Childhood Obesity Literature Review

 
Introduction
Childhood obesity has grown to be an epidemic in the U.S and it’s a very serious issue which leads to many social and health consequences. The world is actually undergoing a rapid nutritional and epidemiological transition characterized by nutritional deficiencies as a prevalence of anemia, stunting, zinc and iron deficiencies. The effects of overweight and childhood obesity also create such an economic impact due to co-morbidity related hospital and clinic visits, treatments and medications Nonetheless, there is a rise in prevalence of diabetes, obesity and nutritional diseases like diabetes, obesity, and cardiovascular diseases. Reports suggest that estimated 16 percent of adolescents and children aged 6-18 years are actually overweight in America. It hence vital to rolling out preventive programs towards reducing the impact of obesity as well as understanding its impacts at an early stage. There is a dire need for healthy promotions in homes and schools concerning exercise and diet, support from private and public industries towards facilitating healthy food and support from the food and packaging industries in offering nutritious food






Mechanisms of Obesity
Obesity is characterized as a medical condition where such individuals have gathered a lot of fat in the body leading to a health problem. During one's growth, fatty cells always increase in number and when a given energy intake actually exceeds its expenditure; the fatty cells grow or increase in size (Wilson, 2007). When these fatty cells reach their maximum size while energy intake still continue to exceed its expenditure, the fatty cells in turn increase in numbers again. When there is a fat loss, none of these fatty cells decrease in number but they only decrease in their sizes.
According to Cavan & Kerr (2006), there is a less fatty acid which actually occurs in our body or in food and most of the time they are converted into triglycerides which are composed of 3-fatty acids and a glycerol molecule. To create these triglycerides, some form of condensation reaction occurs combining fatty acids with a hydrogen atom to create glycerol and a hydroxyl group. Research indicates that this childhood obesity is always linked with high levels of leptin hormones which is a secretion from adipose tissue and mainly involved in regulation of energy expenditure, food intake and energy balance in animals (Scott & Lowet, 2004). In children, obesity is a common nutritional and metabolic disease which affects them at a tender age.
Effects of Childhood Obesity
Obesity has always been established to have such severe consequences on children’s health. Research has shown that children who are obese have such a high risk of high cholesterol and blood pressure which are main ingredients for a heart attack in the future (Satter, 2008). Obesity is said to increase such risk of glucose tolerance within a human body and in turn result in insulin resistance in the body leading to diabetes. With this excessive intake of fats, the child can develop more breathing problems that can eventually lead to sleep apnea or asthma. The extra load that this child puts on as weight compared to her bone development exposes the child' to a lot of discomforts and joint pain. Research has also shown that kids who are overweight can have a gastro-esophageal influx, a fatty liver disease which causes gallstones and heartburn in a kids liver (Willms, 2008).
The physical outlook associated with obese children cause social health and psychological problems with stress and depression which can be seen in public areas and school. This lowers a child’s self-esteem hence affecting how they finally perform in school and relate with others. A study by Mechelem & Hirasing (2008), reveal that this obesity in individuals impairs emotional, physical and social functions of child's development. Obese children have been linked with a higher prevalence of such anxiety disorders compared to non-obese. 
According to studies by Tremblay & Willms (2009), shows social consequences which are linked to obese and overweight children are peer difficulties and poor self-esteem associated with being marginalized. Research on adolescent weight in correlation with risk behaviors shows that nearly half of girls in their adolescent had been on a diet while 30 % of overweight girls and seven percent of overweight boys depict a disorder in eating (Mechelem, 2008). This social isolation is linked with suicide ideation, low self-esteem as well as substance abuse. Research has also linked marginalization of these overweight children to higher rates of college dropouts and adult poverty (Smith & Trwbridge, 2007).
The effects of overweight and childhood obesity create such an economic impact due to co-morbidity related hospital and clinic visits, treatments, and medications. Long-term effect related to adult obesity is associated with life insurance, paid sick leave, lost years of productivity and disability insurance. The rise in the obese children carries such increase in pediatric burden in terms of economy with hospital costs linked with pediatric obesity at around 127 million US dollars yearly (Neiman, 2007).
Causes of Childhood Obesity
Multiple factors have actually been associated with this kind of development including socio-economic groups, energy expenditure, exercise, parental knowledge and food portions as well as lifestyle (Chiumello & Heymsfieldd, 2007). Decreased energy expenditure with increased intake of calories and fast food remains a significant factor. Nonetheless, the explosion of new affordable technology as handheld computer games, cell phones, and video games has promoted a sedentary kind of lifestyle. A sedentary lifestyle is an important environmental factor which determines the level of children's physical activity. Exercise is important for kids towards maintaining their metabolic rate, aid in controlling appetite and improving the overall psychological outlook.
Along with this decrease in exercise, a significant increase in food portion size and nutrient intake has increased for quite a number of years. Many fast food joints have grown and exceeded their recommended sizes. Nonetheless, food advertising especially on television targets children with auditory and visual messages which encourage consumption of these fast food which is high in sugar and fat. Advertising is thus considered as a kind of environmental factor which promotes the childhood obesity. The additional health concerns associated with obesity are breast cancer, kidney cancer, and colon cancer.The cause of liver cirrhosis has been linked to alcohol but it has been lately overtaken by direct result of deposition of fat.
        
