A Major Role in Childhood Obesity in the UK: the Health Promotion Strategies - Literature review Example

CHAPTER 2 2 Introduction Childhood obesity is a global issue of public health concern. The reason for this is that it affects children across different ages, gender and socioeconomic status especially in developed countries (Falaschett et al. 2010). This chapter focuses on a review of literature to examine the role of parents in the increase of childhood obesity. In particular, the review deliberates on pertinent areas such as the definition of childhood obesity and the underlying factors contributing to the rising prevalence. The chapter also looks at the global perspective and UK perspective of childhood obesity with an evaluation of the health promotion strategies and models that can be utilised to reverse the prevailing trends. 2.2 Definition of Childhood Obesity Obesity refers to the physical condition of excess amounts of fat in the body in relation to age, height and weight of a healthy individual (Brunt et al. 2008). Childhood obesity can be defined as body weight in excess of at least 20% of a healthy weight range for children of that height (Chinn & Rona 2001). Due to the biological variations in males and females, nutritionists now define childhood obesity as having 25% and 32% excess body fat in boys and girls respectively (Donato 2006). While adult obesity is measured by means of body mass index, childhood (BMI) obesity is measured using the BMI adjusted to incorporate factors of age, sex and puberty stage (Brunt et al. 2008). As such, the measurement of childhood obesity goes beyond the ordinary BMI computations of height and weight. In adulthood though, obesity is said to be anything above 0.25 BMI points as opposed to the case of children where obesity begins at an average 0.16 BMI points for boys and 0.18 BMI points for girls (Chinn & Rona 2001). 2.3 Childhood Obesity 2.3.1 Global Perspective In their paper, Stamatakis et al. (2010) highlighted that childhood obesity is a high concern on the global scale due to poor eating habits and sedentary lifestyle. Many children are increasingly putting on excess weight especially as a result of the sedentary lifestyle and poor eating habits. Canoy and Buchan (2007) observed that at least 30.3% of all children below 19 years of age in the developed world are overweight. This is contrasted with 16.1% in the developing world (Rudolf 2010). Whereas there is little variation in terms of gender, girls are more susceptible to childhood obesity than boys. The lifestyle of boys up to 15 years is quite active inasmuch as they tend to consume a lot of high calorie foods (Canoy & Buchan 2007). Canoy and Buchan found that girls prefer a relatively sedentary lifestyle and majority of them tend to indulge in fatty and sugary foods such as chocolate, humbuggers, fries, fizzy drinks among others. The ideologies of fast foods and life-on-the-go has led to a society of young people who prefers to eat take-away foods or snacks that suite their fast moving lifestyle. For example, more than 52% of teenagers in the US eat junk foods every day while another 61% of all children below 11 years are fed on high calories foods each day (Kellow 2012). On the other hand, the changing culture has also bred a society of young people whose leisure and entertainment are mostly indoor and technology-based as characterised by computer games, TV and social media. In America, the prevalence stands at 32% while in Europe, childhood obesity is slightly lower at 31.6% (Kellow 2012; British Heart Foundation 2012; Ferry 2013). In the Asian Pacific, the prevalence of childhood obesity is even higher at an estimated 34.3% compared to 16.1% in Africa and other developing countries (Babey 2013). 2.3.2 UK Perspective According to Kellow (2012), the trends of childhood obesity in the UK have been rising since 1995. Kellow established that the average prevalence of childhood obesity by 2003 was estimated at 21.4%. However, the situation has risen to an average 29% as at 2012 for children aged 2-19 years with least 33% of girls and 25% of boys being obese in the UK. It follows therefore that girls are at least 8% more susceptible to childhood obesity than boys as reiterated by Stamatakis et al. (2010). Over 73% of parents in the UK do not care about what their children watch on media adverts or what they eat outside the home (Moira et al. 2010). This is due to the fact that modern parent are busy at work during which they hardly get time to supervise their children’s eating behaviour or the content of fast food adverts that children are exposed to by profit oriented advertisers. The reality according to British Heart Foundation (2012) is that more than 89% of teenagers indulge in fast foods, nine in every ten toddlers are fed on junk food and at least 33.9% of children aged 10-11 are overweight. It is projected that the prevalence of childhood obesity will be around 10.7% or higher by 2015 (British Heart Foundation 2012; Kellow 2012; Babey 2013). A study conducted by the National Child Measurement Programme in 2011,shows that more than 80% of London children aged 12-19 are not supervised as to what type of foods they buy or the quantities that they eat per day (British Heart Foundation 2012). Besides, British heart Foundation observed that the parents in London prefer leaving their toddlers in the hands of nannies. During such hours, children take advantage to eat lots of junk food that they might not access in the presence of their parents. As a result, almost seven in every ten children in London aged 2-19 eat high calorie junk food every single day of the week (Brunt et al. 2008). 