Our children are getting fatter, and it feels like we are powerless to stop it.
A recent study of infants and toddlers in the US found that nearly a third of children were obese by the age of just two [1].
As shocking as this statistic is, the lifelong repercussions are even more concerning.
Infant BMI is one of the most accurate predictors of obesity in later life. By the time children start school, experts estimate that it is already too late to reverse patterns leading to obesity and a lifetime of poor physical and mental health [2].
So is childhood obesity an inevitable part of our children’s future?
Far from it.
Here we explore exactly what is behind the rising trend in childhood obesity, its causes and what you can do to prevent your children heading down the path to obesity.
Obesity is more ‘normal’ than ever
Ever noticed how the archetypal ‘funny fat character’ has disappeared from your TV screens?
The Truffle Shuffle in The Goonies, Mike Myers’ Fat Bastard, South Park’s Cartman… we’re all familiar with these household characters. But could the disappearance of these tropes be a sign that obesity is becoming normalised?
Sadly, the stats show this to be all too true.
Childhood obesity is at an all-time high
In the United States, obesity in children and adolescents tripled between 1980 and 2000 [3]. Obesity is now the fifth leading cause of death worldwide [4].
And if you thought that bigger kids just have some extra ‘puppy fat’, think again.
Children who become obese are far more likely to be obese as adults [5]. The harmful effects of this trend are now apparent in ever younger people: cardiovascular disease, diabetes, cancer, the list goes on.
Still, it’s not just in later life that problems rear their head. Obesity is thought to be responsible for childhood health concerns such as early onset puberty in children as young as eight [6].
Sleep apnoea, gallstones, hepatitis, and intracranial hypertension (a build-up of pressure around the brain) are all less well-known conditions linked to childhood obesity [7].
And it’s not just children’s quality of life that’s suffering, life expectancy is also on the decline.
Kids today can expect to die younger than their parents
For the first time in over 200 years, American children have a shorter life expectancy than their parents [8].
Read that again.
Kids today can now expect to die younger than previous generations, despite ground-breaking advances in science and medicine, with a vaster availability of food than ever before.
And the downsides don’t stop there.
If your children are overweight or obese, they are likely to fare worse than their healthy counterparts across multiple indicators, such as:
1. They’re more likely to be bullied
Studies have demonstrated a strong and correlational relationship between adolescent BMI and rates of psychological and physical aggression from their peers. These aggressions included withdrawing friendships all the way to overt kicking, hitting, pushing [9].
2. They’re more likely to develop poor mental health
Obese children are 33-43% more likely to develop anxiety or depression later in life. This is further complicated by the fact that anxiety and depression can cause additional psychological stress that makes weight loss programs difficult to implement. This is because diet and exercise interventions often take a back seat to psychological and pharmaceutical interventions for mental health conditions [10].
3. They will age before their years
Ever hear of a kid with the arteries of a 45-year-old? That could be the legacy you leave your child if they are overweight or obese.
A US study measured the inter wall thickness of the neck arteries in 70 obese children. The results showed that their vascular age – the age at which thickening is normal for an individual’s gender and race – was 30 years older than their actual age.
The children’s cardiovascular system also appeared to have aged prematurely, with triglycerides and cholesterol similar to those of a middle-aged adult [11].
So, why is there such a shocking crisis in children’s health?
Here’s where it gets complex.
Why are kids getting fatter?
We’ve all heard the clichéd excuses… “it’s puppy fat”, “he’s got big bones!”, “it’s genetic!”
Unfortunately, sugar-coating the truth does nothing to help today’s generation of kids avoid a future of hospital visits, poor mental health and declining independence.
And while genetics may be a contributing factor, they cannot account for the whole story. Just two generations ago, obesity was all but non existent as a primary health concern.
Indeed, it was only in the 1960s that adult obesity first became a subject of research, with childhood obesity not entering the fray until as recently as the 1980s [12], [13].
So what’s changed in those 30 years?
It turns out, there are a range of potential causes that overlap [14], including:
1. Overweight parents
There are many lifestyle factors that set kids up for failure but the greatest is parental obesity [15]. Studies suggest that children with an obese dad are 14 times more likely to also become obese [16].
Maternal obesity has also been found to be a major determinant of children’s health in childhood and later life. The risk of obesity, coronary heart disease, stroke, type 2 diabetes, asthma and reduced cognitive performance all increase if a child’s mother is obese [17].
2. Increased screen time, less activity
Whether it’s TV, smart phones or the latest video game, there’s no doubt that all of us are spending more time sitting in front of a screen and less time moving. Unfortunately, kids are no exception.
While there is a strong correlation between increased screen time and obesity [18], [19] most researchers believe this is a contributory factor rather than a direct cause [20], [21].
Instead, it’s likely that obese children are simply drawn to these activities, displacing time for potential physical activity [22].
3. The cost of healthy eating
With the cost of living becoming an ever-bigger concern for many, it’s no surprise that those on the lowest incomes are likely to struggle most to purchase nutritious foods.
