Article 33: Causes, Harms, and Prevention of Childhood Obesity

Reduced physical activity and a dilution of traditional diets. Improved living standards and a more diversified material and cultural life have, to some extent, reduced people's physical activity. For example, the use of cars for transportation, such as taking children to and from school, making friends and solving problems by phone, transmitting information through electronic means, and the availability of various means of transportation, elevators, escalators, etc., have all reduced physical activity.

On the other hand, poor regulation of the body's movement and rest and failure to maintain balance also reduce people's activity. For example, watching TV, playing video games, operating microcomputers, or watching videos or VCDs for a long time also relatively deprives people of time for physical activity.

Different countries have different dietary habits, and their sources of energy also differ. Westerners usually eat mainly animal-based foods, and their energy mainly comes from fat and protein. Even they themselves recognize that this dietary structure can lead to obesity in the long run.

my country's diet is primarily based on grains, supplemented by animal products. The traditional ratio of the three major nutrients has been approximately 15% protein, 25% fat, and 60% carbohydrates. This economical and healthy diet is considered the most scientific. However, with the changing dining habits, many people, while already consuming more fatty foods, also indulge in hamburgers, fried chicken, and the like-how can they not gain weight?

Many parents believe that their child's slightly overweight physique indicates good nutrition, which in turn promotes healthy growth and development. However, this belief is incorrect. Childhood obesity can lead to a range of problems related to growth and development.

Early childhood obesity can delay the onset of walking, and due to excessive weight and calcium deficiency, children are prone to deformities such as genu varum (knock-knees), genu valgum (bowlegs), and flat feet.

Early weight gain can accelerate growth, especially bone growth, leading to earlier bone age. However, this may cause bone development to stop prematurely and the epiphyseal plates to close prematurely. As a result, obese children may appear taller when they are young, but grow more slowly when others are having their growth spurts, and end up being shorter than children of normal weight.

In obese children, the level of growth hormone is not high, or even low, while the level of free insulin-like growth factor is increased, which is likely the reason for the accelerated growth of obese children.

Obesity also has a significant impact on puberty. Obese girls may experience early puberty, including premature menarche and early breast development, possibly 1 to 2 years earlier than other children.

However, after reaching adulthood, they are more prone to ovulation disorders, poor egg development, and low levels of estrogen and progesterone, resulting in infertility.

The situation is more complex for boys. Obese boys can experience either precocious puberty or delayed puberty. Severe obesity primarily delays the pace of puberty.

Breast development is a major problem for obese boys. Many normal boys also experience breast development during puberty, but it is usually not severe and subsides after 2 or 3 years. The incidence of breast development is significantly higher in obese boys than in boys of average age, and the development takes much longer to resolve.

Some observations have shown that testicular atrophy, micropenis, and poor prostate development are common among overweight boys. These children are more likely to experience decreased sexual function in adulthood.

The reasons for abnormal puberty development in obese children are still unclear. Research suggests that changes in leptin levels are likely an important mechanism by which obesity affects puberty development.

Some parents think that in order to make their children smarter, they should supplement their nutrition. As a result, they feed their children until they become chubby, and they think it is a success. They think that now their children's brains are well-nourished and they will definitely be smart! Little do they know that the result is often the opposite, because obesity often affects the intellectual development of children.

As early as 1989, domestic experts conducted a survey on the academic performance and intelligence levels of some obese students in 18 primary schools in Nanjing. They used the Wesler Intelligence Scale for Children to measure the children's total IQ (including the sum of verbal and performance IQ), and found that obese children had lower total IQs than average children!

The main reason for the low overall IQ in obese children is that their performance IQ is lower than that of ordinary children. Performance IQ reflects the quality of a child's vision, perception, receptiveness, and ability to grasp key points.

Obesity may affect children's abilities in the above-mentioned areas, resulting in lower levels of cognitive, discriminatory, and manual dexterity skills compared to ordinary children.

This survey found that obese children not only have lower performance IQs, but also relatively poor academic performance, scoring lower than normal children in 6 out of 8 subjects.

