works for everyone, there are many people who use this strategy in order to keep their life happy and moving forward when they are dealing with difficult issues in life. In low SES children are using this strategy it could be keeping them from becoming obese, even if they have other problematic factors at play (Kallem, et al., 2013). Middle-school children were studied by Kallem, et al. (2013) and linear regression analyses were used in order to determine whether children were using the shift-and-persist strategy and what their BMI was. The study was also controlled for gender, race, ethnicity, physical activity, and diet (Kallem, et al., 2013). Results indicated that children who did not use the shift-and-persist strategy but who were living in low SES conditions had BMIs that were significantly higher than their peers who used the shift-and-persist strategy as a way of life (Kallem, et al., 2013). Students that used the strategy did not have any correlation between their SES and the obesity rates seen in their group (Kallem, et al., 2013).

That was a significant discovery, because it could lead to teaching the shift-and-persist method as an intervention for obesity. The psychological resilience of children could be improved in this way, and that would help them avoid the obesity trap that often comes with low SES and difficult conditions (Kallem, et al., 2013). While this may not work for every child who comes from a low SES situation, there is enough evidence to indicate that it could be worthwhile for a large segment of that population. The study conducted by Kallem, et al. (2013) is also not the only study that has explored SES and how it affects the obesity of children who grow up in that environment. Another study by Wang & Zhang (2006) also indicated that low SES can be a problem that can cause obesity in children.

In that study, the focus was on an association between SES and obesity, and how there were important public health policy implications involved in that correlation (Wang & Zhang, 2006). This was particularly important where the management of obesity was considered, because it is generally much easier to avoid or manage a condition as opposed to trying to correct it once it occurs. With childhood obesity, issues that occur from it can become a problem for years to come (Wang & Zhang, 2006). The medical problems stemming from an obese childhood can be life long, and can also result in a shortened lifespan (Wang & Zhang, 2006). The study examined secular trends as they related to SES and a body mass index that was higher than the 95th percentile (Wang & Zhang, 2006). Data was collected from the National Health and Nutrition Examination Surveys that were completed between 1971 and 2006 (Wang & Zhang, 2006). Children who participated were between two and 18 years of age at the time their information was collected (Wang & Zhang, 2006).

The children were then divided based on whether they were in the low, middle, or high SES brackets (Wang & Zhang, 2006). There were many differences in sex, race, and age observed when it came to the association between SES and obesity, with the largest risk belonging to African-American children (Wang & Zhang, 2006). While there have been some weakening trends in the correlation between SES and obesity over time, there are still concerns regarding the issue and how the two areas of life tie together. There are also complex patterns in the way the association between the issues is connected, so working solely to reduce income disparities is not going to "fix" the problem of obesity -- especially as it applies to racial disparities (Wang & Zhang, 2006). There are, of course, other factors that can contribute to childhood obesity besides having low SES. One of this is the food these children eat coupled with the lack of exercise many of them receive.

A study by Sothern (2004) indicated that many children do not get enough opportunities for physical activity, but that they do get an abundance of high calorie food. Naturally, that combination can lead to obesity and become a problem for children as they move into adulthood. What they learn at a young age is often what they carry with them throughout life, so if they do not eat right and exercise when they are young, they may choose not to do it when they are older, either (Sothern, 2004). That can lead them down a path toward a lifetime of health problems that could have been avoided. With children who are predisposed to any type of metabolic disorder, poor nutrition and a sedentary lifestyle simply combine to make the issue worse and raise the level of risk (Sothern, 2004).

It is logical that obesity would occur in that context, but many parents do not realize that they can play a big role in helping their children avoid what seems logical for them, providing them with a better level of health (Sothern, 2004). It is not just the parents, however, who must focus on making sure these children get the good start in life they need in order to avoid obesity. This is a community-wide and society-wide problem that has to be carefully addressed (Sothern, 2004). By handling it properly, strategies can be supported which will not only change public opinion but that will also adjust behavior across a person's entire lifespan (Sothern, 2004). If the parents are obese, it is even more important for societal influences to focus on the family and the children, in order to help the children avoid the trap of obesity as they grow and develop (Sothern, 2004). This can begin with educating the parents starting with the first pregnancy visit, but can also be successful if started later in life.

Additionally, schools can play a large and significant role in the health and weight of the students by educating both the children and the parents (Sothern, 2004). This can be done through information on reducing unhealthy snacks and overeating, but also through an encouragement of exercise instead of TV and video games (Sothern, 2004). While not all children and parents will take this to heart, many of them will make positive changes that will help everyone in the family live a better, healthier life. Schools can also provide healthy meals and snacks, along with vending machines that dispense healthier options (Sothern, 2004). Portion sizes also matter, because even healthy food can become a problem for a person's weight if he or she eats too much of it on a consistent basis (Sothern, 2004). For children who already weigh too much, clinical treatment is necessary and financial support for it should be available to the parents (Sothern, 2004).

There are racial and ethnic disparities in health and health care, and that is something that needs to become more of a national focus (Carroll-Scott, et al., 2013). Obesity is one of the prime issues that have to be addressed in this context. In the last three decades the prevalence of childhood obesity has rapidly increased (Carroll-Scott, et al., 2013). There is no age group that has been spared, and problems are being seen in young children that were, in the past, reserved for older people. These are issues such as type II diabetes, hyperlipidemia (high cholesterol), and hypertension (high blood pressure) (Carroll-Scott, et al., 2013). Other long-term adverse outcomes -- both physical and mental -- are also a part of the profile when it comes to childhood obesity, so there is much at stake.

By the time children reach preschool age, the racial and ethnic disparities seen in the levels of obesity are already present (Carroll-Scott, et al., 2013). This suggests that obesity begins very early in life, and that there are even risk factors that occur while the child is still in the womb (Carroll-Scott, et al., 2013). Some of these earliest risk factors include the weight of the mother, whether she is depressed, biological stress on the fetus and the mother, smoking during pregnancy, and gestational diabetes (Carroll-Scott, et al., 2013). However, it is possible for a child exposed to all of those issues to remain slim, and a child exposed to none of those factors to be overweight or obese (Carroll-Scott, et al., 2013). While the factors are certainly important, they are not the only possible issues when it comes to overweight or obese children and young adults.

Studies have found that racial and ethnic disparities can be just as significant as SES, diet, and exercise issues -- largely because SES and related concerns are often tied to specific racial and ethnic groups more than others (Carroll-Scott, et al., 2013). Preschool age children who are in minority racial and ethnic categories have a statistically higher prevalence of obesity when all other variables have been controlled for by researchers (Carroll-Scott, et al., 2013). That is a serious indication that there is more at play in the overall environment, and that study of all factors that could contribute to obesity is needed. That would include analyzing a larger area of environmental factors, because there are many causes for the tripling of obese children and adolescents throughout the last three decades (Dixon, et al., 2012). That much of a change in that short of a time period is a significant problem for society, and can raise the rates of health care for everyone.