2.4 Factors Contributing to Childhood Obesity 2.4.1 Socio-demographic factors Younger children are more vulnerable to childhood obesity than teenagers because they consume a lot of snacks and they always want to eat to their fullest (Rhee et al 2006; Stamatakis et al. 2010). This is due to the fact that children under 11 years are highly driven by taste, physical appeal and smell of food. They are less likely to take physical exercise on their own without parental guidance. Older children especially girls are a bit choosy and preferential in terms of taste, quantity and frequency of eating (Lindsay et al. 2006). Genetics is also a predisposing factor to obesity. Children of genetically obese parents have a higher likelihood of developing obesity at some point in their life (Hawkins et al. 2009). However, a study conducted by the Early Growth Genetics Consortium in 2012 in Philadelphia identified two gene variants implicated in extreme cases of childhood obesity. These comprised the OLFM4 gene located on chromosome 13 and the HOXB5 gene located on chromosome 17 in the novel loci (Struan 2012). Children born of obese parents with these genetic variations are likely to develop extreme obesity at some point in their childhood years. Nevertheless, cases of genetically motivated childhood obesity are rare (Jotangia et al. 2006). As opposed to the poor, children from rich families can easily access fast foods along the streets as desired. In addition, richer families enjoy the pleasure of stocking their pantries with lots of meaty foods, high calorie ready-to-eat starches and wide range of assorted junks (Lisa 2010). On the other hand, Moira et al. (2010) looked at the impact of socioeconomic status on the increase of childhood obesity. They found that children from rich families are prone to childhood obesity due to the trendy accessibility and indulgence in electronic media and virtual leisure gadgets. In addition, similar studies established that children from rich families can afford to nibble, ride to school, play computer games and spend the whole leisure time on social media (Golan et al. 2006; Gable et al. 2007; Stamatakis et al. 2010; Lee et al. 2011). The result is that they eat a lot, live sedentary and put on excess fat deposits (Lisa 2010). On the contrary, children from the poor families cannot easily afford healthy balanced diets. As a result, they tend to eat what fills the stomach as opposed to what suits the daily recommended dietary requirement (Hawkins et al. 2009; Stamatakis et al. 2010). Junk foods and less nutritious diets are usually cheap and much affordable to low income families. However, unbalanced diet and intake of foods high in carbohydrates only aid the accumulation of excess body fats in the body. Just like their counterparts from the rich families, children from low income families are equally getting obese: not because of sedentary lifestyle but because of inadequate ability to access to balance diet (Patrick & Nickolas 2005). 2.4.2 Parental Role According Faith et al (2004), parents play a major role in the behavioural development of their children including eating habits and health perceptions. For example in their study focussing on parental role modelling, they found that children easily learn from the eating patterns of the parents and how parents perceive issues of weight and growth. They concluded that parents may find it difficult to stop their children from eating poor diets if they also indulge in junk. Health seeking behaviour is another crucial issue (Patrick & Nickolas 2005). Parents are the best motivators when it comes to influencing children to embrace healthy eating, physical exercise and active lifestyle. The absence of such role modelling motivations and less concern over diet planning predisposes children to the risk of unhealthy eating and sedentary lifestyle resulting in childhood obesity (Adler & Stewart 2009). When children are left on their own with no proper parental guidance or supervision, there is always the temptation to exploit freedom. According to a study conducted on the role of parenting in childhood obesity, the researchers found that children are more susceptible to appearance of food and the perceived taste (Rhee et al. 2006). They established that are easily allured to sugary and fatty foods which are often high in calories above the daily dietary requirement of children. For that reason, it is essential for parents to help their children understand the concept of healthy eating and what constitutes healthy diet. In that way, parents would help their children to take personal responsibility in making healthy choices for healthy eating habits as well as active participation in physical exercise (McKenna et al. 2008). 