2. Introduction
Body
Mass Index (BMI) is normally the tools use to estimate overweight and obesity
in both in adults and children. The prevalence of adulthood and childhood
obesity is a global issue and remains the major epidemic in the United States. This
epidemic is really threatening global population which represent serious health
threat and increases the risk of developing many chronic diseases especially
cardiovascular diseases. BMI is defined as weighted in kilograms divided by
height in meters squared and is related to the amount of fat in the bodies
which can raise the risk of many health problems. Therefore, a health care
professional can determine if a person’s health is at risk because of their
weight. BMI of adults ages 20 and older normal weight is in the range of 18.5 to
24.9 and overweight classification is in the range of 25 to 29.9. When the
weight is over 30 it is classified as obesity. A weight over 40 is classified
as extreme obesity. For children and adolescents ages 2 to 19, overweight or
obesity is classified at or above the 85the percentile on the Center for
Disease Control and Prevention (CDC) growth charts while at or above the 95th percentile is classified as obesity; extreme
obesity is at or above 120% of the 95th
percentile on the CDC growth charts [1].
Overweight
and obesity is a risk factor that can significantly impact an individual's
morbidity and mortality throughout the lifecycle in both low income as well as
middle-income countries. Child overweight and obesity prevalence have increased
substantially in the past three decades and continued to worsen. Children, and
adolescents who are affected by overweight or obesity has more than tripled
since the 1970s.Data from the National Health and Nutrition Surveys (NHANES)
database show alarming statistics on the growth in the number of children who
are at risk for obesity, falling between the 85th
and 95th percentiles of the weight
for length growth references created by the CDC [2].
Childhood
obesity is a complex health issue that is known to have a significant effect on
a child’s social and emotional well-being, as well as physical health. Being
overweight/obese can affect academic performance and can potentially lower the
quality of life experienced. However, the current epidemic of obesity maybe caused
largely by an environment that promotes excessive food intake and discourages
physical activity. Humans most of the time have weak physiological mechanisms
to defend against body weight gain when food is abundant even though we
generally and mentally have excellent physiological mechanisms to defend
against body weight loss if we regularly involve in physical activity that
protect against obesity. Studies have also shown that childhood obesity is a
crucial predictor of obesity in adulthood and comorbidities are similar in
children as in the adult population.These co-morbidities include high blood
pressure, hyperlipidemia, type 2 diabetes, osteoarthritis, and mental disorder
such as depression. Although the exact mechanism of developing obesity is not yet
fully understood, there are several causes of becoming overweight or obese.
The
most common reason is the consumption of high-calorie and low-nutrient foods
and beverages.Other factors that influence unhealthy diet is behavior,
community/cultural environmental influences, and lifestyle preferences [3].Currently, healthcare cost in the United States
continue to rise; accounting for 17.6% of the gross domestic product.The United
States is ranked the costliest amongst the developed countries in the world [4].With the continued increase of cost in healthcare
and the decreasing resources to fund, it is imperative that early detection,
prevention, and treatment of childhood obesity are addressed. Early detection
and prevention can potentially be achieved using the school system.
3. Purpose
Studies
have shown that national childhood obesity rates between the ages 2 to 19 years
old is at 18.5% and continues to rise. Currently, 91% of American children get
less than the recommended 60 minutes of daily physical activity. Children have
a poorer diet, and almost two-thirds of American children consume high sugar
beverages daily. The increase in the prevalence of obesity can create a burden
on society and the healthcare industry. Therefore, the purpose of this study was to determine behavioral factors that affect
dietary fat on the development of obesity both in children and adulthood.
Children grow at different rates and times as it is sometime difficult to tell
if a child is overweight compared to adult with mere body structure of the
person. It is important for healthcare provider to regularly evaluate a child’s
BMI, growth, and potential health risks due to excess body weight.
