Childhood obesity rates are surging worldwide

Since 1990, childhood obesity has significantly increased on all continents, nearly doubling in prevalence. Although the United States currently has the highest prevalence, many other nations are not very far behind.

Childhood obesity worldwide 

For instance, in Southern European countries such as Greece, Italy and Spain, 10 to 15 percent of children are obese, and, although Eastern European countries have for the moment slightly lower rates, they are experiencing a rapid surge which may soon match Southern Europe. 

At a global level, Asia has almost half of all overweight children under five, while Africa has one-quarter of such children. Finally, in Latin America, nearly 20% of children under 20 are overweight. 

And sadly, a great number of developing countries currently face not only the challenge of  overweight/obesity in their children, but also malnutrition.

Epidemic levels of childhood obesity 

This obesity epidemic leads to a variety of health issues, including childhood hypertension and type 2 diabetes. 

Recently, a team of scientists led by Florida Atlantic University (FAU) has discussed these challenges and provided possible solutions in a commentary published in the The Maternal and Child Health Journal.

Study lead author Charles H. Hennekens is a professor of medicine and preventive medicine at FAU. 

“Pediatric overweight and obesity have reached epidemic levels in the U.S. and are becoming a pandemic globally. These conditions lead to high blood pressure, type 2 diabetes and lipid disorders, which contribute to metabolic syndrome,” said Hennekens.

“In adults, these issues significantly increase the risks of heart attacks, stroke, liver disease, obstructive sleep apnea, arthritis and certain cancers – many of which are now occurring at younger ages.”

Hennekens noted that through coordinated clinical and public health efforts, we can address these troubling trends and work toward a healthier future for children and families globally.

Misconceptions about childhood obesity 

In the United States, a preschooler is considered overweight if their body mass index (BMI) surpasses the 85th percentile. 

Previous research has shown that such children are at a significantly higher risk of being overweight in their adolescence than those with a BMI at the 50th percentile. This highlights the current misconception that children can simply “outgrow” overweight problems.

Boosting daily activity among children 

According to the experts, health care providers and public health practitioners face great challenges in their attempts to boost daily physical activity among children, which could significantly increase metabolic rates, lower BMI, and reduce risks of coronary heart disease later in life.

“With declining physical education in schools and excessive time spent on electronic devices, many children fail to meet recommended activity guidelines,” said co-author Panagiota “Yiota” Kitsantas, the chair of FAU’s Department of Population Health and Social Medicine. 

“This sedentary behavior contributes to overweight and obesity through poor diet, reduced sleep, and decreased physical activity. Encouraging organized, enjoyable activities rather than competitive ones can help children achieve necessary physical activity levels.”

Contributing factors to childhood obesity 

However, the scientists warn that while increasing the amount of physical activity among children is necessary, it is far from sufficient to have a large impact on the rates of childhood overweight and obesity.

This is due to the fact that other major contributors are the increase of foods containing high quantities of sugars, together with the consumption of ultra-processed foods.

“Nearly 70 percent of the average U.S.-based child’s diet is made up of ultra-processed foods,” Hennekens said. “Moreover, consumption of ultra-processed foods among children under 24 months is rising worldwide, triggering not only the potential of developing obesity but also decreased immunological protection.”

The role of ultra-processed foods 

Although further research is needed to clarify which components of ultra-processed foods lead to weight gain in children, it is already clear that a diet high in such foods is connected to increasing rates of overweight and obesity.

“Evidence suggests that enhancing school lunch nutritional standards could help reduce obesity, particularly among low-income children,” Kitsantas said. 

“We recommend adopting school food policies that remove ultra-processed foods from menus and promote healthier alternatives, alongside educational programs on healthy eating, despite the challenges posed by external influences on children.”

Public health measures 

Some of these challenges include the use of social media and advertising, which affects children’s food choices and behaviors such as sharing unhealthy food posts.

“Despite recommendations from the World Health Organization and public health authorities to restrict food marketing aimed at children, few countries have implemented such measures,” Hennekens explained. 

“The effectiveness of existing regulations in today’s media landscape is uncertain, creating an opportunity for health providers and public health practitioners to educate families about the impact of this advertising.”

Managing the public health crisis 

The scientists argue that tackling the rising pediatric obesity epidemic requires a multidimensional approach. In 2023, the American Academy of Pediatrics endorsed World Health Organization’s guidelines, while releasing their own recommendations for managing this public health crisis. 

The guidelines suggest that healthcare providers and public health professionals address the social determinants of health, utilize motivational interviewing to encourage changes in nutrition and physical activity habits, and consider options like pharmacotherapy or surgery to achieve individualized patient objectives.

Reversing the troubling trends

Yet, the study authors argue that although there are approved drug therapies available, maternal and child health care providers should employ therapeutic lifestyle changes before prescribing pharmaceutical interventions.

“While the ultimate goal is prevention of pediatric overweight and obesity as well as metabolic syndrome, to paraphrase Voltaire, we should not ‘let the perfect be the enemy of the good,’” Hennekens said.

“Health care and public health professionals must collaborate across disciplines to address these issues with patients, families, communities and policymakers. United efforts can help reverse these troubling trends and ensure a healthier future for children worldwide,” Kitsantas concluded.

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