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<div class="noeditbox">Welcome to [[Current and Emerging Roles in Physiotherapy Practice|Queen Margaret University's Current and Emerging Roles in Physiotherapy Practice project]]. This space was created by and for the students at Queen Margaret University in Edinburgh, UK. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox">
<div class="editorbox">'''Original Editors ''' - [[User:User Name|Alexander Dow]], [[User:User Name|Andrea Civitarese]], [[User:User Name|Lynne Turner]], [[User:User Name|Alison O’Brien]], [[User:User Name|Rachael Le Page]], [[User:User Name|Courtney Ferguson]] as part of the [[Current_and_Emerging_Roles_in_Physiotherapy_Practice|Queen Margaret University's Current and Emerging Roles in Physiotherapy Practice Project]]<br>
'''Original Editors ''' - Alexander Dow, Andrea Civitarese, Lynne Turner, Alison O’Brien, Rachael Le Page, Courtney Ferguson  


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} &nbsp;[[File:240 F 99188502 DtGX9G7KqeQ80FrfEjugS1SWSXRxFDzJ.jpg|center|frameless|902x902px]]</div>
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
== Introduction ==
[[Obesity]] is the excessive or abnormal accumulation of fat or [[Adipose Tissue|adipose]] tissue in the body that may impair health.


==<center><u>'''Let's Talk About Childhood Obesity'''</u></center>==
The obesity epidemic around the world affects not only adults but also children. About 50% of the time, obesity in childhood is carried into adulthood in a phenomenon known as "tracking." Per the latest data from the World Health Organization, the number of overweight and obese children under five years of age is estimated to be close to 39 million.


== Aims ==
* By 2030 some epidemiologists suggest that 20% of the world's population will be obese, i.e., having a body mass index ([[Body Mass Index|BMI]]) of more than 30 kg/m² in adults, or a BMI ≥95th percentile for age and sex in children aged 2 to 18 years. See also [[Waist Measurement|waist measurement]] and [[Body Composition|body composition]]
* Obesity as a disease itself is multifactorial and occurs due to complex interactions occurring between genetics and the environment.<ref>Tirthani E, Said MS, Rehman A. [https://www.statpearls.com/ArticleLibrary/viewarticle/131519 Genetics and Obesity]. StatPearls [Internet]. 2021 Aug 4.Available:https://www.statpearls.com/ArticleLibrary/viewarticle/131519 (accessed 13.11.2021)</ref>
* Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity needs high priority<ref name=":7">World Health Organization. [https://www.who.int/news-room/q-a-detail/noncommunicable-diseases-childhood-overweight-and-obesity Noncommunicable diseases: Childhood overweight and obesity]. Available: https://www.who.int/news-room/q-a-detail/noncommunicable-diseases-childhood-overweight-and-obesity (accessed 9.10.2021)</ref>.


The goal of this page is to provide guidance and information for parents of overweight children, and to empower them to feel confident in managing childhood obesity.  
=== Why Does This Matter? ===
Obese children carry an increased risk of [[asthma]], [[Diabetes Mellitus Type 2|type 2 diabetes]], and orthopedic disorders.  Studies have also found a link between childhood obesity and poor academic performance.


== Learning Outcomes  ==
* The roots of childhood obesity can begin in utero.  Maternal obesity and excessive weight gain during pregnancy, for example, both correlate with a higher risk of childhood obesity.  Moreover, other determinants of childhood obesity, eg rapid weight gain during infancy, are well established before age five.
* Define childhood obesity and recognize its impact 
* Obese children are more likely to become obese adults.  As obese adults, they will have a higher risk of many of the major causes of adult mortality, including [[Coronary Artery Disease (CAD)|coronary artery disease]], [[hypertension]], [[stroke]], [[Chronic Kidney Disease|chronic kidney]] and [[Liver Disease|liver]] disease as well as many types of cancer.  <ref>ASN Childhood Obesity Prevention Strategies Must Start Early Available:https://nutrition.org/childhood-obesity-prevention-strategies-must-start-early/ (Accessed 13.11.2021)</ref>
* Recognize the benefits of physical activity and risks of inactivity 
* Apply physical activity guidelines for children
* Define  the role of physiotherapists in managing childhood obesity
* Apply management strategies for childhood obesity 
* Identify local resources and physical activity opportunities for overweight or obese children and their families


