Factors that Influence Childhood Obesity

The cause of pediatric obesity is multifactorial (1). There is not a single cause, nor solution, found that leads to all cases of pediatric obesity. Parental discipline in regard to the child is not proven to lead to less adiposity or obesity in children. Parental feeding strategy may actually be a cause of obesity with restrictive approach to food by the parent shown to increase the proclivity for the restricted foods (2). Likewise, when parents allowed their children to have more say in the foods they (the children) ate, there were mixed results with both positive and negative outcomes (2).

Family dynamics may be a more important contributor to pediatric obesity. Though initially the obesity may stem from a different issue, the obesity can be worsened by a family dynamic that is not conducive to the wellbeing of the child. It was demonstrated that obese children are often part of families with weak marital bonds overprotective mothers and weak fathers, and families with poor cohesion (3). Parental obesity is also highly predictive of child obesity (3), and the obese parents can instill habits in children through their (the parents') lifestyles. Parental lifestyle may play a more important role than the actual discipline the parent instills on food. In a systematic review, it was found that parental screen time and physical activity could influence how a child behaved in a similar way (4). Along the same line, paternal and combined work schedules that were considered nonstandard (work schedules that included weekends, overnights, and/or hours worked outside of 0900 to 1800) were found to attribute to pediatric obesity (5). Specifically, when either both parents or the paternal figure worked nontraditional work schedules, the child was more likely to be obese. Parents ultimately have a large amount of influence on the child, but there are other factors that lead to obesity in children.

Although parental engagement is responsible for many of the habits children form that can lead to obesity, there are more factors that result in obesity in children. Socioeconomic status seems to play a part in obesity (6,7). There is evidence to support the fact that there are differences in prevalence of obesity between income as it relates to the poverty line (6). While the overall increase in obesity over the past 40 years has affected all levels of income, lower levels of income tended to have higher rates of obesity to begin with, thus there is a larger proportion of people affected by obesity in lower income levels (6-8). Further affecting the incidence of obesity can be genetic factors. While genetic factors alone not make a child obese (1, 8), genetics can increase the risk of developing obesity (1, 9). Genetics are something that cannot yet be effectively manipulated to change the risk of obesity in children. Thus, this is out of the control of the parent.

An increase in sedentary lifestyle as a nation as a whole is also somewhat responsible for the rise in childhood obesity (1, 10). One factor that is often associated with increased risk of obesity is the amount of screen time that a child has. Television (tv) viewing over about two hours is associated with increased obesity (11, 12). Part of this is thought that increased tv viewing is related to increased calorie consumption while tv viewing (12). Lack of physical activity can also contribute to increased risk of obesity. Those that were below a normal threshold of steps per day were at a higher risk of developing obesity than those that managed to maintain a normal level of steps (12). Sleep can also play a role in developing obesity. A decrease in the amount of hours slept was found to have an influence on developing obesity in both children and adults (13).

Ultimately, childhood obesity is multifactorial (1, 7-10). Though parents play a large role in a child's eating and physical activity habits (14), parental discipline is just one small factor that plays a part in the larger problem that is childhood obesity. Family issues, including family dynamics and habits, look to be more of a contributing factor. Socioeconomic status, genetic factors, and an increasingly sedentary lifestyle are all contributing factors in childhood obesity. Multicomponent prevention and treatment strategies are needed to combat the childhood obesity epidemic.

References

1. Xu S, Xue Y. Pediatric obesity: Causes, symptoms, prevention and treatment (Review) [Internet]. Biomedical Reports. Spandidos Publications; 2016 [cited 2018Nov30]. Available from: https://www.spandidos-publications.com/10.3892/etm.2015.2853?text=abstract
2. Kröller K, Warschburger P. Associations between maternal feeding style and food intake of children with a higher risk for overweight. Appetite. Science Direct; 2008; 51(1):166–72.
3. Kalra G, De Sousa A, Sonavane S, Shah N. Psychological issues in pediatric obesity [Internet]. National Center for Biotechnology Information. Industrial Psychiatry Journal; 2012 [cited 2018Nov30]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678172/
4. Xu H, Wen LM, Rissel C. Associations of Parental Influences with Physical Activity and Screen Time among Young Children: A Systematic Review [Internet]. Advances in Decision Sciences. Journal of Obesity; 2015 [cited 2018Nov30]. Available from: https://www.hindawi.com/journals/jobe/2015/546925/
5. Miller DP, Chang J. Parental Work Schedules and Child Overweight or Obesity: Does Family Structure Matter? Journal of Marriage and Family. 2015;77:1266–81.
6. Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and Socioeconomic Status in Children and Adolescents: United States, 2005-2008. NCHS Data Brief. Number 51. [Internet]. Journal of Research in Education. Eastern Educational Research Association. George Watson, Marshall University, One John Marshall Drive, College of Education and Professional Development, Huntington, WV 25755. e-mail: [email protected]; Web site: http://www.eeraorganization.org; 2010 [cited 2018Dec1]. Available from: https://eric.ed.gov/?id=ED530165
7. Phelan S, Ventura AK. Individual and Environmental Factors Contributing to and/or Associated with Childhood Obesity. Childhood Obesity. 2016;:125–35.
8. Silventoinen K, Rokholm B, Kaprio J, Sørensen TIA. The genetic and environmental influences on childhood obesity: a systematic review of twin and adoption studies [Internet]. Nature News. International Journal of Obesity; 2009 [cited 2018Dec1]. Available from: https://www.nature.com/articles/ijo2009177
9. Maes HHM, Neale MC, Eaves LJ. Genetic and Environmental Factors in Relative Body Weight and Human Adiposity [Internet]. SpringerLink. Behavior Genetics; 1997 [cited 2018Dec1]. Available from: https://link.springer.com/article/10.1023/A:1025635913927
10. Overweight & Obesity [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2016 [cited 2018Nov30]. Available from: https://www.cdc.gov/obesity/childhood/causes.html
11. Rey-López JP, Vicente-Rodrí­guez G, Biosca M, Moreno LA. Sedentary behaviour and obesity development in children and adolescents. Nutrition, Metabolism and Cardiovascular Diseases. 2008;18:242–51.
12. Laurson KR, Eisenmann JC, Welk GJ, Wickel EE, Gentile DA, Walsh DA. Combined Influence of Physical Activity and Screen Time Recommendations on Childhood Overweight. The Journal of Pediatrics. 2009;153:209–14.
13. Cappuccio FP, Taggart FM, Kandala N-B, Currie A, Piele E, Stranges S, et al. Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults. Obesity and metabolism. 2008; 31:619–26.
14. Lindsay AC, Sussner KM, Kim J, Gortmaker SL. The Role of Parents in Preventing Childhood Obesity. The Future of Children. 2006;16:169–86.

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