The reasons for lower intelligence in obese children are still unclear. In some obese children, the difficulty in breathing, increased blood viscosity, and decreased oxygen-carrying capacity of red blood cells caused by obesity may lead to varying degrees of hypoxia in brain cells, resulting in drowsiness, memory loss, and slow response to external stimuli, which in turn affects intellectual development.

Another very important issue is psychological factors. Obese children are relatively clumsy in their movements, which can easily lead to feelings of inferiority and depression. They are often at a disadvantage in group activities or games, and may even withdraw. As a result, obese children receive relatively less behavioral training, which also makes their intellectual development less complete than that of ordinary children.

The incidence of hypertension in moderately to severely obese children is 30%; the incidence of fatty liver in severely obese children is as high as 80%.

The dangers of obesity extend beyond fatty liver. Since 80% of childhood obesity will extend into adulthood, childhood obesity is a significant risk factor for a range of modern diseases in adults, including hyperlipidemia, arteriosclerosis, hypertension, coronary heart disease, diabetes, and fatty liver cirrhosis.

For children who are still growing and developing, obesity can also affect the metabolism of parathyroid hormone and vitamin D, making them prone to rickets; growth hormone secretion is sluggish, sex hormone secretion is disordered, and in men it can cause low sexual function and erectile dysfunction, while in women it can cause menstrual disorders and infertility.

Whether a person is obese or not depends primarily on the number and size of their fat cells. The number of fat cells, in turn, depends mainly on growth and accumulation during three stages: the first three months of pregnancy, the first year after birth, and between the ages of 11 and 13.

If a child's fat cells grow excessively due to overeating during these three periods, the fat cells will only shrink slightly in size afterwards, without any change in number. Once the dieting stops, these fat cells that have "lost" weight will quickly return to their original state, which is why childhood obesity is so difficult to correct.

Everyone hopes to have a chubby baby. As the saying goes, "A plump body means a strong body." Therefore, when a mother is pregnant, her family hopes that she will give birth to a chubby child, and the mother also feels that the chubbyer her baby is, the more proud she will be.

After the child is born, fearing that the child is not eating well, they often add high-energy and high-fat foods when adding complementary foods to the child's diet, making the baby chubby and lovable.

Parents' wishes are good, but experts disagree. They believe that newborns weighing over 4 kilograms are macrosomic (large for gestational age), and macrosomic infants are more vulnerable than children of normal weight. Furthermore, significantly excessive weight can lead to various problems.

If a child is overweight, has a bloated physique, and moves slowly, a normally lively and cheerful child may become reluctant to exercise. In adulthood, this can easily lead to conditions such as high cholesterol, high blood pressure, coronary heart disease, diabetes, gallstones, and arthritis.

Because of their weight, children may have limited mobility during play, and other children might tease or even shun them. This can cast a shadow over a child's young mind. Being overweight also makes children prone to calcium deficiency... Therefore, for children who eat too much or consume too many high-calorie foods, their diet should be restricted, and they should be encouraged to be active so that their weight gradually decreases to a normal range, leading to a strong and healthy body.

Dieting doesn't mean not letting children eat; it means ensuring they get all the necessary nutrients for growth and development while limiting their calorie intake. For example, avoid giving children high-sugar, high-fat sweets and snacks, as these foods, like chocolate, can easily cause tooth decay.

A diet for obese children should be high in protein, rich in vegetables and fruits, with moderate amounts of staple foods and reduced fat intake. High-protein foods include milk, eggs, lean meat, fish, and soy products. Obese children should eat less fried food, fatty meat, and cream cakes, and should eat more fresh vegetables to supplement vitamins and minerals and reduce hunger.

In addition to a reasonable diet, it is also important to increase children's exercise. This can motivate children, reduce their feelings of inferiority, let them experience the joy of exercise, and help them lose weight.

Obesity caused by overeating is physiological and not difficult to correct. As long as the weight is normal, the child will still be a healthy and strong little one. However, some obesity is pathological and related to certain diseases. Children often appear weak and have corresponding symptoms. For them, controlling diet and exercise will not be effective, and they need to go to the hospital for treatment.