== Obesity Overview ==


==== <u>What is Childhood Obesity?</u> ====
For adults, body mass index (BMI) is the method that is most commonly used to diagnose obesity. This method uses an individual's height and weight to establish whether or not they fall within a healthy weight range. BMI ranges are listed below:
* Healthy weight: BMI = 18.5-24.9
* Overweight: BMI = 25-29.9
* Obese: BMI = 30-39.9
* Severely Obese: BMI = ≥40
In children, BMI alone is not used to diagnose obesity, as children's bodies are constantly changing. To diagnose childhood obesity, paediatricians need to take many factors into consideration. Your child's doctor will first calculate which percentile of weight your child falls into. For example, if your child is in the 80th percentile for weight (based on BMI), this means that 80% of children of the same sex and age have a lower BMI. Along with this calculation, the paediatrician will take into consideration how your child is growing and developing, your family's history of obesity and related health problems (such as diabetes and heart disease), and your child's eating habits, activity levels, and general health. A diagnosis of childhood obesity will rely on all of these factors taken together, rather than BMI calculation alone.


==== <u>The Problem</u> ====
This less than 2 minute video is a worthwhile watch.{{#ev:youtube|5Km1fFLX6T8|600}}&nbsp;<ref>Childhood Obesity in the UK Available from: https://www.youtube.com/watch?v=5Km1fFLX6T8 [last accessed 15/03/18]</ref>
* 16% of children in Scotland age 7-11 and 15% age 12-15 are at risk of obesity (REFERENCE). This means that about 150,000 children are currently at risk for obesity.
* Children who live in deprived areas are less likely to be of a healthy weight (REFERENCE)
* Younger children are more likely than older children to meet physical activity guidelines (REFERENCE)
* Girls tend to have lower levels of activity than boys (REF)
* Children tend to consume food and drinks high in fat and/or sugar more often than adults (REF)


==== <u>Why does Childhood Obesity Matter?</u> ====
== Etiology ==
* Childhood obesity is linked to a greater risk of disability and premature death in adulthood
[[File:Junk food.jpg|right|frameless]]
* Individuals who are overweight or obese in childhood are more likely to be overweight or obese in adulthood
The fundamental cause of childhood overweight and obesity is an energy imbalance between calories consumed and calories expended.
* Obesity is associated with early development of diseases such as diabetes, heart disease, and certain types of cancer
* Childhood obesity can predispose children to sleep apnoea, joint problems, back pain, and early puberty
* Psychological issues such as low self-esteem and depression are more common in overweight children than in children of healthy weight


==== <u>Things seem to be improving...</u> ====
Global increases in childhood overweight and obesity are attributable to several factors.
* 76% of children age 5-15 meet physical activity guidelines, which is an increase from 71% in 2008 (REF)
* 70% of children are considered to be a healthy weight
* Childhood obesity has declined from 17% to 14% since 2014


== Benefits of Physical Activity for Your Child (...and risks of inactivity) ==
# There has been a global shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other healthy micronutrients.
# There is also a trend towards decreased [[physical activity]] levels due to the increasingly sedentary nature of many forms of recreation time, changing modes of transportation and increasing urbanization.


There has been a lot of  research and evidence highlighting the physical and psychosocial benefits of children undertaking regular physical activity between the ages of 5 and 12 years old. These benefits  include:
The problem is societal and therefore it demands a population-based multisectoral, multidisciplinary and culturally relevant approach.


<u>Physical</u>
* Unlike most adults, children and adolescents cannot choose the environment in which they live or the food they eat. They also have a limited ability to understand the long-term consequences of their behaviour. They therefore require special attention when fighting the obesity epidemic<ref name=":7" />.
* Builds and strengthens muscles and bones
* Reduces body fat and maintains a healthy weight
* Improves balance, coordination and posture
* Establishes healthy and active lifestyles which transfers to later life
* Improves cardiovascular health and fitness
* Reduces the risk of developing chronic and major illness listed below
* Builds on core skills such as walking, running and throwing
<u>Psychosocial</u>
* Enhances confidence, self-esteem and mood
* Builds social skills, peer integration and social networks
* Reduces stress, anxiety and depression
* Enhances concentration, learning and academic performance
* Improves the quality and duration of sleep
[[File:PA and children.png|alt=This diagram shows the importance of physical activity and its links with health and academic performance in children.|thumb|489x489px|This diagram shows the importance of physical activity and its links with health and academic performance in children.
(Image: British Heart Foundation National Centre for Physical Activity and Health (2014))
]]<u>Risk of inactivity</u>


There are also multiple risk factors associated with inactivity and sedentary behaviours eg sitting watching television or playing of computer/online games. Though these do not show until adulthood higher risk and development of major illnesses and diseases have been found to develop from an inactive childhood (HW Kohl III, 2013) including:
== Fighting the Epidemic ==
[[File:Parent_image_4.png|frameless|499x499px|alt=|right]]
WHO recommends the following to reduce and prevent childhood overweight and obesity:


