Jurnal Bisnis Darmajaya

Childhood obesity has become an uncontrolled disease: Spain is already suffering the ravages of up to 40% of childhood obesity

The epidemics of obesity in general, and childhood obesity in particular, seem to know no bounds in the Western world. In fact, some experts already suggest that obesity is normalizing, as a kind of "variant of normality." But the reality is very different: obesity is a disease that goes far beyond the initial aesthetic appearance that everyone usually looks at.

The obesity as disease, also proved capable of giving rise to other epidemic diseases of our age, such as type 2 diabetes (obesity being 80-85% of individuals with this metabolic disease), hypertension, various gastrointestinal diseases and it would even be one of the major risk factors for cardiovascular disease or stroke, not forgetting certain types of cancer.

But the problem is not only in obesity in general, but is worryingly spreading to younger ages: childhood obesity has been increasing progressively for years, and in most cases without the parents being aware of it. Probably on more than one occasion we will all have heard the expression “they are only a few extra poundsâ€, an expression that only wants to hide the real problem.

The childhood obesity, just as happens in adulthood, is not an aesthetic but health problem; a problem that has been shown to increase the risk of other associated diseases also in adulthood.

Childhood obesity in Spain

According to data from a study carried out by the London School of Public Health together with the World Health Organization (WHO), the number of children and adolescents suffering from obesity has multiplied by 10 worldwide in the last 40 years: in 1975 only eleven million children suffered from obesity, while in 2016 there were already 124 million minors who were obese. But the data does not end here, and this work suggests that if the trend continues in a similar way, in just five years there will be more young people who are overweight or obese than with a normal weight.

Focusing on data from Mediterranean countries in particular, collected between the years 2015 and 2017, Cyprus stands out above all of them with up to 43% of overweight or obese children, followed by Spain, Greece and Italy with rates of more 40% overweight at that age. When dividing by gender, Spain would have 19% of boys with obesity and up to 17% of girls with this disease.

On the other hand, some studies have looked for other factors associated with obesity. Although it is true that previously it was believed that a higher socioeconomic level would be associated with greater weight (having more money available, one has access to more food), the reality is that this trend is completely the other way around, at least according to a study by United Kingdom, the country with the highest level of obesity in Europe (followed closely by Spain, according to a 2017 Lancet study ): the poorest children are more obese ; specifically, an average of 2 kilos more than the richest children, according to another work published in The Lancet in 2018.

Why are there more and more obese children?

This paradigm shift was due to the changes that occurred in the last 70 years: Until 1954, children in the United Kingdom were raised on ration coupons, so they had a diet high in vegetables and low in fat and sugar (it was cheaper); However, today the most obesogenic and sugar-rich foods are the cheapest and most accessible.

The authors of several of these studies associate this increase in obesity in general, and childhood obesity in particular, with a high consumption of carbohydrates and processed foods, together with poor lifestyle habits such as little physical exercise. Others, in addition, also suggest the hypothesis that healthy foods have become more expensive, since developing countries seem to be those that have increased their weight compared to rich countries.

To this we must add that precisely these rich countries are, in turn, those that have the most means to carry out awareness campaigns with the aim of reducing the rates of overweight and obesity, although at the moment in countries like Spain it seems not be working.

The long-term risks of childhood obesity

In addition to the well-known problems associated with obesity in adulthood, which we will review later, childhood obesity itself has already been shown to wreak havoc.

Risks to the bones of childhood obesity

One of these problems is the need for a hip replacement: in the UK, in just three years, the need for an orthopedic hip replacement due to obesity has increased by as much as 60% overall. However, this increase has not occurred in the adult population, but in adolescents and 10-year-old children.

According to the National Health Service of that country, in the last four years there have been up to ten hip replacements in children and adolescents between 10 and 19 years old, and two of them also required a knee replacement. In addition, up to 86 20-year-olds needed a hip replacement, and 11 of them also required a knee replacement. And in all cases, the main cause was being overweight.

According to the World Obesity Federation, this would not be the only problem associated with childhood obesity, as it is expected that back pain and joint pain (hips, knees and ankles) in children will increase dramatically due to obesity itself; without forgetting that suffering from obesity at such an early age also causes, in turn, an alteration in growth whose consequences can be irreversible.