Its widely known that increase in obesity is caused by an imbalance between expenditure and energy intake, with this increase in positive kind of energy being associated with dietary intake and lifestyle preferences (Satter, 2008). However, increasing evidence links genetic background to this kind of risk. Genetics sometimes contributes to this obesity but at one percent due to a hormonal imbalance where there is a mutation that leads to uncontrolled secretion of hormones. The genetic factors of this overweight can lead to children's gene while causing disorders as Prader-Willi syndrome (Mechelem, 2008). However, this genetic susceptibility has to be coupled with behavioral and environmental factors in order to affect weight.
The basal metabolic rate is linked to causes of this child's overweight and obesity. Metabolism accounts for 60 percent of overall energy expenditure in such sedentary adults (Verma M, 2007). A recent study showed how fast foods and energy drinks consumptions lead to greater intake of calories and fats as well as decreased intake of vegetables and food. A study by Birch (2007) revealed that 30 % of children are taking fast food with approximately 200 more calories adding up to 6 pounds of the fat each year. Studies have also shown that youths associate fast, junk food with independence, pleasure, and convenience while the healthy food is odd (Satter, 2008). This fast food is said to have a high number of calories but low nutritional values. Sugary beverages are less filling compared to junk food but can be easily and quickly consumed resulting in such higher caloric intake. 
Moreover, this research by Yu, H., & Goldstein (2010) revealed that kids are capable to adjust their food intake to always match the energy outflow but as they grow, their food and drinks intake becomes reliant mainly on external cues as the type and amount of food available. Other studies concluded that child's environment has to affect ted children since with increased availability of junk food, increased time for television and computer viewing and less physical activity in schools promote the imbalance of energy expenditure and intake resulting to overweight and obesity among children.  
Organized and unorganized kind of physical activity is said to be negatively associated with overweight and obesity. This physical activity, in turn, decreases the risk of children becoming obese by nearly 23% to around 43% (Chiumello & Heymsfieldd, 2007).In contrast, playing video games and watching television increases the risk of actually being obese by 10% to 60%, overweight by 17% to 44% (Neiman, 2007).In this 21 at century activities such as riding bikes, jumping robes and skating has replaced video games, television, and computer games. Television has hence been proven to a key factor in this childhood obesity because viewing it during childhood period could have devastating and lasting effects on future lifestyles. According to the study by the American health, nearly one out of four children between 6 and 12 are actually obese due to television viewing encouraging a kind of sedentary lifestyle and contributes to this childhood obesity through their aggressive campaign of marketing of the junk food (Teufel, 2007). The American Pediatric Society, in turn, found that nearly all the advertisement on children's shows are candy, fast food, and sweetened cereals. The healthy food commercials, on the other hand, make up just 4 percent while an average kid spends around 25 hours each week watching television (Scott & Lowet, 2004).
Prevention Strategies and Discussion
The healthcare Practitioners have developed many preventive recommendations for teachers, parents, officials and government administrators indicating various ways to reducing weight and obesity among the children. Peter Niemba (2002) cites that pediatrics need to evaluate every child's growth based on a calculation of BMI on a regular basis. Exercise should be practiced most of the time in order to maintain an ideal kind of bodyweight. Breastfeeding has been depicted to actually decrease the risk of being overweight with a 35 percent lower risk of their kid being overweight (Gibson, 2008).Parents need to check on their child's eating habits by regulating their kid's interests and promoting a healthy pattern of well-balanced diets. Nonetheless, prevention of this childhood obesity should begin prior to its conception by educating parents on various risks of maternal diabetes, high birth weight and obesity among families (Kim, 2007).
As shown by National Taskforce on overweight and obesity, fiscal policies such as providing incentives for healthy food distribution, taxing unhealthy food and investing in more recreational facilities, as well as the aesthetic quality of homesteads, enhance the physical activity and healthy eating. A public policy which is based on healthy behaviors can help alleviate obesity as the government can in turn support such policies which reinforce physical activities and healthy eating.
In order to maintain healthy habits adverts on junk food and beverages should be gaged and proper legislation should be enacted as increase taxes on these adverts. Evidence supports the current measures which in turn ensure that healthy diet, physical activity, and adequate behavioral support reduces such risk of being overweight (Satter, 2008). A multi-faceted form of the approach of education, nutrition, physical activity and behavioral therapy showed this can actually reduce obesity (Kim, 2007). There are also different behaviors within a family which cause this prevalence as opportunities to actually share meals and mother's knowledge of food and nutrition. 
In conclusion, child obesity is increasingly being a major problem among the western countries which impacts on its overall health. This review dealt with various evidence and theories surrounding childhood obesity such as preventive measures, treatments, causes, and effects accompanied by being overweight. There is a dire need for healthy promotions in homes and schools concerning exercise and diet, support from private and public industries towards facilitating healthy food and support from the food and packaging industries in offering nutritious food. The national and local governments should team up to ensure there are legislation and funding in order to increase access to recreational and playground facilities. Advocacy and leadership from the health scientist and professionals are required to actually bring various changes towards ending the childhood menace.