2.5 Health Promotion Strategies The most common health promotion strategy is physical exercise to keep the body fit, burn extra fat and manage weight to healthy levels (Donato 2006; Gibson et al. 2007). In the case of children, this strategy is dynamically incorporated into the school schedule. Such strategies are entrenched in school policies relating to regular exercise, active learning lifestyle and controlled eating and meal plans for pupils. Therefore, health promotion strategy forms part of the learning process at all levels of schooling. The school health program of extra-curriculum activities including physical education has been quite successful in alleviating sedentary life and curbing the risk of childhood obesity among school going children as reiterated by Lee et al (2011). Other health promotion strategies revolve around dietary planning and healthy eating habit. According to Rudolf (2010), nutritional balance including regulated quantity and proper scheduling of meals is a good place to start promoting healthy lifestyle for the management of growth and weight of children as they develop. Particularly, the strategy incorporates individual initiative and family involvement in teaching children to adopt healthy eating behaviour. The proponents of this strategy suggests that dietary planning should take into account several factors including balanced diet of controlled quantities with less sugar or fat content and more vegetables and fruits (McKenna et al. 2008; Rudolf 2010). However, some programs for dietary planning have not been quite successful because not all families can afford well balanced meals or even sponsor their children to take part in specific physical exercise programs (Golan et al. 2006). 2.6 Models of Health Promotion According to Adler and Stewart (2009), health promotion refers to an integrated concept of routine and practices that seek to prevent the occurrence of ill health such as obesity, diseases or injuries. Some of the models include parent-centred role modelling which put the parents at the forefront of initiating and sustaining healthy lifestyle while promoting their children to imitate such lifestyle. The model encompasses a uniform approach to life in which the entire family takes part in health promotion activities such as regular physical exercise and home-made meal preparation and eating. As such, the children will progressively be influenced by the same family customs for healthy living as argued by Wilma (2009) and Rudolf (2010). Apart from parenting role modelling, the other model for health promotion encompasses the play, activity and sleep model. According to Adler and Stewart (2009), this model advocates from active playing among children both at home and in school. As such, the model seeks to ensure that the family setting makes virtual playing such as computer games and TV are less comfortable for children. It also encourages outdoor playing and physical activities for children which makes it vital for the creation of safe playing space within the home. Moreover, this model advocates for adequate sleeping for children which should however not be excess as to promote sedentary lifestyle for the children. These models are complementary and if well implemented can promote good health and reduce the risk of childhood obesity (Rudolf 2010). 2.7 Conclusion Having reviewed the literature, it is apparent that parenting is major determinant of childhood obesity. In the UK, the rate of childhood obesity is on the rise while majority of parents are less actively involved in the prevention efforts to reverse the trend especially when it come to supervising the eating habits of their children. On the contrary, parent-centred role modelling with particular emphasis on healthy eating behaviour and regular exercise can greatly help in the management, reduction and prevention of childhood obesity. The next chapter will outline the methodology and design that is used to collect and analyse data from which to draw relevant conclusions and recommendations in line with the study objectives. To that end, the thesis statement to this study holds that parents play a major role in childhood obesity in the UK. References Adler, NE & Stewart, J 2009, ‘Reducing obesity: Motivating action while not blaming the victim’, Milbank Q, vol.87, no.1, pp.49-70. Babey, SH 2013, Parents blamed for Childhood Obesity, Accessed March 3, 2013 British Heart Foundation, BHF 2012, Childhood Obesity Figures: New figures show rising levels of obesity in children, British Heart Foundation, London. Brunt H, Lester, N & Davies, G et al 2008, ‘Childhood overweight and obesity: Is the gap closing the wrong way’, Oxford Journal of Public Health, vol.30, no.2, pp.145-152. 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