Childhood
overweight and obesity are associated with premature mortality, development of
chronic disease, like adults, as well as a decline in the quality of life. With
the ongoing epidemic and increase in prevalence in the US, the issues add
burden to the overall healthcare expenditure. Childhood obesity greatly impacts
the economy as it accounts for 0.7-2.8% of a country's total healthcare
expenditure. An obese individual has a 30% higher medical cost compared to an
individual with a healthy weight [5].With the
ACA mandate, California is one of the few states that cover weight loss
programs. As of 2012, nutritional counseling and therapy have been included in
the decree. California is one of the sixteen states that include some coverage
and reimbursement for any nutritional screening, dietary counseling, and
therapy addressing obesity.Also, as of 2014, there is no cost sharing for
consumers when it comes to obesity screening and counseling for both adults and
children [6].Having this form of coverage will
help the parents be more receptive to enrolling their children in the
counseling classes.
4.
Methodology
A secondary data
set was utilized to determine the causes and health consequences of overweight
and obesity. This lone question also tests the hypothesis that exercise alone
would not prevent childhood obesity. This study is set out to compare finding
and results from NHANES survey of the National Center for Health Statistics
(NCHS) and the California Health Interview Survey (CHIS). NCHS is part of the
Centers for Disease control and prevention and its data presented on prevalence
are from the 2013-2014 unlike the 2011-2012 California Health Interview Survey
(CHIS 2011-2012) Child Data [7]. The data file
consists of individual records from the Child interview of CHIS 2011-2012. The
health topics covered in the CHIS vary in topics. The range goes from screening
information and demographics to health care access and utilization as well as
diet, physical activity and park use.
CHIS data is useful
to many different users, including, but not limited to legislators, policy
makers, local health departments, state agencies, community organizations,
advocacy groups, foundations, researchers, and many others. The data is used to
either gain funding for social programs, or gain a further understanding to
current issues that California citizens are facing. Ultimately, the CHIS data
is used to justify programs that fight health threats such as the obesity and
diabetes epidemic, as well as help set policies that improve the overall public
health. The research question for this study was to determine what are the
causes and health consequences of overweight and obesity.
5.
Findings and Analysis
Descriptive
statistics findings from the CHIS data using the Statistical Package for Social
Sciences (SPSS) based on the overweight or obese indicated that about 14.2% are
overweight or obese compared to 85.8% that are not overweight in California. Data
also indicated that there is significant relationship between overweight or
obese teens and volunteer work or community service for males and females.
The proportion of obese or overweight male teens that have done some
volunteer work or community service is 10.3% less
than their counterparts (normal males) and 13% for females. Lastly, the data
analysis indicated that there is significant relationship between overweight or
obese male teens and participation in those extracurricular activities but for female teens, the
difference is not significant. The proportion of obese or overweight male teens
that participated
in any clubs or organizations outside of school in the past 12 months is 7.4% less than their counterparts. In
total, obese teens are participating 6.4% less in Clubs or organizations outside of school than normal teens.
The NCHS report
indicated that 17.2% among children and adolescents were considered to have
obesity and 6% to have extreme obesity. An independent t-test was conducted to
determine whether the number of days in a typical week that a teen is
physically active for 60 minutes or more is different between teens that are
considered overweight or obese and teens that are of normal weight. Teens that
are overweight or obese have significantly fewer days were they are physically
active for 60 minutes or more than those who are not overweight or obese
(t=-2.361, p=.018).In the sample, the overweight or obese teens have an average
that is .275 less than the average of the teens that are not overweight or
obese. In addition, from Chi-squared test, taking PE at school is significantly
related to overweight/obese (p=.0032).
In the NHANES
data, more than 70.2% adults were considered to be overweight or have obesity,
32.5% were considered to be overweight, 37.7% were considered to have obesity
and 7.7% were considered to have extreme obesity. Also, prevalence of obesity
continues to increase significantly among adult population children between
2013 -2014. Factors that causes of overweight and obesity among adults and
children/youth includes genes, eating habits, physical inactivity, computer,
too much time on cell phone, sleep habits, TV, medical conditions or
medication, geographical location of where people live including their access
to health food, or basic healthcare.
