Since 1990, childhood obesity has experienced a significant increase worldwide, with the U.S. leading this concerning trend. To effectively combat pediatric obesity, a comprehensive strategy is essential; this includes addressing social media and advertising influences on children’s food preferences and promoting physical activity.
Since 1990, the number of overweight and obese children has almost doubled across the globe, with every region affected. The United States has the highest rates, but many other countries are catching up.
In Southern Europe, which includes countries such as Greece, Italy, and Spain, around 10 to 15% of children are classified as obese. Eastern European nations show slightly lower obesity rates, yet they’re witnessing a sharp rise that may soon align with those in Southern Europe. Asia accounts for nearly half of all overweight children under 5, while Africa has about a quarter. Similarly, in Latin America, roughly 20% of children under 20 are overweight. Many nations in the developing world face the challenge of simultaneously battling both obesity and malnutrition in their young population.
The harmful effects of this epidemic are already emerging, as evidenced by increasing cases of childhood hypertension and type 2 diabetes. Researchers from Florida Atlantic University’s Schmidt College of Medicine are ringing the alarm and discussing the challenges and possible solutions in a commentary published in The Maternal and Child Health Journal.
“Pediatric obesity and being overweight have reached epidemic levels in the U.S. and are becoming a global pandemic. These conditions can lead to serious problems like high blood pressure, type 2 diabetes, and lipid disorders, which are contributors to metabolic syndrome. In adults, these issues significantly amplify the risks for serious health events such as heart attacks, strokes, liver disease, obstructive sleep apnea, arthritis, and certain cancers, many of which are now appearing at younger ages,” stated Charles H. Hennekens, M.D., lead author and the first Sir Richard Doll Professor of Medicine and Preventive Medicine at FAU Schmidt College of Medicine. “By working together in clinical and public health settings, we can tackle these alarming trends and strive for a healthier future for families and children worldwide.”
The commentary reveals that the main drivers of this epidemic include a high body mass index (BMI), which heightens the chance of severe health problems. In the United States, a preschooler is considered overweight if their BMI exceeds the 85th percentile. Studies indicate that these children face far greater risks of becoming overweight during their teenage years compared to those with a BMI at the 50th percentile. This highlights the false belief that children will simply “outgrow” weight issues.
Furthermore, the authors highlight that healthcare providers and public health officials encounter significant hurdles in promoting more daily physical activity among children, which is vital for enhancing metabolic rates, lowering BMI, and reducing future risks of coronary heart disease.
“The decline of physical education in schools and the excessive screen time among children mean that many fail to meet recommended activity levels. This sedentary lifestyle contributes to issues of overweight and obesity, exacerbated by poor dietary habits, reduced sleep, and limited physical activity,” mentioned Panagiota “Yiota” Kitsantas, Ph.D., co-author and chair of the FAU Department of Population Health and Social Medicine. “Promoting enjoyable and organized activities, rather than competitive ones, can help kids to reach the needed physical activity levels.”
While boosting daily physical activity is necessary, the authors caution that it alone won’t sufficiently curb rising rates of childhood overweight and obesity. The proliferation of sugary foods and the rise in consumption of ultra-processed options play significant roles as well.
“Nearly 70% of the average child’s diet in the U.S. consists of ultra-processed foods,” Hennekens explained. “Additionally, the intake of these ultra-processed foods among children under 24 months is soaring globally, heightening the risk of obesity and diminishing their immunological defenses.”
The authors emphasize the necessity for further studies to clarify which aspects of ultra-processed foods contribute to weight gain in children. However, they warn that a diet rich in ultra-processed foods correlates with increasing incidents of overweight and obesity, especially as schools often serve these foods.
“Research indicates that improving nutritional standards for school lunches could mitigate obesity, especially in low-income children,” Kitsantas noted. “We suggest implementing school food policies to eliminate ultra-processed foods from menus and promote healthier alternatives, alongside educational programs on nutrition, despite external pressures on children’s choices.”
Another challenge addressed in the commentary is the impact of social media and advertising on children’s dietary decisions, which often involve sharing posts about unhealthy foods and recognizing numerous unhealthy brands through exposure.
“Despite guidance from the World Health Organization and public health entities to limit food marketing to children, few countries have adopted such measures,” Hennekens stated. “The effectiveness of current regulations is uncertain in today’s media environment, creating an opportunity for health professionals and public health advocates to inform families about the effects of such advertising.”
The authors argue that the escalating pediatric obesity crisis requires a well-rounded plan of action. In 2023, the American Academy of Pediatrics supported WHO guidelines and released their own recommendations to manage pediatric overweight and obesity. These recommendations encourage healthcare providers and public health workers to consider social health determinants, employ motivational interview techniques to modify nutrition and activity habits, and evaluate the potential for pharmacotherapy or surgery to achieve individual patient objectives.
Nonetheless, the authors stress that although there are approved pharmaceutical treatments, maternal and child health professionals should prioritize lifestyle changes before considering medication.
“While we aim to prevent pediatric obesity and metabolic syndrome, to paraphrase Voltaire, we should not ‘let the perfect be the enemy of the good,'” emphasized Hennekens.
The authors conclude by urging the use of all available resources to at least arrest the increasing rates of childhood obesity and its associated health risks. Neglecting these issues could result in an unprecedented global epidemic of obesity among children and adolescents, with severe repercussions for future health, as seen in the U.S.
“Healthcare and public health professionals need to work across different fields to tackle these challenges with patients, families, communities, and policymakers. Collaborative efforts can help reverse these troubling trends and ensure a healthier future for children worldwide,” added Kitsantas.
Co-authors of the commentary include Dawn Harris Sherling, M.D.; Allison H. Ferris, M.D., associate professor and chair of the Department of Medicine at FAU Schmidt College of Medicine; Alicia Caceres, a fourth-year premedical student at Tufts University; Katerina Benson, a third-year pre-medical student at FAU; Alexandra Rubenstein, a second-year medical student at Tufts University School of Medicine; and Sarah K. Wood, M.D., director of the Harvard Macy Institute at Harvard Medical School and former interim dean and professor and chair of maternal and child health at FAU Schmidt College of Medicine.
