Risk Factors and Implications of Childhood Obesity
Purpose of Review
This review summarizes our current understanding of factors associated with childhood obesity, including latest prevalence rates, effectiveness of intervention strategies, and risk for concomitant disease later in life.
Obesity has reached global dimensions, and prevalence of childhood obesity has increased eightfold since 1975. Interventions for obesity prevention have mainly focused on behavioral settings to date, i.e., interventions that have focused on behavioral changes of the individuum such as increasing daily physical exercise or optimizing diet. However, effects have been very limited worldwide and could not stop the increase of obesity prevalence so fare. Thus, community-based/environment-oriented measures are urgently needed, such as promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals in kindergarten and schools, increase of daily physical activity at kindergartens, and schools as well as ban on unhealthy food advertisement for children.
Restructuring obesity interventions towards community-based/environment-oriented measures to counteract an obesogenic environment is mandatory for sustainable success and to stop the obesity epidemy. There is need to move fast, as already moderate overweight before the start of puberty is associated with significantly increased risk for type 2 diabetes and cardiovascular disease in midlife.
KeywordsObesity Childhood Adolescence Prevention Cardio-metabolic disease Risk factor Type 2 diabetes
Compliance with Ethical Standards
Conflict of Interest
Susann Weihrauch-Blüher and Susanna Wiegand declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1659–724.CrossRefGoogle Scholar
- 3.• GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–26 The global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013 is presented. Obesity prevalence is increasing worldwide, and no national success stories have been reported in the past 33 years. Thus, urgent global action is needed. CrossRefGoogle Scholar
- 6.Pervanidou P, Akalestos A, Bastaki D, Apostolakou F, Papassotiriou I, Chrousos G. Increased circulating High-Sensitivity Troponin T concentrations in children and adolescents with obesity and the metabolic syndrome: a marker for early cardiac damage? Metabolism. 2013;62:527–31.CrossRefGoogle Scholar
- 11.Oude Luttikhuis H, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009:CD001872. https://doi.org/10.1002/14651858.CD001872.pub2.
- 12.•• Bjerregaard LF, Jensen BW, Ängquist L, Osler M, Sorensen T, Baker JL. Change in overweight from childhood to early adulthood and risk for type 2 diabetes. N Engl J Med. 2018;378(14):1302–12 The study has investigated 62,565 Danish men whose weights and heights had been measured at 7 and 13 years of age and in early adulthood (17 to 26 years of age). Childhood overweight at 7 years of age was associated with increased risk of adult type 2 diabetes only if it continued until puberty or later ages. CrossRefGoogle Scholar
- 13.Lange D, Wahrendorf M, Siegrist J, Plachta-Danielzik S, Landsberg B, Müller MJ. Associations between neighbourhood characteristics, body mass index and health-related behaviours of adolescents in the Kiel Obesity Prevention Study: a multilevel analysis. Eur J Clin Nutr. 2011;65:711–9.CrossRefGoogle Scholar
- 18.• Hawkes C, Smith TG, Jewell J, et al. Smart food policies for obesity prevention. Lancet. 2015;385:2410–21 Four mechanisms through which food policies can affect diet are identified and presented. Comprehensive policy actions are needed that create an enabling environment for infants and children to learn healthy food preferences. CrossRefGoogle Scholar
- 29.•• Twig T, Yaniv G, Levine H, et al. Body Mass Index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 2016;374(25):2430–40 A BMI between the 50th to 74th percentiles (i.e., within the accepted normal range) during adolescence is already strongly associated with increased cardio-vascular and all-cause mortality during 40 years of follow-up. Thus, already mild overweight during adolescence may lead to significant morbidity and increased mortality in adulthood . CrossRefGoogle Scholar
- 31.NCD-Risk-Factor-Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017. https://doi.org/10.1016/S0140-6736(17)32129-3.CrossRefGoogle Scholar
- 32.Waters E, de Silva-Sanigorski A, Hall B, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011:CD001871. https://doi.org/10.1002/14651858.
- 34.•• Iguacel I, Michels N, Ahrens W, Bammann K, Eiben G, Fernández-Alvira JM, et al. Prospective associations between socioeconomically disadvantaged groups and metabolic syndrome risk in European children. Results from the IDEFICS study. Int J Cardiol. 2018. https://doi.org/10.1016/j.ijcard.2018.07.053 Children from socioeconomically disadvantaged families are at high metabolic risk independently of diet, physical activity, sedentary behaviors, and well-being. As obesity interventions have failed to target these groups to date, future interventions should be developed to tackle health disparities. CrossRefGoogle Scholar