II. Introduction
Contemporary problem of childhood obesity is becoming an ever greater issue in the world and also in the United States that is among the countries where the problem has reached alarming rates. The majority of obese children live in developing countries. For the complex problem the comprehensive solution and reform are needed in order to achieve the reduction of obesity. The paper will focus on the identification of the major key factors that cause and contribute to the childhood obesity and measures to be taken to achieve reduction of obesity in the whole society and nation. Beside the reasons also the consequences of the obesity will be presented to show the importance to solve the issue and need to change the eating habits. The obesity is contemporary problem that causes health, physiological and social problems and must be addressed by focusing on the causes, factors that contribute to it and ways how to reduce the increasing rates of contemporary issue.
III. BODY
A. Background
The scope of the issue of child obesity is showing the importance of taking the obesity very seriously. The obesity trend is showing increasing numbers of adults and also children that are dealing with the overweight and obesity issues. Based on the World Health Organization the global obesity has more than doubled since the year 1980. In the year 2014 there were around 1.9 billion overweight adults and in 2013 42 million of children under the age 5 with obesity problems. The reasons are mainly the lack of physical activity, sedentary lifestyle and imbalance between the calories consumed and used (World Health Organization, n.d.). Obesity has emerged as one of the most serious health concerns and has increased in the last three decades and is leading to emerging of the comorbid diseases at very early ages (Güngör1, 2014). The increasing trend of obesity among children has been seen on the global scale. Centers for Control and Prevention has shown that in the United States the obesity of children stayed at unacceptable stable 17%, which means that 12.7 million of children and adolescents are affected by obesity. There was seen the reduction of obesity among 2 to 5 years old children and was in 2011-2012 at 8.4%, among 6-11 years old at 17.7% and 20.5% among the 12-19 years old children and adolescents. The childhood obesity was in the United States also more common among certain racial and ethnic groups – among Hispanics and non-Hispanics Blacks (Centers for Disease Control and Prevention, n.d.).
The childhood obesity must be reduced since obesity causes various psychological, health and social problems. The neglecting of the problem is therefore unacceptable. Health problems of children are leading to health risks in adulthood. Among the most common health issues are greater risks of cardiovascular diseases along with the high blood pressure and increased cholesterol levels. Other risk obese children are exposed are diabetes and various respiratory issues such as asthma, sleep apnea and shortness of breath. The seriousness of possible health related risks shows also the higher risks of fatty liver or muscle and bone disorder because of the weight (Karnik & Kanekar, 2012). The children with obesity problems need routine screening and treatment for their conditions also face the problem of inadequate primary care pediatric providers. Obese children are suffering for comorbidities connected with the obesity, such as abnormal blood pressure, fatty liver, dyslipidemia, prediabetes, diabetes, polycystic ovary syndrome and many others psychological problems. The high numbers of obese children are exposed to the obesity-related comorbidities that have just been identified and the situation can deter because of the shortage of subspecialists in pediatric that would deal with the issue (Estrada & Eneli, 2014). The childhood obesity can affect almost all child organ systems with leaving great consequences and complications and is the cause for the increased health care expenditures. The early detection, reaction and treatment play a vital role (Güngör1, 2014). There were evidence (Nadeau, Maahs, Daniels, Eckel, 2015) found that adults who suffer from cardiovascular health issues had the disease in their childhood. The prevention of obesity in childhood is extremely important to increase the overall health of the whole nation. The health risks are usually increased at the early life stage in childhood. The obesity is significant chronic disease that can be treated with medication, surgery and where important role in the treatment is put on the pediatric gastroenterologist (Huang & Barlow, 2013).
