Prevention of Childhood Obesity

Abstract

Global childhood obesity increased more than 8-fold over 40 years, inducing a very large personal, societal, and economic burden. Effects of available treatments are less than satisfactory; therefore, effective prevention is of high priority. In this narrative review, we explore preventive opportunities. The available evidence indicates large benefits of improving nutrition and lifestyle during early life, such as promoting breast-feeding and improving the quality of infant and early childhood feeding. Promoting healthy eating patterns and limiting sugar-containing beverage consumption from early childhood onwards are of great benefit. Regular physical activity and limited sedentary lifestyle and screen time alone have limited effects but are valuable elements in effective multicomponent strategies. The home environment is important, particularly for young children, and can be improved by educating and empowering families. School-and community-based interventions can be effective, such as installing water fountains, improving cafeteria menus, and facilitating regular physical activity. Reducing obesogenic risk factors through societal standards is essential for effective prevention and limiting socioeconomic disparity; these may comprise food, drink, and physical activity standards for day cares and schools, general food quality standards, front-of-pack food labeling, taxation of unhealthy foods, restriction of food advertisements to children, and others. Effective prevention of childhood obesity is not achieved by single interventions but by integrated multicomponent approaches involving multiple stakeholders that address children, families, and societal standards. Pediatricians and their organizations should be proactive in supporting and empowering families to support their children's health, and in promoting societal measures that protect children.

Nutritional Strategies for Childhood Obesity Prevention

“…The Cochrane review of 2019 reported the effectiveness of the interventions conducted both at home and at the community level [20], and community and home-based child obesity interventions seems to have lower costs per child and greater compliance, with similar impacts [67]. Approaches that modify the food environment (vending machines at school, installing water fountains, advertising) and facilitate physical activity, perhaps also achieved through the internet and social media, can be suitable for older children and adolescents [2,20]. Interventions on fast-food marketing or on subsidies for the poorer classes might also be useful [46].…”

“…Overweight and obesity in childhood are growing worldwide, affecting not only the countries with the highest income but also the poorest ones [1,2]. The high prevalence of the disease and its persistence and consequent relationships with chronic diseases in adulthood make it essential to identify strategies to prevent its onset [2][3][4].…”

“…There is common agreement that obesity prevention in children and adolescents is the first-line and high-priority approach to reduce obesity and, consequently, cardiovascular risk [2,17,18]. Prevention of childhood obesity must be directed at promoting behavioral changes from early life (pregnancy, infancy, and early childhood) to adolescence and young adult age, involving family, schools, society, media, and policy makers [2,16,19]. Developing effective intervention strategies and reducing long-term health costs associated with obesity is a major challenge for physicians [14].…”

Promoting Breastfeeding and Interaction of Pediatric Associations With Providers of Nutritional Products

“…We see the risk that banning all information regarding complementary foods and formulas for young children may lead families to take uninformed inappropriate choices and could induce a preferential use of low-quality products without restricted advertising, such as soft drinks and junk foods. In the current situation with a very high prevalence of childhood obesity with its life-long adverse health consequences (18), this would be a highly undesirable effect.…”

Front-Of-Pack Nutrition Labelling: A Position Statement of the European Academy of Paediatrics and the European Childhood Obesity Group

“…Prevention of childhood obesity is an important priority for public health given the >8-fold increase of the global prevalence of childhood and adolescent overweight and obesity during the last 4 decades [1-3]. In many European countries, this increase has been attenuated or halted, but overweight and obesity rates in children and adolescents remain very high, with major adverse effects on the quality of life, health, and life expectancy of affected individuals [4, 5]. Overweight and obesity predispose to type 2 diabetes and cardiovascular diseases, and they can also contribute to the risk for many types of cancer [6, 7].…”