During puberty, children often experience rapid growth and may weigh significantly more than their peers, appearing quite large. However, parents must understand that a child being overweight is not necessarily obese.

Some adolescents are overweight due to the growth of non-fat tissues, such as muscles and bones, rather than excessive fat. This is considered normal puberty development and usually does not harm their health.

Obesity is defined as the excessive accumulation of fat in the body. Only excess fat is associated with diseases such as high blood pressure, lipid disorders, and diabetes, and it significantly increases the likelihood of becoming obese in adulthood.

Therefore, it is important to distinguish between a child's growth spurt and obesity. So, how do we differentiate them? First, we can calculate the Body Mass Index (BMI), which accurately reflects the amount of subcutaneous fat and total body fat.

Moreover, body mass index (BMI) is positively correlated with blood pressure, blood lipids, and lipoproteins. In other words, the higher the BMI, the higher the blood pressure, blood lipids, and lipoproteins.

In addition, the higher the body mass index during puberty, the more likely one is to become obese in adulthood, and thus more likely to suffer from obesity-related diseases such as hypertension, dyslipidemia, diabetes, coronary heart disease, etc., and consequently, a shorter lifespan.

Obese children have abnormally high body mass index (BMI), while children with normal puberty have a normal BMI. Therefore, using BMI to distinguish between obesity and normal puberty is a reliable method.

Alternatively, the thickness of a child's subcutaneous fat can be measured directly. The method involves having the child stand upright, drawing a vertical line downwards from the midpoint of the collarbone, and then drawing a horizontal line along the navel. Find the intersection of these two lines, place the thumb and forefinger of your left hand on the skin, about 3 centimeters apart, pinch the skin, and measure the thickness of the skin fold using precision calipers. This directly reflects the amount of subcutaneous fat. More fat indicates obesity, while less fat indicates normal puberty development.

There are two main factors contributing to childhood obesity: overeating and insufficient physical activity. Parents can help by controlling their children's diet and finding ways to increase their physical activity to help them lose weight.

Preschool children typically spend most of their time in kindergarten. If a child is already overweight, it's crucial not to give them an extra dinner after the three meals at kindergarten. Allowing children to experience a little hunger isn't a bad thing, and there's no need to give them any diet pills.

Every evening when you get home, take your children outdoors to increase their physical activity, such as skipping rope, chasing a ball, or jogging. If there is no space available, they can slowly climb stairs. Do this for half an hour to an hour every day.

Obese children generally don't like to be active. To encourage them, the amount and duration of exercise should be increased gradually until they adapt well. After starting to exercise, they may experience shortness of breath, excessive sweating, leg weakness, general weakness, or even coughing and chest pain. As long as these are caused by exercise, it's nothing to worry about.

Even if your child is hungry after exercise, don't let them eat freely. If they're hungry, let them rest at home and drink some plain water first. If that's not enough, give them some thin porridge or leafy green vegetables. If they eat a lot for dinner and then go to sleep without exercising, it's most likely to be converted into fat and stored under the skin.

For school-aged children, who get more physical activity than kindergarten children, the principle for meals is to eat a full breakfast, because the main activities of the day are in the morning, and hunger will affect their listening and memory.

For lunch, about 100 grams of staple food is sufficient, including fresh vegetables, tofu, fish, and lean meat. 50 to 100 grams of any one of these is enough. Dinner should mainly consist of thin porridge, noodle soup, and vegetarian dishes. Fruit can be eaten before bed as a supplement.

This daily diet ensures the supply of protein, starch, and vegetable oil, while leafy green vegetables and fruits contain various vitamins and electrolytes such as potassium, sodium, and magnesium.

Obese children should eat less starch and replace it with more vegetables. If they consume too much high-protein food, it will be converted into fat and stored under the skin after metabolism. Their diet should be light and easily digestible. Like preschool children, they should increase their daily physical activity with the encouragement of their parents. With persistence, they will definitely lose weight, and this will also help develop the willpower of only children.