Psychological problems connected with the obesity reside in the negative body-image the obese children have which is leading to the low self-esteem, which is further affecting the social problems. Self-esteem has an impact on the social and academic school achievement. Obese children are exposed to the stigmatization and discrimination from the peers and also adults (Karnik & Kanekar, 2012). Washington (2011) has pointed out that social implications are usually not addressed in various intervention programs to reduce obesity, but play a crucial role. The child can be exposed to the teasing and discrimination which has an impact on the overall progress. By ignoring the emotional consequences of obesity the clinical depression, negative body image and low self-esteem can become an ethical problem. Stigma is caused which can have a life lasting effects on the individual. Güngör1 (2014) beside already mentioned psychological complications points out also the loss-of-control in eating that can result in the extreme weight control behavior, that leads to the reduction of quality of life, suicide attempts and eating disorders.
B. Analysis of the Problem
There are various reasons and prerequisites of childhood obesity. There are different factors that are pushing the people toward unhealthy eating behavior. Beside the genetic factors important roles have also the behavior factors. Lack of physical activity with eating large portions of energy rich and high sugar food, with the sugared beverage and a sedentary lifestyle are factors that contribute to the obesity. Computers, video games, televisions and snack without any physical activity. The environmental factor is the third group that influences the choice of food and activity. Home, school and community environment are the biggest influence factors that can motivate and develop the food choices and physical activity (Kanekar & Karnik, 2012).
There has been evidence that some groups and people are more likely to suffer from child obesity because of various reasons. The ethnic origins play a significant role since ethic group, Hispanics and South Asian appear to be more affected by the obesity that another ethnicity. Children in the urban areas are more likely to suffer from the disease. Socioeconomic factors have shown to have an impact on the obesity where among the low-income families and their children the rate of obesity is higher (Güngör1, 2014). Families in poorer communities do not have the access to the healthier foods, because of the higher prices, fewer health choices of food, with the fast food establishment near the playgrounds and schools (American Psychological Association, n.d.). Some groups have been identified as more vulnerable to the obesity issues because of the lack of the opportunity or access to the healthy food, because of poverty and lack of finances, because of the environment and the neighborhood they are living in and the eating habits of that community. Family, community and school affect the eating and drinking habits and impact the child obesity. Based on the Cluss et al (2013) the low-income children and minorities are in the United States overrepresented among the obese children. The poverty is definitely the biggest contributor to the obesity. Low-income households are focusing on buying the cheapest calories that can be found in junk food. The reason why the low income and poorer individuals suffer more for obesity is because the unhealthiest foods are the cheapest.
The rising trend of the obesity can be partially explained with direct and indirect promotion of unhealthy eating and drinking habits. The aggressive marketing and advertising of food with poor nutritional value influences the formation of unhealthy eating habits for children. The children are subject to manipulation when the substitution of concepts takes place: instead of nutritional concerns the game and entertaining are in the focus. The unhealthy choices that people make serve as a fuel for the current economy. Thus, the manufacturers of junk food are fed, so as, consequently, the pharmaceutical companies, which produce the medications used for treatment of the diseases caused by unhealthy eating habits. Television advertisement of the junk, sugared and high-energy food have a severe impact on the childhood unhealthy choices (Kanekar & Karnik, 2012). Bernard (2015) has also expressed concern that the leading cause of child obesity is money. He argues that the food industry and many companies in the country are making money out of the unhealthy school meals that are causing the childhood obesity, which were even advertised in schools. The family, community, school and environment all play important role in reduction of the obesity rate.
The marketing is not only present in the food, but also in the beverage industry. The ignorance can be seen in one of the main causes of obesity in sugar sweeten beverage. Reducing the consumption of the sugary drink should be one of the main goals in reducing the rates of obesity. Everyone knows Pepsi and Coca-Cola because of the big advertisement of the drinks, but a direct connection to the sugar and obesity is not always directly acknowledged and people do not see the sugar drinks as unhealthy. The amount of calories consumed with the sugared drinks is one of the main reasons for gaining weight and is contributing to the obesity epidemic since it affects the body fat. Data collection, provided from the Avery and McCullough (2015) showed that among the lower income families the consumption of sugar-sweetened beverage was bigger as among the consumption of the higher income families. In order to reduce the consumption of sweeten beverage schools should offer only waster and low fat milk that would reduce the calorie intake (Powers, 2011).
