Childhood obesity

Childhood obesity is the most common nutritional disease in developed countries and is on the rise. The World Health Organization (WHO) considers obesity as the "epidemic of the XXI century". In Spain, it affects 16% of children under 14 years of age. Currently the main concern is the evolution of the childhood obesity to adult obesity. More than a genetic problem, it is a family one, since on many occasions the obese baby is preceded by fathers and siblings who are also obese. In these cases the cause is clear, the whole family eats excessively and physical activity is not carried out on a regular basis. It is a problem of overeating and we must re-educate all members of the family. The physical and emotional consequences of obesity concern us. Above all, the alarming increase in type 2 diabetes in children.

What is the childhood obesity?

Childhood obesity is a metabolic disorder that results in an excessive accumulation of body fat that is due to an excessive intake accompanied by little energy expenditure (little physical activity).

The measure that indicates the degree of obesity is the one calculated by dividing the weight in kg, entering the size squared expressed in meters. There are tables where the BMI of the boy or girl can be compared with the rest of the population of the same age. If the value is above the 95th percentile, it is classified as obese. If it is between the 85-95 percentiles it will be said that the child is overweight. Being overweight is the precursor to obesity, so it should be prevented.

The most common cause of childhood obesity is the lack of balance between energy expenditure and the daily calories ingested in the diet. That is, the one accompanied by a sedentary lifestyle. Bad eating habits are transmitted from parents to children, so it is common for all members of the family to be obese. Radical lifestyle changes have favored a sedentary lifestyle and nutritional habits that have increased the consumption of sugars (pastries and sweets) and fats (pastries, pre-cooked food and fast food).

In only 5% of cases there is a hormonal or hereditary disease that causes obesity: endocrinological diseases (hypothyroidism, hypogonadism, hyperinsulinemia or hypercorticism) or hypothalamus disorders (Prader Willi syndrome).

The obese infant

It is very difficult to recognize the obese child under three years of age and the different expert societies do not agree on the criteria to define them. What there is unanimous consensus on is the importance of preventing obesity in childhood. Most chubby babies regain a balanced weight when they begin to move: crawling, crawling, and first steps. Prevention In the prevention of obesity there are two extremely important factors in the first months of life:

• Promote exclusive in the first six months of life and promote prolonged breastfeeding, up to two years or more (as desired by the baby and the mother).
• Do not introduce food (other than milk) before four months of age.
• Do not sweeten food or offer sweet drinks (packed juices, carbonated drinks ...) to children.
• Avoid processed foods (hydrolyzed cereals) or prepared porridges in favor of a balanced and homemade diet, low in salt, fat and sugar.

The obese child

These are the risk factors in childhood that can promote obesity in adulthood:

• • Do not perform
  • Do sedentary activities
  • Offer the child a larger portion of food than is appropriate for his or her age
  • Abuse of sweet drinks instead of water
  • Artificial lactation
  • Abuse of refined sugars (sweets, pastries, sweets ...)
  • Not following a balanced diet in the family nucleus

Changing habits in the family context is key to establishing healthy living guidelines both in terms of food and activity. Parents should be an example for their children, it is the best way to teach good habits from childhood. All the studies that have been done to prevent and treat childhood obesity focus on parental responsibility. Educating parents to give the best to their children, that is the best public health strategy on the issue of overweight and obesity.

• Obesity is a multifactorial disorder, that is, many factors participate, such as genetics or health policies (which we cannot change) and eating and physical habits (for which we are responsible).
• In the child the situation is more complicated because none of its conditions is under his control: it is the responsibility of his parents.
• Abusing refined sugars and doing little or no exercise are two risk factors that, from childhood, can lead to obesity in adults.

Pediatric Specialist