Obesity can cause many health problems for children and adolescents, mainly in the following aspects:

(1) Obese babies learn to walk later than normal babies, and because their joints bear too much weight, they are prone to wear and tear, which can lead to joint pain. They are also more likely to develop deformities such as flat feet, genu varum or genu valgum, and varus hip varus. In addition, obesity makes them clumsy and prone to accidents.

(2) Obese children and adolescents are prone to hypertension, lipid abnormalities and abnormal glucose metabolism. In severe cases, they may develop type 2 diabetes, which can accelerate the formation of arteriosclerosis and cause the onset of cardiovascular and cerebrovascular diseases in adulthood to occur earlier.

It is important to emphasize that the prevailing view in the past was that all diabetes in adolescents was type 1 diabetes. However, the incidence of type 2 diabetes in children is currently increasing at an alarming rate.

According to statistics from Cincinnati Children's Hospital in the United States, the number of children with type 2 diabetes at the hospital increased tenfold from 1982 to 1995, and currently, type 2 diabetes accounts for 33% of newly diagnosed diabetic patients aged 10 to 19.

Furthermore, the type of childhood diabetes is clearly related to obesity. The average body mass index (BMI) of children with type 2 diabetes is 5 ± 1.1 kg/m², while the average BMI of children with type 1 diabetes of the same age is only 20 ± 0.8 kg/m². Obesity obviously increases the risk of type 2 diabetes in children.

(3) Obesity may cause breathing difficulties in children and adolescents, making them more susceptible to pneumonia and bronchitis. In severe cases, sleep apnea syndrome may even occur. The interval between each breath after falling asleep is prolonged, causing hypoxia, and the child will always be sleepy and lethargic during the day.

(4) Other possible complications include fatty liver, gallstones, and developmental abnormalities.

(5) In addition to the physical harms mentioned above, obesity also has negative psychological effects on children. Obese children are more likely to exhibit depression and low self-esteem, and their intellectual level is generally lower than that of children of normal weight.

Furthermore, obese children are more likely to become obese in adulthood than average children. 80% of overweight children in puberty remain obese as adults. Moreover, those who are obese from childhood have a significantly higher chance of developing complications and dying compared to those who become obese in adulthood.

Picky eating can lead to both overnutrition and vitamin deficiency. Due to a combination of family and social factors, children often consume too much high-calorie food while lacking sufficient vitamins. To satisfy children's psychological needs, parents often allow them to be picky eaters, which in turn exacerbates the problem.

Some parents and schools arbitrarily allow extra snacks during breaks, bringing desserts, chocolates, fried foods, or sugary drinks to school. Some students even eat lamb skewers after morning exercises. Children having more pocket money also makes them more likely to overeat.

Families should arrange children's meals reasonably. The daily calorie distribution can be 30% for breakfast, 35% for lunch, and 35% for dinner. Give more vegetables and fruits to ensure various inorganic salts and vitamins, and cultivate good habits such as not being picky about food, combining whole grains and refined grains, and not being too sweet or salty.

Studies suggest that some obese children still crave fatty meats, and even their parents find it difficult to dissuade them. This is because the accumulation of fat in the body affects metabolic regulation.

Normally, the satiety center and feeding center (hunger center) of the hypothalamus regulate each other to maintain a balance. However, if there is too much fat near the center, it will affect its regulatory function, especially making it easy to reduce the "satiety" and cause the state of "being fat and being able to eat a lot".

Domestic research has also found that some obese children experience delayed sexual development during puberty, such as pale and delicate skin, lack of secondary sexual characteristics, and underdeveloped sex organs. This is due to the fatty deposition of the pituitary gland. Since the pituitary gland is connected to the nerve fibers and glial cells of the hypothalamus, excessive fat deposition in the pituitary gland can affect the synthesis and secretion of sex hormones. To address this, a low-sugar, low-salt, low-fat diet with high protein and high vitamins can be used, along with guiding children to exercise scientifically and increase physical activity, which can improve the situation.