The Risks and Complications Associated with Obesity of School-Going Children in Schools - Term Paper Example

Maternal and Paediatric Health Student’s Name: Course: Tutor’s Name: Date: Introduction This paper answers five questions related to obesity and the role that schools can play in ensuring that school-going children make healthy dietary choices. Through the questions, the paper addresses how schools can use screening programs to monitor the health and wellbeing of the students therein. Additionally, the paper discusses the risks and complications associated with obesity and how socio-economic status and education levels affect the nutrition status of school-going children. In the concluding sections of the paper, two health promotion and maintenance strategies are presented, and ways identified through which the school can monitor the strategies’ progress as well as evaluate their outcomes. The potential risks and complications of childhood obesity in primary school aged children Childhood obesity for school-going children has both short-term and long-term consequences. In the short-term, children with obesity are likely to suffer low self-esteem, health complications such as diabetes, and lower physical wellness. The most common cited consequences of childhood obesity are that it leads to a high incidence of “diseases of the cardiovascular, pulmonary, GI, musculoskeletal, and endocrine systems in adulthood” (Robinson, Geier, Rozzolo, & Sedrak, 2011, p. 58). More specifically, childhood obesity has been seen to lead to the following conditions: Orthopaedic complications, which may include flatfeet, fractures, lower-limb misalignment, musculoskeletal discomfort and impaired mobility, are just some of the less serious conditions that are associated with childhood obesity (Han, Lawlor & Kimm, 2010). More serious medical conditions are however also witnessed among obese children, including tibia vara and “slipped capital femoral epiphyses” (Han et al., 2010, p. 1741). The former condition manifests itself as bowing of legs in adolescents or Blount’s disease. Metabolic syndrome is also another condition whose incidence increases with childhood obesity. According to Robinson et al. (2011), metabolic syndrome and hyperinsulinemia are considered risk factors for Cholelithiasis. It has also been claimed that obesity increases insulin resistance and dyslipidaemia, thus leading to the development of type 2 diabetes mellitus (Robinson et al., 2011). Indeed the incidence of type 2 diabetes, which was previously named “adult onset diabetes” since it rarely affected children, has increased as obesity becomes more prevalent. Increased incidence of cardiovascular disease among children has also been linked to childhood obesity, with Robinson et al., (2011) noting that the prevalence the diet that obese children feed on, atopy, hormonal influences, and the mechanical influences of obesity contribute to cardiovascular ailments. Notably, it has been established that Obstructive Sleep Apnea (OSA) “is four to six times more likely to develop in obese children as it is in children of normal weight” (Robinson et al., 2011, p. 61-62). Obesity is also associated with lower vital expiratory capacity, reserve volume, functional residue volume and total lung capacity (Guntlu & Ten, 2007). The endocrine system also suffers the effect of obesity causing low concentration of sex hormones. Han et al. (2010) for example observe that childhood obesity complications are associated with menarche and thelarche in girls, while their male counterparts experience pubertal advancement. Robinson et al. (2011) further note that obese adolescent girls are more likely to suffer from menstrual abnormalities such as metrorrhagia, polycystic ovary syndrome, and amenorrhea. Psychosocial effects of childhood obesity are linked to the low self-esteem, the social-exclusion, and the inferiority they feel when socialising with children of normal weight. Robinson et al. (2011) for example observe that obesity is often associated with lower intelligence or/and laziness. As such, obese children are often discriminated against, and this leads to them feeling excluded from the most of the social activities they would like to take part in. As a result, the low self-esteem and the social exclusion lead to the development of depression due to perceptions of distorted body image. In some instances, obese children have been seen to engage in eating disorders and alcohol and drug abuse, consequently leading to a low quality of life and high mortality. Socio-economic status and level of education might impact on the current nutritional status of primary school aged children Normally, the socio-economic status of a particular demographic segment refers to the social, economic, and cultural wellbeing of the same. In the case of primary school aged children, their socio-economic status has been found to have an effect on their likelihood to adopt good or bad eating habits hence their likelihood of obesity or lack thereof. In relation to education, it would be expected that people who have higher levels of education have more disposable incomes and are also likely to make better nutritional choices. Melchers, Gomez and Colagiuri (2009) for example found that people with high income and education levels were more likely to have high vegetable and fruit intake compared with their counterparts from the low-income levels. Further, it was established that “people who are socio-economically disadvantaged are more likely to purchase grocery items that are comparatively low in fibre and high in fat, salt and sugar” (Melchers et al., 2009, p. 241). In most cases, one’s level of education determines their levels of income, and their socio-economic wellbeing. Such causal links imply that people with high education levels are able to access not only better nutrition, but are able to live in better neighbourhoods, send