* Obesity (both childhood and adult)
# Increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts
* Heart diseases eg
# Limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats
* Stroke
# Limit the intake of sugars
* Diabetes
# Be physically active and accumulate at least 60 minutes of regular, moderate- to vigorous-intensity activity each day that is developmentally appropriate.
* Cancer
Image 3: Eat well guide for parental guidance .
* Mental/psychological conditions including anxiety, depression and dementia
* Reduced cardiorespiratory and muscular fitness
* Increased risk of earlier morbidity and mortality


(REF: Exercise for children and young people – Great Ormond Street; HW Kohl III (2013) – Educating the Student Body: Taking PA and Physical Education to School Chapter 3)
See also


== '''Physical Activity Guidelines for Children (Age 5-12)''' ==
# [[Physiotherapy communication approaches in management of obesity and overweight]]
[[File:CMO+early+years+infographic+July+2016.png|left|thumb|566x566px]]
# [[Promoting Active Living in Young People Through Behaviour Change]]
[[File:Infograph.png|center|thumb|566x566px]]
# [[Fostering Behaviour Change in Obese Adolescents]]


== Barriers and Facilitators to Managing Childhood Obesity - Behaviour Change Models for Children?? ==
== The Benefits Of Physical Activity==
One of the key roles of health visitors and health professionals is to effectively present parents with the most up to date evidence on childhood obesity and interventions. Factors such as race, ethnicity, lifestyle, genetics, culture, socio-economic status, and the environment tend to have great influence on dietary choices (El-Sayed et al, 2011). Dealing with obesity is a complicated process, which involves a broad sociological awareness and understanding. It also requires tactful and compassionate communication skills that can influence behaviour and bring about positive lifestyle changes by breaking down barriers and identifying facilitators.
Physical activity and inactivity can have a big effect on a child's health and development in many ways. It is important to know and understand the benefits of regular activity and the risk of inactivity for a child between the ages of 5 - 12 years old.  


==== '''Barriers: can be defined as things that get in the way''' ====
=== Regular Activity ===
'''Resources Barriers'''
Encouraging a child participate in regular physical activity between the ages of 5 - 12 years old will benefit their body and mind health in a variety of ways including mentally, physically and academically <ref>Gov.UK. Publication: Start active, stay active: infographics on physical activity. Available from:https://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity (accessed 02 April 2018)</ref><ref>SSEHS Active. Interpreting the UK physical activity guidelines for children. Available from:http://www.ssehsactive.org.uk/young-people-resources-and-publications-item/39/443/index.html (accessed 02 April 2018)</ref><ref name=":0">Great Ormond Street. Exercise for children and young people. Available from: https://www.gosh.nhs.uk/medical-information/general-health-advice/leading-active-lifestyle/exercise-children-and-young-people (accessed 02 April 2018)</ref><ref name=":1">Kohl III, H. W., and CooK, H. D. Educating the Student Body: Taking Physical Activity and Physical Education to School. Washington: The National Academies Press. Available from: https://www.ncbi.nlm.nih.gov/books/NBK201497/<nowiki/>(accessed 02 April 2018)</ref><ref>SSEHS Active. Children and young people evidence briefing. Available from:http://www.ssehsactive.org.uk/resources-and-publications-item/40/475/index.html (accessed 02 April 2018) </ref>. These benefits are detailed below:
* ''Financial resources.'' financial barriers can be a massive barrier to physical fitness. In particular the costs of community exercise programs can be a barrier to enrolling their children in structured activities. this problem is then magnified for larger families.
[[File:Screen Shot 2018-03-28 at 19.36.55.png|left|381x381px|frameless]]
* ''Limited time''. work hours for parents can be a barrier to family exercise, especially if having to work during evenings or on weekends, thus limiting their opportunities to exercise with their children
[[File:Screen Shot 2018-03-28 at 19.37.03.png|centre|381x381px|frameless]]  
* ''Access to programs.'' access to exercise programs can often be limited, particularly for young children such as those in pre-school and primary school
<br />
* ''Knowledge gaps.'' incomplete knowledge surrounding healthy eating as another important barrier to successful weight management. According to Keenan and Stapleton (2010) and Redsell et al (2010), many parents regard large children as cute and healthy
The video below provides more details of the top 5 benefits of physical activity for children.  
'''Social Barriers'''
* ''Cultural practices and expectations.'' cultural differences can contribute to difficulty in maintaining a healthy diet. Some cultural diets can lead to increased consumption of unhealthy foods.
* ''Interpersonal dynamics.'' challenging family dynamics can add an additional aspect of social context that can pose a barrier to weight management. Some parents may have shared custody of their children so trying to maintain a healthy eating and exercise routine can be very challenging.  
'''Emotional Barriers'''
* ''Lack of confidence.'' uncertainty over their ability to control their child’s weight, with resultant feelings of worry and stress for parents
* ''Defeat.'' feelings of defeat related to previous failed attempts at weight management
* ''Loneliness.'' adolescents in particular often described feelings of isolation and loneliness related to their overweight status
* ''Denial.'' despite their involvement with the medical system, some families did not acknowledge any problems regarding their child’s overweight status, and others expressed satisfaction with their child’s current lifestyle and overall health. According to Keenan and Stapleton (2010) and Redsell et al (2010), most parents are unwilling to accept that their child has a weight issue, despite the health professionals’ diagnosis, as they conform to the belief that a big child equals a happy child.
* ''Negative attitudes.'' from parents, staff and peers can hinder your child’s interest in physical activity [REF] It may come in the form of teasing from other children and/or teachers who lack training in adapting activities to suit your child needs. This also results in excluding them from taking part in school clubs and activities [REF]
* ''Embarrassment.'' vulnerability, disappointment and shame at appearing physically incapable are just some of the uncomfortable emotions your child may experience