Metabolic problems associated with childhood obesity

On the other hand, and associated with both childhood obesity and adult obesity, there are other closely related diseases. The first of these is the aforementioned type 2 diabetes mellitus, a metabolic disorder in which an individual suffers resistance to insulin, the hormone whose function is to absorb and process nutrients such as glucose ("sugar") and others such as fats and proteins.

Suffering resistance to this hormone implies a greater risk that these nutrients end up being poorly processed, or accumulating as fat easily, in an endless cycle. Diabetes, in turn, is associated with other problems such as heart disease, kidney involvement and even retinal involvement; In other words, having diabetes can lead to blindness, kidney failure and even increase the risk of having a heart attack or stroke, among other cardiovascular and cerebrovascular diseases.

Childhood obesity and cardiovascular problems

For its part, it is known that obesity is closely related to an increase in blood pressure, which in turn is the main risk factor for suffering a cerebrovascular accident or stroke. According to a study published in Cell in 2014, this association is due to the increase of another hormone responsible for metabolism, leptin, whose secretion increases in order to produce a feeling of satiety. However, it is suspected that obesity also produces resistance to this hormone (as happens with insulin), so its levels would be increased without being useful for the body as such.

Likewise, a study published in The Lancet in 2014 directly blamed obesity as the cause of up to 500,000 cancers a year, highlighting breast cancer, colon cancer and endometrial cancer in women, and kidney cancer and cancer colon in men.

Finally, other studies have linked obesity to a brain disorder and a higher risk of anxiety. Specifically, a study published in the Journal of Neuroscience in 2015 would have ensured that obesity alters the functioning of the brain's reward system, involved in the production of pleasant sensations: obesity would reduce the opioid receptors of this system, which in turn would give lead to excessive consumption of food to compensate for the lack of pleasure in such meals.

How to prevent childhood obesity

The prevention of childhood obesity is crucial, especially considering that up to 90% of children with severe obesity will end up being obese adults, according to a study published in The New England Journal of Medicine in 2016. Although children should be the first focus of attention, given that their consumption of soft drinks and processed juices is something daily, Harvard experts advocate focusing on young adults (around 20-25 years), who have more votes to end up being obese adults at age 50.

Instill good eating habits both at home and at school

In the case of children, these experts advocate acting on the products sold in schools and institutes, and knowing how to correctly spend public aid for food. They even suggest increasing the legislative burden on certain foods (such as the sugariest products).

On the other hand, more recently, another work published in the British Medical Journal by the Harvard University School of Public Health focused specifically on the habits necessary to reduce the risk of our children being obese, in other words, advice for expectant mothers.

In this work the habits were well known, although the fact that all together would reduce the future childhood obesity of children by up to 75% stands out: do not smoke, carry out a healthy diet, do at least 30 minutes of exercise a day, maintain a healthy weight (BMI between 18.5 and 24.9) and consume no more than 15 g of alcohol per day.

Another tip to take into account to reduce childhood obesity would be to involve the little ones in the purchases of the house, or if it is possible to carry out school campaigns like the one carried out in Navarra in 2017: teach good eating habits through games at school. In this particular campaign, the games were based on a deck of cards through which the little ones demonstrated their knowledge about eating (after receiving a visit from a nutritionist who had previously taught them).

Increase the hours of physical activity

Finally, there are other ideas worth mentioning, such as the possibility of increasing the hours of Physical Education at school, as suggested a while ago by Professor José Miguel del Castillo. According to del Castillo, "not increasing the hours of this matter is against Public Health", and taking into account all the data discussed, he is right.

The reality is that there are multiple fronts on which to act , both in childhood obesity and in adult obesity, but unfortunately not enough money is being invested or the time necessary to tackle the root problem: nutritionists in health Public and schools are notable for their absence, nursing and medical professionals lack the knowledge and time necessary to teach patients to eat, and the advertising campaigns carried out by large processed food companies are every more and more powerful. We already know many factors that could be solved, but getting to solve them is somewhat more complicated.

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