Our
environment foster behaviors that significantly contribute to obesity because
even though if the body has excellent physiological defenses against the
depletion of body energy stores and at the same time has weak defenses against
the accumulation of excess energy stores when food is abundant.
Individual’s
body weight and body composition are generally determined by interactions
between the environment and genetics and the environment’s contribution to
obesity must be thought of in terms of how it increases the frequency of
behaviors that increase the risk of positive energy balance. What this means is
that having positive energy balance will increase body mass in order to restore
energy balance and obesity can be viewed not as a result of defective
physiology but as the natural response to the environment. The key to avoiding
obesity in unsupportive environments is maintaining a pattern of healthy
behaviors. Although, genetic makeup plays a major role in that it determines
the strength of an individual’s physiological defense against gaining and maintaining
an obese body fat level. According to Research Chair in Obesity [8], genetics plays a role in obesity and can directly
cause obesity in disorders such as Bardet-Biedl syndrome and Prader-Willi
syndrome. Again, genes do not always predict future health; genes and behavior
may both be needed for a person to be overweight or in some cases, multiple
genes may increase one’s susceptibility for obesity and require outside factors
such as abundant food supply or little physical activity.
6. Conclusion
and Discussion
After carefully
reviewing the material collected, the different sources and analyzing the
results, it is evidence that obesity has become not only a national problem,
but also a worldwide epidemic that requires immediate attention. The key to
solving the obesity epidemic is prevention by way of providing effective
educational tools for parents in order to teach their children about proper
diet and health living lifestyles. The worldwide trend has been making steady
improvement in lowering the obesity rates among children and the most important
preventative measure is to eat healthy and participate in regular physical
exercise. Prevention measures must also be taken on a social level. Government
programs must be able to provide funding for providing effective policies in
which encourage healthy programs [9].
In conclusion,
childhood obesity has become not only a major national health concern in the
United States, but has also become a major issue across the globe. It has been
well documented that the number of obese children has increased significantly
since the 1970’s.According to the Centers for Disease Control and Prevention [10], approximately 17% (or 12.5 million) of children
and adolescents aged 2-19 years of age are obese. Some of the major risks of
obese children are that they are more likely to have high blood pressure, high
cholesterol and type-2 diabetes, which are risk factors for cardiovascular
disease. In addition, obese children are more likely to become obese adults.
The reality of the issue is that the family dynamics has changed significantly.
The need for dual incomes in a family household is necessary for survival,
which results in less time for preparation of healthy meals for the family and
more dependency on fast food.
In March of 2013 report, the American Diabetes Association released a
study that estimated the total costs of diagnosed diabetes have risen to over
$245 billion dollars in 2012.That was a 41% increase over a five period from
2007, when the costs were estimated to be at $174 billion [11]. The study provided valuable insight into how the
$245 billion was calculated. In 2012, it was estimated that $176 billion was
attributed to direct medical costs and $69 billion was correlated to reduced
productivity [9]. Health risks such as cardiovascular
disease, cancer, diabetes, osteoarthritis, and chronic kidney diseases can be
prevented creating an environment that does not promote overeating and lack of
regular activity. The food and restaurant industries should be encouraging to
promote actions that reduces portion sizes or high-energy density foods. These
includes foods that are naturally low in fat and energy density (fruits,
vegetables and whole grains; to be made available and affordable in both
restaurants and grocery stores) and public health efforts that promotes
appropriate incentives. Physical activity is also very important and helps
individual maintain a relatively low risk of obesity by engaging in regular
high levels of physical activity. These diseases increase when a person’s BMI
exceeds 23. Obesity and overweight were estimated to have caused over 3.4
million deaths (most of which were from cardiovascular causes) globally in
2010.
research article