==== '''Facilitators: can be defined as what can make it easier''' ====
{{#ev:youtube|nD-0Wc6eSUE|600}}&nbsp;<ref name=":2">5 Reasons Why Physical Activity is Important for Children Available from: https://www.youtube.com/watch?v=nD-0Wc6eSUE [last accessed 28/03/18]</ref>
'''Building Partnerships'''
=== Inactivity ===
* the importance of building strong partnerships between patients, families, schools and health care providers is essential
It is common to find children playing video games and watching television, however, this leads to a lot of sitting and therefore to an inactive lifestyle which can have a detrimental effect on on children's future health<ref name=":0" /><ref name=":1" />. These effects may not show until later life. It is important to be aware of the higher risk of developing non communicable diseases due to childhood inactivity<ref name=":1" /> and encourage regular physical activity to help reduce and prevent a child developing them in adulthood.
* specifically discussed goal setting in collaboration with providers as a helpful element for weight management.
* Obesity
* engaged as an entire unit, so that parents and children could better partner to achieve goals around healthy living.
* Heart disease eg [[Coronary Artery Disease (CAD)|coronary arterial disease]]
* GP or practice nurse may be able to refer you to a local weight management programme for children, such as those run by [https://www.mytimeactive.co.uk/cwm MEND] and [http://www.more-life.co.uk/ More Life]. These programmes are often free to attend through your local health authority, and typically involve a series of weekly group workshop sessions with other parents and their children
*[[Stroke]]
'''Access to Resources'''
* Diabetes
* primary care centre directly providing programs, including fitness classes, nutrition courses, and cooking classes
*[[Oncology|Cancer]]
* showing parents and children how to create a healthy snack that not only looks good but tastes good. Access to support groups could be potentially helpful resource and nutrition education classes
* Mental health disease eg anxiety, [[depression]] and [[dementia]]
* access to free local community programmes and after school clubs for those who require assistance on health grounds
* Earlier death
* clearer signposting to available resources
== Physical Activity Guidelines for Children (Age 5-12) ==
'''Consistent Encouragement'''
[[File:Infograph.png|alt=|right|frameless|779x779px]]
* the use of consistent encouragement by providers needs to be a key component of successful weight management.
Children (aged 5-12) should partake in at least 60 minutes of physical activity a day - this should range from moderate activity to vigorous activity<ref name=":5">NHS., 2015. ''Physical Activity Guidelines for Children and Young People'' [online]. [viewed 9<sup>th</sup> April 2018]. Available from: <nowiki>https://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-young-people.aspx</nowiki>
* use of technology (eg, via text-messaging or email) for providing ongoing encouragement related to weight management between visits
</ref>. Amounts of physical activity greater than 60 minutes, provides additional heath benefits to your child<ref>World Health Organization., 2016. ''Physical Activity and Young People'' [online]. [viewed 9<sup>th</sup> April 2018]. Avaiable from: <nowiki>http://www.who.int/dietphysicalactivity/factsheet_young_people/en/</nowiki>
 
