It is well known that childhood obesity is a worldwide problem. Also in Spain there has been a significant increase in recent years. Some publications conclude that the current prevalence of childhood and juvenile overweight and obesity in Spain can reach up to 40%. Obesity is a multifactorial condition in which environmental and genetic risk factors coexist. As for the role of genetic factors, very little progress has been made in their study despite the great efforts made. Recent worldwide genetic studies have shown that there are mutations along the genome that lead to different forms of obesity at different stages of life, including pediatric age.
What factors contribute to obesity?
In order to treat childhood obesity, we must know the factors that contribute to aggravate the problem, which will allow us to act earlier.
- It is known that mothers who have suffered from gestational diabetes have children who are already overweight at birth and are prone to obesity.
- We also know that children with intrauterine growth retardation or preterm infants with low birth weight, who in their first years of life regain weight very quickly, are at greater risk of obesity and its consequences.
- Children who grow up in obese families are more likely to be obese in childhood, youth and adulthood.
- It is important to know that obese children are more likely to develop a number of health problems in adulthood. These include heart problems, diabetes, osteoarticular problems such as osteoarthritis, as well as a greater predisposition to some types of cancer such as endometrial, breast or colon cancer.
How can obesity be prevented?
We have mentioned some factors such as genetic predisposition, gestational diabetes, prematurity or low birth weight that cannot be avoided, but we have also mentioned the importance of environmental factors, among which is a correct diet in the different stages of development, physical exercise and the awareness of families in the face of this serious problem.
One of the most important pillars in the fight against obesity is correct nutrition, and it is in this area where the pediatrician must act by providing guidance and exhaustive follow-up.
In the infant stage, the importance of breastfeeding is emphasized. If the mother can, it should be exclusive until 6 months of age and should be maintained together with other foods at least until the first year of life and, if possible, until the second year of life. In the case that the breastfeeding is with adapted milk formulas, it is necessary to avoid excessive sugars, checking a correct relation of proteins and the number of daily intakes offered to the baby.
The introduction of complementary feeding starts from the sixth month and should be adapted to the needs of each child. In the second year of life, the introduction of solid foods should be favored, as well as the progressive introduction of meat, fish, legumes and above all vegetables and fruits. At this age the child is curious to try new foods and it is a good time to introduce healthy foods.
In the preschool stage, from 2 to 5 years of age, what we call “neophobia” begins, that is to say, the child rejects foods that until then he/she had been eating and becomes more capricious and selective. It is a crucial stage in which we must insist on a healthy and balanced diet and not give in to the child’s whims. It is important to increase water consumption and stress the importance of breakfast. Physical activity should be encouraged to create the habit, which will be maintained in the following stages of life.
In the later stages, school and adolescence, social conditioning can alter the habits achieved so far. Emphasize the consumption of fruits and vegetables and do not start the indiscriminate consumption of manufactured products, pastries and foods rich in sugars and fats.
Finally, it should be remembered that childhood obesity not only has a negative effect on the predisposition to the diseases already mentioned, but also determines various risks in the psychological, biological and social spheres. It can lead the child to suffer social isolation and decreased self-esteem, affecting their social, personal, family and even academic relationships. The pediatrician should accompany children and their families during these stages to guide them and detect if there are any problems that can be solved before they become too important.