The issue of nutritional ignorance of the population is also contributing to the rate of obesity. The people lack critical thinking in the matters concerned with food consumption. The knowledge and education in terms of nutrition among parents affect the childhood obesity. The childhood obesity problems persist into the adulthood and the statistics has shown that the poor and minorities are at higher risks of becoming obese. Parental nutrition plays a vital role in the development of child obesity. Shopping, preparation, and delivery of food differ based on the nutrition knowledge. It has been assumed that parents from low socioeconomic status have poorer recognition of food nutrition value. The less knowledge of the nutrition can lead to the increased weight and results in the poor eating habits. With the poor nutrition knowledge the food items are perceived healthier than they in reality are. This can be used in the prevention and intervention goal to reduce obesity (Cluss et al, 2013). The parental style and practices have a great effect on the children eating habits and practices since they represent a role model. The eating patterns of children are usually the portrait of parents eating habits and that is why all factors that influence the perceptions of health are important. From the surveys, there has been seen that the parents of the obese children do not perceive them as overweight, which can be the major factor to reduce the obesity (Birch, Fisher, Savage, 2008).
C. Responsibility for the problem of childhood obesity
Responsibility of the legislation on the federal level has been in the US almost nonexistent. The role of government institutions is mostly limited to the formal setting of the standards and statistical research gathering (data on childhood obesity). The Centers for Disease Control and Prevention report (n.d.A) shows that legislation of various health categories has seen much legislation enacted and even more proposed in the area of nutrition and physical activity. The legislative bills addressing the nutrition and physical activity have outnumbered those aiming at obesity. The SLRA Database shows the state legislative bills in the area of obesity. The federal efforts to prevent and reduce obesity are involving research, providing best practices and guidelines. There are various agencies dealing and promoting physical activity and health nutrition with various programs, with advice, guidance, nutrition assistance programs, educational campaigns, oversight over the diary and agricultural market. On the state level, there is more legislation implemented in the area of obesity, such as nutrition standards for schools. The same situation is seen in other countries as well since the legislation on the countries levels are usually very scope.
The responsibility of the food manufacturers and its contribution to the obesity levels should be more acknowledged. With various misleading marketing, focusing especially on children with unhealthy products they are promoting unhealthy eating and drinking habits. By using different Disney characters they are promoting many sugar and energy dense food with low nutritional value. Besides the marketing, there is also the fact of false advertising and labelling with various decisive pictures and names. Since there is a link between the unhealthy consumption and obesity the companies should bear the burden and take responsibility for obesity. The food manufacturers should not leave all on the personal responsibility and the states and countries should also not allow that. The companies and food providers can do a lot to improve the health of the nation by offering more nutritious products with low levels of fat and sugar.
D. Solutions: complex Childhood Nutrition Reform
Resetting industry standards in the area of advertising of food and beverage production would lead to more quality standards of products. Setting a nationwide public discussion between governmental committees, business associations and corporations in order to drive attention to the problem and openly discuss the food industry standards. The result should be the profound reframing of standards and communication of new standards to public. All should bear a reasonability and constructive dialog with implementation of standards and set of regulation is needed to tackle the obesity problems among children. With the dialog the quality ingredients for the beverage and food could be improved and also the requirements that need to be met by various actors should be pointed out.