their children to good schools, and probably shop in supermarkets which stock more nutritional choices. Melchers et al. (2009) for example observed that supermarkets in high-income neighbourhoods stocked more nutritional options compared to supermarkets in low-income areas hence availing more nutritional options to shoppers. In other words, even the supermarkets or retailers affect the food choices that people make. A study conducted in India by Cherian et al. (2012) and Carmina, Corey, Young and Phil (2011) however creates a different perspective. In their findings, Cherian et al. (2012) noted that the economic empowerment in developing countries creates an easy way to acquire “calorie-rich foods, especially for the higher socioeconomic groups” (p. 476). On their part, Carmina et al. (2011) found out Aboriginal Canadians, despite their socio-economic status, were more likely to suffer obesity when compared to the non-Aboriginal population. Viewed against Melchers’ et al. (2009) observations, the information by Cherian et al. (2012) and Carmina et al. (2012) means that one’s level of education or economic wellbeing does not automatically translate to good nutritional choices. Another study conducted by Chhatwal, Verma and Riar (2004) in India further revealed that urbanisation, rising affluences, and technology changes such as playstation games, computer games, and satellite television affect the nutritional status of school going children. As they watch TV or play video or computer games, children are more likely to snack on processed, low-fibre, high-calorie foods such as biscuits. Their parents on the other hand have less time to cook or shop for healthy food choices since a significant part of their time is spent in pursuit of economic prosperity (Chhatwal et al., 2004). As such, the parents prepare low-nutrition fast-cooking foods, or prefer to eat at fast food restaurants. Once established, the habitual consumption of fast food or low-nutritional fast foods is hard to drop afterwards, even when a parent wants to introduce better nutritional food choices (Chhatwal et al., 2004). Overall, it is evident that general education needs to be complimented with knowledge regarding healthy food choices and the importance of leaving an active life among people of different education and socio-economic levels. Most importantly, it appears that parents need to be involved more in making the right lifestyle choices to avert or reduce obesity, since they purchase food items, and often affect the type of indoor or outdoor activities that their children engage in. Health promotion and maintenance strategies that the school management should engage in Based on the foregone conclusion that genetic factors are not a significant contributing factor to childhood obesity as are poor nutritional choices and a sedentary lifestyle, this paper recommends the following health promotion and maintenance strategies: Strategy 1 The school canteen should sell healthy food choices to children, and should avoid processed and fatty foods, and/or fizzy drinks. The healthy alternatives should include fresh fruits, vegetables, and salads. Additionally, the strategy will include promotional days (e.g. making Friday a fruits promotional day, where children get to savour the different kinds of fruits, as well as understand their nutritional value). The healthy canteen will also wipe out any junk food from its shelf, hence leaving the children no other option but to purchase healthy snacks or juices. This strategy is based on the observation that school canteens can play a pivotal role towards supporting school children to make healthier food choices both in and outside school. Additionally Terre (2008) has observed that the school environment provides unequalled access to diverse students, thus providing a platform where strategies can impact positively on the entire student population without considering their socio-economic conditions. In most developed countries for example, most children between the ages of five and 17 years are enrolled in schools. It has also been suggested that no other institution has intensive and consistent contact with children during their early years of development (Story, 2004). As such, lessons taught and values instilled in the school environment are likely to persist in their adult years. In other words, the strategy as suggested herein would improve the chances of children making healthier choices in both the short- and long-terms. Specifically, it is possible that stocking healthy food choices in the school canteen would enhance the possibility of children to make the same healthy choices outside school, and such would probably make the choices habitual thus lessening the risk of obesity. Further support for a school-intervention programme is made by Story (2004), who argues that unlike clinical programs, school-intervention programs target all children despite their socio-economic background or ethnicity. By empowering the children to make healthy choices, the strategies initiated by the schools can also indirectly educate the parents or families involved since the children pass on the message when they go home. Story (2004) underscores the importance of the school administrators working together with the teachers, parents and students to investigate the merits and demerits of such a strategy. Additionally, it is advisable for parents and the children to understand that by opting not to sell junk food, fizzy drinks and other unhealthy food choices in the school canteen, the school administration does not bar children from purchasing the same in other places. Rather than coerce, the school’s actions should be perceived as a setting the pace for the food and nutritional environment in the school. Strategy 2: Addressing inactivity among children Under this strategy, the school will: Put up a gym with the intention of increasing the level of