</ref>. 
==== '''Utilising a Transtheoretical Behaviour Change Model''' ====
[[File:Behaviour change model.png|thumb|540x540px|This diagram shows the stages involved in behavioural change in the treatment of childhood obesity (Mason et al.2008)|center]]


The Transtheoretical Model for treatment of childhood obesity (Mason et al 2008)
'''Moderate Activity'''[[File:30440825_10160213199190285_6406574266132725760_n.png|right|frameless|156x156px]]
Moderate activity raises the heart rate and can make a person sweat.  Examples of activities which involve moderate exertion for children include:
* Cycling on flat ground
* Walking to school
* Playing in the playground
* Walking the dog
* Riding a scooter
* Rollerblading<ref name=":5" />
'''Vigorous Activity'''[[File:30414685_10160213199510285_1474170515588382720_n.png|right|frameless|232x232px]]
Vigorous activity is known to improve general health, bone and muscle strength and self-esteem.  Vigorous activity can bring health benefits over and above that of moderate activity. Every one-minute of vigorous activity provides the same health benefits as two-minutes of moderate activity <ref name=":5" />.  eg
* Swimming
* Running
* Gymnastics
* Football
* Karate
* Rugby<ref name=":5" />
'''Bone Strengthening Activities'''[[File:Screen_Shot_2018-04-09_at_00.05.49.png|right|frameless|215x215px]]
Children should include [[bone]] and muscle [[Strength Training|strengthening]] exercises at least 3 days a week.  Many vigorous activities can help to build strong muscles and bones in children. This can include anything involving running and jumping, such as football or gymnastics<ref name=":5" />.  eg
* Body weight lifting exercises
* Jumping and climbing activites
* Hopscotch
* Rope Skipping
Examples of suitable muscle-strengthening activities for children:
* Sit-ups and Press-ups
* Gymnastics
* Resistance band exercises
* Rock Climbing<ref name=":5" />


== Managing Childhood Obesity as a Parent ==
Click [https://www.nhs.uk/Livewell/fitness/Documents/children-and-young-people-5-18-years.pdf <u>here</u>] to download a helpful fact sheet on physical activity guidelines for children <ref>GOV.UK. 2011. ''UK Physical Activity Guidelines'' [online]. [viewed 9<sup>th</sup> April 2018]. Available from: <nowiki>https://www.gov.uk/government/publications/uk-physical-activity-guidelines</nowiki>
</ref>.


== Local Opportunities for Physical Activity in Edinburgh ==
== Managing Childhood Obesity ==
See [[Management of Obesity]][[File:Parent 1 image.png|frameless|620x620px|alt=|right]]Encourage parents to take proactive steps in managing their child's weight<ref>TURNER, K.M., SALISBURY, C. AND SHIELD, J.P., 2011. Parents’ views and experiences of childhood obesity management in primary care: a qualitative study. ''Family Practice'', ''29''(4), pp.476-481.</ref>'''.''' Once they have identified problems it is important to take steps to effect change.


== '''The Role of the Physiotherapist in Managing Childhood Obesity''' ==
Remind parents they are not alone, they can consult their General Practitioner and other health professionals for advice<ref name=":6">ACADEMY OF NUTRITION AND DIETETICS., 2017. ''How to Talk to Kids about Weight and Obesity'' [online]. [viewed 30 March 2018]. Available from:  ''<nowiki>https://www.eatright.org/health/weight-loss/overweight-and-obesity/how-to-talk-to-kids-about-weight-and-obesity</nowiki>.'' </ref> <ref>CENTER FOR DISEASE CONTROL AND PREVENTION., 2017. ''Tips for Parents-Ideas to Help Children and Maintain a Healthy Weight'' [online]. [viewed 29 March 2018]. Available from: <nowiki>https://www.cdc.gov/healthyweight/children/index.html</nowiki>.
Physiotherapists have many unique skills that are well-suited to addressing childhood obesity. Physiotherapists undergo training in anatomy, movement science, and behaviour-change techniques that allow them to prescribe physical activity and lifestyle changes in an effective and safe manner. Though physiotherapy may be traditionally thought of as a clinical or hospital role, physiotherapists work in a variety of settings including schools, care centres, and in the community. The continuing trend of inactivity and risk of obesity in children means that the role of physiotherapists will need to further expand in order to address these problems.  
</ref>.