References

Chiumello & Heymsfieldd, S. (2007). Body mass index as a measure of adiposity among children and adolescents: A validation study, Journal of Pediatrics.
Gibson, L. e. (2008). The role of family and maternal factors in childhood obesity. Medical Journal of Australia,
Kim, J. &. (2007). The role of parents in preventing childhood obesity. The Future of children.
M., R. (2007). Prevalence of overweight and obesity in affluent adolescent girls.
Mechelem, W. &. (2008). Overweight and obesity in children and adolescents and preventative measures. Ned Tijdschr Geneeskd, 148.
Neiman, P. (2007). Childhood Obesity. Retrieved from http://ditk-kids.com/articles/childhood_obesity.htm.
Satter, E. (2008). Internal regulation and the evolution of normal growth as the basis of prevention of obesity in Children. Journal of the American Dietetic Association.
Scott & Lowet, M. (2004). The obesity epidemic. Alberta Heritage Foundation for Medical Research.
Smith & Trwbridge, F. (2007). Preventing Childhood Obesity: establishing Healthy Lifestyle Habits in the Preschool Years. Journal of Pediatric Health Care, 315-319.
Teufel, J. A. (2007). Early adolescents perceptions of health and health literacy.
Verma M, R. S. (2007). Obesity among pre-adolescent and adolescents of a developing country.
Willms, J. (2008). Early Childhood obesity: a call for early surveillance and preventive measures.,. Canadian Medical Association, 243-244.
Wilson, R. &. (2007). Standardized percentile curves of body-mass index for children and adolescents. American Journal of Disease of Child.