Alarm Bell Sounds for Children on World Obesity Day

October 11, 2016

New research indicates that World Health Organization (WHO) targets to limit childhood obesity by 2025 will likely not be met, and the World Obesity Federation (WOF) is calling for urgent government action around the globe to tackle the issue.

On World Obesity Day, the WOF is highlighting the fact that child and adolescent obesity has risen rapidly around the world, "with few countries taking action against this damaging health issue, which affects later health, educational attainment, and quality of life."

And although levels of obesity are plateauing in some countries and regions, "the absolute numbers continue to rise, particularly in low- and middle-income countries," it stresses.

The organization aims to provide practical solutions to help people achieve and maintain a healthy weight and to reverse the obesity crisis. On its Obesity Day website there are examples of national campaigns to enable the spread of best practices.

"Governments need to strengthen their leadership to prevent, manage, and treat national obesity with robust strategies," the organization emphasizes.

This includes a focus on primary healthcare for women — including weight guidance in pregnancy and assistance with breastfeeding — as well as support for healthy infant growth, including maternity leave, baby-friendly hospitals, breastfeeding counselors, and mother and child community facilities.

Also much needed is the adequate provision of health promotion in schools, with high standards of nutrition and an emphasis on physical activity,

And healthcare professionals are pivotal, the WOF notes. For the prevention of childhood obesity, multidisciplinary teams of trained specialists in the community are required, covering nutrition, physical activity, and psychological and counseling support.

And for the adequate management of childhood obesity, care pathways for children with weight difficulties must be provided, including family-based interventions through to bariatric surgery.

"Universal access to the necessary healthcare interventions and follow-up services" is key, the WOF concludes.

China Tops World League for Number of Overweight/Obese Children

The new research, published in the October issue of Pediatric Obesity by Tim Lobstein, PhD, head of policy at the WOF and Rachel Jackson-Leach, MSc, takes childhood obesity figures for 2013 and projects forward to 2025 on the basis that no effective intervention is implemented to significantly change the trend of rising overweight/obesity.

In 2013, 14.2% of the global population of children were overweight, of whom 4.9% were obese, according to the estimates.

The countries of the Pacific Islands — Kiribati, Samoa, and the Federation of Micronesia — have the highest prevalence of overweight children in the world; around half of all children in these nations are overweight, according to the 2013 figures.

And looking at the problem from a different angle, the researchers illustrate how obesity among kids is ballooning in emerging markets — Vietnam saw an almost doubling of the prevalence of overweight (including obesity) in schoolchildren between 2000 and 2013, while Brazil and China saw an almost 40% increase.

And by 2025 — assuming no policy interventions have proven effective at changing current trends — it is predicted that 15.8% of the overall global population of school-age children worldwide will be overweight and 5.4% will be obese.

This translates to 91 million obese school age children and 268 million who will be overweight.

By then, China is expected to top the table at almost 50 million overweight children, followed by India and the United States, with both predicted to have around 17 million overweight.

The 10 Highest Ranking Countries for Overweight (Including Obese) Children

Country Millions of overweight (including obese) children by 2025 Country Prevalence of overweight (including obese), 2013 (%) Country Increase in prevalence 2000–2013 (%)
China 48.5 Kiribati 56.9 Vietnam 94.8
India 17.3 Samoa 46.1 Azerbaijan 72.7
US 16.7 Federation of Micronesia 45.6 Serbia 45.4
Brazil 11.4 Tonga 43.6 Bahamas 42.0
Egypt 10.6 Solomon Islands 38.8 Guinea-Bissau 42.0
Mexico 9.5 Libya 37.1 Mali 41.5
Nigeria 9.5 Egypt 35.5 Benin 40.8
Indonesia 6.2 Kuwait 35.1 China 40.2
Pakistan 5.3 Uruguay 34.5 Kazakhstan 39.9
Russian Federation 4.9 Chile 34.3 Brazil 39.8
"Plan for the Worst": Type 2 Diabetes, Hypertension, and Cancer

Dr Lobstein and Ms Jackson-Leach also stress the burden that will arise from obesity-related comorbidities, including impaired glucose tolerance, type 2 diabetes, hypertension, and hepatic steatosis, and the demand these will place on health services by 2025, if no action is taken.

"It would not be unreasonable to assume that around half of the 90 million obese school-age children anticipated for 2025 will have one or more of the comorbidities listed, raised blood triglyceride or cholesterol levels, or elevated aminotransferase," they note.

And cardiometabolic conditions are not the only consequence of obesity.

In a statement issued to coincide with World Obesity Day, Cancer Research UK notes that obese children are around five times more likely to become obese adults.

Being overweight or obese is the second biggest preventable cause of cancer after smoking and is linked to 13 types of cancer including bowel, breast, and pancreatic, it notes.

"It's concerning to know that so many children start secondary [high] school — formative years in a child's life — carrying too much weight," says Alison Cox, Cancer Research UK's director of prevention.

"We must give children the best chance for a healthy future," she stresses, noting that measures such as sugar taxes and restricting advertising of junk food can make a difference, and governments must be encouraged to enact such legislation.

In their paper, Dr Lobstein and Ms Jackson-Leach note that if there is no screening service in place for these comorbidities of obesity among children/adolescents, "these conditions are likely to remain untreated until they become significantly disabling and potentially expensive health problems in adulthood."

They are less than hopeful that the situation will turn around.

"We see no reason to rely on optimism as a strategy for planning for the future, not only for coping with the childhood obesity problem and its comorbidities but also the rising levels of ill-health that will become manifest as those children retain or increase their adiposity moving into adulthood."

"It is important to plan for the worst," they conclude.

Dr Lobstein and Ms Jackson-Leach report no relevant financial relationships.

Follow Lisa Nainggolan on Twitter: @lisanainggolan1. For more diabetes and endocrinology news, follow us on Twitter and on Facebook.

Pediatr Obes. 2016;11:321–325. Article


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