physical activity that children take part in; set up a regular sport days where all children engage in outdoor sporting activities; introduce gardening at class levels for purposes of enhancing their gardening skills as well as creating knowledge about healthy foods; introduce cooking lessons where children can be taught on how to cook without losing the nutritional content of foods; and assist children in finding and trying out healthy food recipes. The latter two activities are especially necessary for purposes of creating the impression that healthy food choices can be fun to cook and eat. If Somerset, Flett and Geissman’s (2005), observations are anything to go by, the suggested strategy is not only comprehensive, but is likely to succeed in promoting health among children. It is also easy to maintain since it involves activities that can be adopted as part of the school co-curricular activities. Specifically, Somerset et al. (2005 citing O’Dea, 2003), observe that “availability, convenience, taste preferences, peer pressure and parental/school support” present a potential barrier to the adoption of healthy diets by children. By engaging students in the activities indicated as part of this strategy, schools would be enhancing the possibility of adopting better diet choices by a larger percentage of the student population. Additionally, the cooking and recipe-related activities would be working for purposes of enhancing the student’s taste preferences for healthier food choices. Somerset et al. (2005) further observe that in addition to boosting physical activity, activities such as establishing a vegetable garden as included in this strategy has been found to “have the potential to incorporate activity-based learning (planting, growing, eating) in the school environment” and are thus linked to enhanced subsequent vegetable consumption patterns (p. 27). The proposed gym, sports day, and gardening activities can also be perceived as part of physical education, which according to Wolny (2009), is part of the contemporary school environment where schools are not just places for attaining knowledge, but where children can grow holistically. The concept of holistic health and development has been adopted by educators since it argues that a child needs to have his or her physical, emotional, spiritual and social needs catered for (Wolny, 2009). How the school could monitor the progress and evaluate the outcome of the strategies The two strategies identified above are meant to help children attain better health (ideally through the use of the body mass index as an indicator), through a combination of healthier food choices and enhanced physical activities. To monitor the progress and evaluate the effectiveness of the strategies in attaining the desirable outcomes, children will be questioned about their food choices both at home and in school in order to establish whether they have internalised the importance of consuming healthy diets. Based on the responses provided by the students, the school can then determine if more efforts are needed (say from the parents) in encouraging the children to adopt healthier diets. For example, if it turns out that children purchase healthy foods from the school canteen but still use junk food while at home, the parents could be brought in to encourage the children towards choices similar to those in school by for instance, refraining from purchasing or feeding on junk foods themselves. In classes, or in groups, the students will be encouraged to participate in physical activities and some of the activities such as recipe-making and cooking can take a competitive nature where the best group or class is awarded. Gym usage and students’ participation in sporting activities are also other tools that the school can use to monitor the progress of the strategies. Ideally, higher gym attendance would be seen to mean that the student population is generally more physically active, same thing as high participation of students in sporting activities. A health screening exercise for purposes of establishing the BMI and weight of all students will also be carried out as the ultimate signifier of the success or lack thereof of the strategies. To avoid the perception that the strategies are targeting some students, all students should undergo the health screening as well as BMI measurements, since in the same context, underweight students can be advised about more nourishing food choices. Overall, the success of the strategies may also contribute to lower incidence of obesity-related diseases as discussed in the second question, and as such, children may present with less orthopaedic, GI, cardiovascular, musculoskeletal, pulmonary, and endocrine system complications both in the short- and long-terms. Although health-related outcomes of the strategies may not be attainable at a school level (i.e. given their clinical nature), it is possible, that a more physically vibrant school population should be perceived as an indicator that the strategies are relatively successful. Targeted interventions should probably then focus on addressing the needs of children who seem to be lagging behind in their adoption of the suggested strategies. References Story, M. (2004). School-based approaches for preventing and treating obesity. International Journal of Obesity, 23(suppl 2), s43-s51. Chhatwal, J., Verma, M., & Riar, S. K. (2004). Obesity among pre-adolescent and adolescents of a developing country (India). Asia Pacific Journal of Clinical Nutrition, 13(3), 231-235. Cherian, A. T., Cherian, S., & Subbiah, S. (2012). Prevalence of obesity and overweight in urban school children in Kerala, India. Indian Paediatrics, 49(June), 475-477. Melchers, N.V.S., Melchers, V., Gomez, M., & Colagiuri, R. (2009). Do socio-economic factors influence supermarket content and shoppers’ purchases? Health Promotion Journal Australia, 20, 241-246. Read More