Some of the ways in which physiotherapists could help in the management of childhood obesity include:
== Apps ==
* Assisting in the development of physical education programmes in schools
We are in the age of technology and it may be easier to encourage children to get active by the use of free online Apps.  Below is a list of free apps online that may help parents to engage their child in physical activity and also provide ideas of activities. This is not an exhaustive list and there is a wide variety and many more apps available.
* Address childhood obesity when coming into contact with overweight or obese children in a clinical setting
# '''HOOP:''' Find and book fun things to do in your local area for children aged 0-11 years old. ([https://itunes.apple.com/gb/app/hoop-whats-on-for-families/id996073365?mt=8 iOS] & [https://play.google.com/store/apps/details?id=uk.co.hoop.android&hl=en_GB Android])
* Encourage physical activity and outline physical activity guidelines for all children
# '''Wuf Shanti Yoga Fun Machine:''' Yoga app using games and music to promote health and happiness for your child through yoga, meditation and mindfulness. ([https://itunes.apple.com/us/app/wuf-shanti-yoga-fun-machine/id1296345752?mt=8 iOS])
* Discuss lifestyle changes with parents of overweight or obese children including changes in nutrition and exercise
* Treat muscle and joint problems that may be interfering with physical activity
* Provide feedback and motivation for children and their families


== Conclusion ==
== Conclusion ==
Childhood obesity between the ages of 5-12 years old is rising and is a current global concern and challenge. Unfortunately, in this present age the growing popularity in the daily use of technology in children, among the many other barriers mentioned above, is enhancing an inactive lifestyle. It is important to recognise and understand childhood obesity and how to encourage children to become more active and make changes to help manage a child’s weight and maintain a healthy lifestyle.


== Useful Links ==
== Useful Links ==
* [https://www.nhs.uk/Livewell/childhealth6-15/Pages/child-health-measurement-programme-very-overweight-advice.aspx NHS Choices: What can I do if my child is very overweight?]
* [http://www.bbc.co.uk/news/health-37116611 BBC: What to do if your child is overweight]
* [https://www.nhs.uk/change4life NHS: Change 4 Life]
*[https://www.familiesonline.co.uk/child/child-wellbeing Families online: child-wellbeing]
*[http://www.more-life.co.uk/ More Life]
*[https://www.helpguide.org/articles/diets/childhood-obesity-and-weight-problems.htm Childhood Obesity and Weight Problems Help Guide]
*[https://www.eatright.org/health/weight-loss/overweight-and-obesity/how-to-talk-to-kids-about-weight-and-obesity. Kids eat right: How to Talk to Kids about Weight and Obesity]
*[https://www.cdc.gov/healthyweight/children/index.html Tips for Parents – Ideas to Help Children and Maintain a Healthy Weight: Centers for Disease Control and Prevention]
*[https://www.bbcgoodfood.com/recipes/collection/school-lunch Healthy Kids' Lunchbox Recipe Ideas]


== References  ==
== References  ==
see [[Adding References|adding references tutorial]].


<references />  
<references />  


[[Category:Queen_Margaret_University_Project]] [[Category:Projects]]
[[Category:Queen_Margaret_University_Project]]
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[[Category:Paediatrics - Conditions]]
[[Category:Paediatrics - Physical Activity]]

Latest revision as of 15:20, 15 November 2021

Original Editors - Alexander Dow, Andrea Civitarese, Lynne Turner, Alison O’Brien, Rachael Le Page, Courtney Ferguson as part of the Queen Margaret University's Current and Emerging Roles in Physiotherapy Practice Project
Top Contributors - Andrea Civitarese, Rachael Le Page, Lynne Turner, Kim Jackson, Lucinda hampton, Courtney Ferguson, Alison O' Brien, Alexander Dow and Rachael Lowe

Introduction[edit | edit source]

Obesity is the excessive or abnormal accumulation of fat or adipose tissue in the body that may impair health.

The obesity epidemic around the world affects not only adults but also children. About 50% of the time, obesity in childhood is carried into adulthood in a phenomenon known as "tracking." Per the latest data from the World Health Organization, the number of overweight and obese children under five years of age is estimated to be close to 39 million.

  • By 2030 some epidemiologists suggest that 20% of the world's population will be obese, i.e., having a body mass index (BMI) of more than 30 kg/m² in adults, or a BMI ≥95th percentile for age and sex in children aged 2 to 18 years. See also waist measurement and body composition
  • Obesity as a disease itself is multifactorial and occurs due to complex interactions occurring between genetics and the environment.[1]
  • Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity needs high priority[2].

Why Does This Matter?[edit | edit source]

Obese children carry an increased risk of asthma, type 2 diabetes, and orthopedic disorders.  Studies have also found a link between childhood obesity and poor academic performance.