The cost of nutrient-dense, single-ingredient food has increased disproportionally more over the years compared to unhealthy, heavily processed foods [23]. A recent study found that between 1990 and 2012 fruits and vegetables increased in price by an average of 7% whereas ‘junk’ foods actually decreased in price by 15% [24]. Skip to today and this figure is likely to be even higher.
And this correlates with other data that shows that children under 12 from the most deprived areas are more than twice as likely to be obese compared to those living in the least deprived areas [25].
All this sounds like we are leaving a bleak inheritance for future generations. But is this glimpse into the future inevitable?
Absolutely not.
Obesity is preventable and reversible.
On a parental and societal level, we owe it to current and future generations to lead the way in making some serious changes.
Childhood obesity: What are we going to do about it?
There is no silver bullet that will resolve the multifaceted problem of childhood obesity.
But there are a number of steps that you can take as a parent to give your child the best possible opportunity at a healthy, happy life.
1. You are the role model
It goes without saying that you set the example for your children. And this is backed up repeatedly by study after study.
Parental influence has been demonstrated to be a key risk factor for childhood weight gain. Whether it’s the foods you keep in the house, your habits and attitudes to exercise and food, how you cook and eat meals – all these factors are being soaked up and internalised by your children [26].
If you want your children to maintain a healthy weight, the work has to start with you first.
Here’s how.
2. It starts before they’re even born
Your child’s health future is being shaped from the very moment they are conceived.
If your diet consists mostly of ultra-processed foods, few vegetables and minimal nutrients, you could be programming your child to be averse to foods such as fruit and vegetables in later life.
It is thought that mothers’ nutrition and lifestyle before and during pregnancy, as well as breastfeeding and early childhood, may have have several health effects on children. This includes an increased risk of developing diseases like obesity, diabetes and -cardiovascular disease [27-31].
There is growing evidence that the influence of the mother’s nutritional and hormonal environment during pregnancy can permanently alter our appetite and energy expenditure [32]. This is a phenomenon known as ‘early metabolic programming’ of long-term health and disease and may be one reason why breastfed children are less likely to be obese [33, [34].
What you feed your kids from day one also strongly influences what they will (or won’t) eat later on [35-37].
There are a complex variety of factors that influence kids’ dietary habits in children, but taste preference appears to be important [38]. Bitter tastes, often associated with dark green vegetables, could be programmed during early age [39].
Introducing your children to as many high-quality, unprocessed foods as early as possible will make it far more likely that they will have a lower BMI during childhood and adolescence [40]. Think ‘eat a rainbow’, with plenty of fresh fruit and veggies, high-quality proteins and lots of healthy fats, like nuts, seeds, avocado, oily fish, etc.
3. It starts at home
Unfortunately, if you don’t fix it at home, it’s unlikely to get better at school either.
Multiple studies have attempted dietary and exercise interventions at schools with little to no success [41].
Educating yourself is the first step.
4. Get kids excited about exercise early on
Making exercise fun and engaging for kids early on is one of the most effective ways you can set your child up for life.
Studies have suggested that active children are many times more likely to be active adults than their sedentary counterparts. One study found that young children were more likely to play outdoors simply by making more outdoor toys available [42].
5. Make food fun!
This is understandably easier said than done! Yet it won’t surprise you that your approach to nutrition at home is critical for keeping your kids a healthy weight.
Some research suggests that four out of five parents let their kids choose what they eat for most meals [43]. Let’s face it… how many children do you know who would choose a piece of grilled chicken and vegetables over a burger and fries if left to their own devices?
Modern, hectic lifestyles also mean that families are eating out ever more frequently [44]. The average child eats on average 25% of their total daily calories in restaurants and other similar businesses [45, 46].
Evaluations of the nutritional quality of kids’ meals from fast food chains shows that most menu options exceed the recommended children’s calorie intakes. In one example, the main dish equated to between 100% and 270% of the average energy intake recommendations for that meal, depending on the child’s age bracket [47].
Yet more frequent consumption of home-cooked meals is consistently associated with increased likelihood of normal BMI and body composition.
A UK cohort study compared the self-reported frequency of home cooked main meals with obesity in adults aged 29-64 years. Those consuming home cooked meals more than five times, compared to less than three times a week, were 28% less likely to be overweight and 24% less likely to have excess body fat [48].
Encourage the kids to get in the kitchen with you and collaborate on fun, tasty and colourful meals that will get them hooked on fresh, natural flavours, without a tonne of e-numbers, saturated fat and sugars.
The take-home
Children are getting fatter, unhealthier and unhappier. And despite what some media outlets might suggest, there are many reasons why you should be concerned if your child is overweight.
Current statistics are frightening but their downstream effects in coming decades are likely to be even more concerning.
While there may be many potential causes, there can be no doubt that we, as adults, hold the burden of responsibility when it come to reversing the tide of childhood obesity.
