Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 3
Childhood o besity p revention o verview
Ricardo Uauy, 1,2 Rishi Caleyachetty 3 and Boyd Swinburn 4
1 Nutrition and Public Health Intervention Research Unit, London School of Hygiene and
Tropical Medicine, London, UK
2 Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
3 MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK
4 WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia
Summary
• The childhood obesity epidemic demands a concerted
prevention effort from governments, international
organizations, the private sector and civil
society.
• A life-course approach to preventing childhood
obesity provides multiple opportunities for intervention
and many childhood settings offer opportunities
for access to children and parents.
• Government policies are needed to provide the
backbone for health promotion activities.
• International agencies and multinational food companies
have critical supporting roles to play.
• Marketing of unhealthy foods to children is a multi -
billion dollar commercial enterprise and these practices
severely undermine the efforts of parents,
governments and health and education professionals
to provide a healthy environment for children.
Introduction
The rising prevalence of childhood obesity in most
populations around the world is a matter of grave
concern because the physical, psychological and social
consequences of obesity in childhood are substantial. 1
The increase in the prevalence of obesity has been
accompanied by a more rapid increase in the severity
of obesity with more children becoming severely
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
obese, indicating that obesity - related medical conditions
will rise at least as rapidly as the overall obesity
prevalence rate. Furthermore, as these children carry
that risk of excess weight into adulthood, the impact
of obesity on the management of chronic disease and
disability will continue to grow as the epidemic gains
momentum.2 The consequences of the obesity burden
and related diseases include not only the known health
consequences but also lost educational opportunity
and lost economic contribution from the lost days of
employment by an older adolescent, or by a parent or
carer in the family if the child requires medical attention.
Furthermore, there are many intangible costs
such as the psycho - social consequences of obesity. 1
Since the early 1990s, the prevalence of overweight
and obesity in children has increased in virtually every
country of the world: in some it has doubled and in
others it has tripled. 3 It is now recognized that there
are many societal and environmental drivers of
unhealthy weight gain 4,5 and yet most of the research
efforts are directed at the individual level, particularly
the genetic level, and most of the current prevention
efforts center on education and social marketing
approaches rather than underlying determinants.
This is shown schematically in Figure 3.1 . This chapter
provides an overview of some of the approaches
to reducing the rapidly increasing epidemic of childhood
obesity and calls for multiple interventions
across the life course backed by a much greater focus
on reversing some of the underlying drivers of the
epidemic. We also examine one of the critical drivers
of childhood obesity: food marketing that targets
children.
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