  • The roots of childhood obesity can begin in utero.  Maternal obesity and excessive weight gain during pregnancy, for example, both correlate with a higher risk of childhood obesity.  Moreover, other determinants of childhood obesity, eg rapid weight gain during infancy, are well established before age five.
  • Obese children are more likely to become obese adults.  As obese adults, they will have a higher risk of many of the major causes of adult mortality, including coronary artery disease, hypertension, stroke, chronic kidney and liver disease as well as many types of cancer.  [3]


This less than 2 minute video is a worthwhile watch.

 [4]

Etiology[edit | edit source]

Junk food.jpg

The fundamental cause of childhood overweight and obesity is an energy imbalance between calories consumed and calories expended.

Global increases in childhood overweight and obesity are attributable to several factors.

  1. There has been a global shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other healthy micronutrients.
  2. There is also a trend towards decreased physical activity levels due to the increasingly sedentary nature of many forms of recreation time, changing modes of transportation and increasing urbanization.

The problem is societal and therefore it demands a population-based multisectoral, multidisciplinary and culturally relevant approach.

  • Unlike most adults, children and adolescents cannot choose the environment in which they live or the food they eat. They also have a limited ability to understand the long-term consequences of their behaviour. They therefore require special attention when fighting the obesity epidemic[2].

Fighting the Epidemic[edit | edit source]

WHO recommends the following to reduce and prevent childhood overweight and obesity:

  1. Increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts
  2. Limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats
  3. Limit the intake of sugars
  4. Be physically active and accumulate at least 60 minutes of regular, moderate- to vigorous-intensity activity each day that is developmentally appropriate.

Image 3: Eat well guide for parental guidance .

See also

  1. Physiotherapy communication approaches in management of obesity and overweight
  2. Promoting Active Living in Young People Through Behaviour Change
  3. Fostering Behaviour Change in Obese Adolescents

The Benefits Of Physical Activity[edit | edit source]

Physical activity and inactivity can have a big effect on a child's health and development in many ways. It is important to know and understand the benefits of regular activity and the risk of inactivity for a child between the ages of 5 - 12 years old.

Regular Activity[edit | edit source]

Encouraging a child participate in regular physical activity between the ages of 5 - 12 years old will benefit their body and mind health in a variety of ways including mentally, physically and academically [5][6][7][8][9]. These benefits are detailed below:

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The video below provides more details of the top 5 benefits of physical activity for children.

 [10]

Inactivity[edit | edit source]

It is common to find children playing video games and watching television, however, this leads to a lot of sitting and therefore to an inactive lifestyle which can have a detrimental effect on on children's future health[7][8]. These effects may not show until later life. It is important to be aware of the higher risk of developing non communicable diseases due to childhood inactivity[8] and encourage regular physical activity to help reduce and prevent a child developing them in adulthood.

Physical Activity Guidelines for Children (Age 5-12)[edit | edit source]

Children (aged 5-12) should partake in at least 60 minutes of physical activity a day - this should range from moderate activity to vigorous activity[11]. Amounts of physical activity greater than 60 minutes, provides additional heath benefits to your child[12].

Moderate Activity

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Moderate activity raises the heart rate and can make a person sweat. Examples of activities which involve moderate exertion for children include:

  • Cycling on flat ground
  • Walking to school
  • Playing in the playground
  • Walking the dog
  • Riding a scooter
  • Rollerblading[11]

Vigorous Activity

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Vigorous activity is known to improve general health, bone and muscle strength and self-esteem. Vigorous activity can bring health benefits over and above that of moderate activity. Every one-minute of vigorous activity provides the same health benefits as two-minutes of moderate activity [11]. eg

  • Swimming
  • Running
  • Gymnastics
  • Football
  • Karate
  • Rugby[11]

Bone Strengthening Activities

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Children should include bone and muscle strengthening exercises at least 3 days a week. Many vigorous activities can help to build strong muscles and bones in children. This can include anything involving running and jumping, such as football or gymnastics[11]. eg

  • Body weight lifting exercises
  • Jumping and climbing activites
  • Hopscotch
  • Rope Skipping

Examples of suitable muscle-strengthening activities for children:

  • Sit-ups and Press-ups
  • Gymnastics
  • Resistance band exercises
  • Rock Climbing[11]

Click here to download a helpful fact sheet on physical activity guidelines for children [13].

Managing Childhood Obesity[edit | edit source]

See Management of Obesity

Encourage parents to take proactive steps in managing their child's weight[14]. Once they have identified problems it is important to take steps to effect change.

Remind parents they are not alone, they can consult their General Practitioner and other health professionals for advice[15] [16].