The legal steps to regulate unhealthy food should be formed. The action must also be taken in the legislative manner since prescribing the unhealthy eating manners to the individual is not going to solve the issue of obesity, since the numbers in obese children are increasing. We should drive our attention to the importance of the legal limitations of distribution and promotion food of poor nutritional value to children. On the country level the development of criteria of unhealthy food must be formed in order to avoid disagreements which food has rich and which poor nutrition value. With developing the criteria various different actors must be involved to achieve a common agreement that will increase the health of the population and decrease the trend of overweight and obesity among children. The set of criteria of unhealthy food must after the development be promoted in every school, public and private organization where possible and also included in the television and media marketing in order to reach the wider public and develop the awareness raising campaign of unhealthy food and drinks that are the main cause and factor that lead to obesity and further to health, social and psychological problems. The government and leading actors must formulate the restrictions and requirements to limit the advertising messages of the unhealthiest food specifically targeting the children. With today’s way of living many children are actively involved in watching television, computer and listening to the radio where they come across the marketing that is meant to target the children which affect their desires. Regulation of distribution policy is also one way to reduce the rate of obesity. With regulation on a high level, there could be similar steps taken as in the history of regulating of tobacco. With the set of rules and regulation the social disapproval can be built. The public opinion must be controlled and shaped. The leading actors and government could impose higher taxes to the unhealthy food and drinks and definitely with a set of criteria of poor nutrition limit such food from schools.
The promotion and continuation of an overall educational campaign for both parents and children are needed. The issue must be discussed in public and get wider attention. The advertisement of the effects of obesity and unhealthy foods should be implemented. Campaigns of awareness rising should be carried out within the governmental and nongovernmental organizations and among the social groups that would target the perception of food consumption. The advertising of fat’s and sugar’s dangers must point to the diet and health outcomes. Nutritional scientist, physicians, medical and school personnel must be well educated in the matter in order to advise parents and children that are dealing with the obesity issues and also to prevent the obesity from emerging. The education should start early. Parents could be informed in the hospitals when along the doctor’s appointment and children should participate in school lessons about the healthy eating habits and the importance of physical activity. With the discussion in public the steps towards defining what is normal and abnormal would be created which would lead to the improved situation of food consumption. Education and knowledge about nutrition plays a vital role among both parents and children since eating habits are depended on the individual consumption and perception of health or unhealthy nutrition. As have pointed our Karnik and Kanekar (2012) interventions should include the family based lifestyles since the behavior modeling and influence is very strong inside the family. Parents are essential to improving healthy choices of eating and they should be aware of potential risks children could be facing. Children can participate in school-based intervention. School can encourage children with their meals to eat healthier and balance nutrition food with the promotion of physical activity with classroom education courses and making various different physical courses available for children to participate (Karnik & Kanekar, 2012).
IV. Conclusion
Childhood Nutrition Reform is necessary and should be provided as soon as possible. Recognizing the scale and the disastrous consequences of childhood obesity and its medical conditions, the measures should be radical and complex covering all spheres of children’s life and engaging all levels of society. Only joint efforts of government institutions, manufacturers, parents, teachers and all socially active people can lead to the quality shift in the community for changing the collective behavior and setting new norms fostering healthy eating habits of children. The increasing trend of obesity is causing an economic and social burden on nations and individuals. There are many factors that contribute to the obesity and should be taken into account when making the strategy, legislation and framework to tackle the problem. The health, psychological and social impacts of obesity are too high to leave the situation at the current levels. With reduction of the childhood obesity the overall health of a nation can be improved by lowering the costs of health care and loss of productivity. The nutrition reform is needed and must include all layers from the state, local levels, communities, districts, schools and families. The nutrition reform must take into an account that the obesity is contemporary problem that causes health, physiological and social problems and must be addressed by focusing on the causes, factors that contribute to it and ways how to reduce the increasing rates of obesity. The nutrition reform must include different causes beyond the genetic ones, such as lack of physical activity with a sedentary lifestyle, and energy dense and poor nutrition food consumption, along with the environmental factor, education and knowledge about the obesity problem. With the causes and factor in mind the constructive dialog must be implemented among all important actors to build the legal framework and awareness raising campaign that would include the impact of the advertisement and provision of unhealthy food and drinks in schools and in shops since the responsibility lies with individuals, government and on the food manufactures.
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