Apps[edit | edit source]

We are in the age of technology and it may be easier to encourage children to get active by the use of free online Apps. Below is a list of free apps online that may help parents to engage their child in physical activity and also provide ideas of activities. This is not an exhaustive list and there is a wide variety and many more apps available.

  1. HOOP: Find and book fun things to do in your local area for children aged 0-11 years old. (iOS & Android)
  2. Wuf Shanti Yoga Fun Machine: Yoga app using games and music to promote health and happiness for your child through yoga, meditation and mindfulness. (iOS)

Conclusion[edit | edit source]

Childhood obesity between the ages of 5-12 years old is rising and is a current global concern and challenge. Unfortunately, in this present age the growing popularity in the daily use of technology in children, among the many other barriers mentioned above, is enhancing an inactive lifestyle. It is important to recognise and understand childhood obesity and how to encourage children to become more active and make changes to help manage a child’s weight and maintain a healthy lifestyle.

Useful Links[edit | edit source]

References[edit | edit source]

  1. ↑ Tirthani E, Said MS, Rehman A. Genetics and Obesity. StatPearls [Internet]. 2021 Aug 4.Available:https://www.statpearls.com/ArticleLibrary/viewarticle/131519 (accessed 13.11.2021)
  2. ↑ 2.0 2.1 World Health Organization. Noncommunicable diseases: Childhood overweight and obesity. Available: https://www.who.int/news-room/q-a-detail/noncommunicable-diseases-childhood-overweight-and-obesity (accessed 9.10.2021)
  3. ↑ ASN Childhood Obesity Prevention Strategies Must Start Early Available:https://nutrition.org/childhood-obesity-prevention-strategies-must-start-early/ (Accessed 13.11.2021)
  4. ↑ Childhood Obesity in the UK Available from: https://www.youtube.com/watch?v=5Km1fFLX6T8 [last accessed 15/03/18]
  5. ↑ Gov.UK. Publication: Start active, stay active: infographics on physical activity. Available from:https://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity (accessed 02 April 2018)
  6. ↑ SSEHS Active. Interpreting the UK physical activity guidelines for children. Available from:http://www.ssehsactive.org.uk/young-people-resources-and-publications-item/39/443/index.html (accessed 02 April 2018)
  7. ↑ 7.0 7.1 Great Ormond Street. Exercise for children and young people. Available from: https://www.gosh.nhs.uk/medical-information/general-health-advice/leading-active-lifestyle/exercise-children-and-young-people (accessed 02 April 2018)
  8. ↑ 8.0 8.1 8.2 Kohl III, H. W., and CooK, H. D. Educating the Student Body: Taking Physical Activity and Physical Education to School. Washington: The National Academies Press. Available from: https://www.ncbi.nlm.nih.gov/books/NBK201497/(accessed 02 April 2018)
  9. ↑ SSEHS Active. Children and young people evidence briefing. Available from:http://www.ssehsactive.org.uk/resources-and-publications-item/40/475/index.html (accessed 02 April 2018)
  10. ↑ 5 Reasons Why Physical Activity is Important for Children Available from: https://www.youtube.com/watch?v=nD-0Wc6eSUE [last accessed 28/03/18]
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 NHS., 2015. Physical Activity Guidelines for Children and Young People [online]. [viewed 9th April 2018]. Available from: https://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-young-people.aspx
  12. ↑ World Health Organization., 2016. Physical Activity and Young People [online]. [viewed 9th April 2018]. Avaiable from: http://www.who.int/dietphysicalactivity/factsheet_young_people/en/
  13. ↑ GOV.UK. 2011. UK Physical Activity Guidelines [online]. [viewed 9th April 2018]. Available from: https://www.gov.uk/government/publications/uk-physical-activity-guidelines
  14. ↑ TURNER, K.M., SALISBURY, C. AND SHIELD, J.P., 2011. Parents’ views and experiences of childhood obesity management in primary care: a qualitative study. Family Practice, 29(4), pp.476-481.
  15. ↑ ACADEMY OF NUTRITION AND DIETETICS., 2017. How to Talk to Kids about Weight and Obesity [online]. [viewed 30 March 2018]. Available from:  https://www.eatright.org/health/weight-loss/overweight-and-obesity/how-to-talk-to-kids-about-weight-and-obesity. 
  16. ↑ CENTER FOR DISEASE CONTROL AND PREVENTION., 2017. Tips for Parents-Ideas to Help Children and Maintain a Healthy Weight [online]. [viewed 29 March 2018]. Available from: https://www.cdc.gov/healthyweight/children/index.html.
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