Childhood obesity, is it due to genetic or environmental factors?
According to the World Health Organisation (WHO), a child is said to be obese when his/her weight exceeds that of 95 out of 100 children of the same age.
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In Ghana, the prevalence of childhood obesity was reported to be 15 per cent in 2012 among children of school age in the Accra Metropolis.
In normal healthy individuals, energy intake should equal energy output in what is known as the energy equation (energy intake = energy output). In children, their energy output includes energy required for growth, normal body function, as well as physical activities such as jumping, walking, running, etc. Hence, factors that increase energy intake but reduces energy output increases the risk of being obese. In children, many factors have been associated with increased energy intake, largely environmental and cultural factors.
In Ghana, like many African countries, children are cherished by all members of the family. It is common to see relatives buying gifts for children every now and then. Unfortunately, most of these gifts come in the form of foods such as chocolate, ice cream, toffees, drinks, usually high in sugar and sometimes fat. Unfortunately, these components of food are the culprits of obesity not only in children, but also in adults.
It is also common for food to be used as rewards for good behaviour or excellence, be it in academic or social achievements. Parents and other members of the family and sometimes teachers give these same high sugars and high fat foods as reward to children for good behaviour. These make children eventually develop the appetite for these foods. Consequently, they would rather have more of those than eat well-balanced meals served at home.
Meals served to children in schools may also contribute to childhood obesity. This is because healthy sources of nutrients such as proteins, minerals and vitamins which are needed for growth and normal functioning of these children are usually expensive. School authorities in their bid to reduce cost may opt for less healthy sources of these nutrients in preparing food for their students. A typical example is the upsurge in the use of sausages in the meals of many pre- and primary schools instead of healthier options such as boiled eggs, cooked beans, fish powder and soybeans.
Another key contributor to the current rising incidence of childhood obesity is the scarcity of time spent on preparing meals for children at home. In their effort to obtain economic stability, many parents resort to the feeding of fast foods to their children. Instead of feeding fresh fruits, many families now give juices which are more convenient and faster. Incidentally, because these juices are concentrated and because children tend to drink in large portions, they end up eating more than they would if fresh foods were served.
Studies have shown that foods prepared away from home are high in fat, especially saturated and trans fat (‘bad fat’), sugars and salt. Apart from predisposing children to obesity, these food components increases their risk of developing diet-related chronic diseases such as diabetes, high cholesterol, hypertension, stroke and cancers early in life.
This developing trend is especially alarming because it is coupled with decreasing physical activity (the component of the energy output a person consciously embarks on). It helps to use up excess energy left in the body to prevent obesity.
More children will now spend lots of time watching television, playing computer and telephone games rather than play football, ampe or go cycling. Children are now driven to school rather than walk. In effect, all the excess energy obtained from the bad dietary habits remains in the body unused, stores as fat and leads to early onset of obesity.
Some people argue that for most obese children, the cause of obesity is more genetic than environmental. However, research has shown that the environment is a greater predictor of obesity outcomes than genes. For example, immigrants from traditional populations where foods were eaten fresh with lower fat and sugar levels,and migrated to more affluent societies which supported bad dietary habits reported higher obesity prevalence than their native populations. Also, twin studies show that, twins who have lived in different environments and had different eating habits show different obesity outcomes with higher prevalence among those who lived in obesogenic environments. Even in situations where families have been shown to have a trend of obesity, members of the family who have practised healthier lifestyles have shown lower obesity outcomes.
In conclusion, whether a child becomes obese or not depends largely on lifestyle and environment rather than genetic factors. Parents and schools should, therefore, ensure provision of healthier meals to children. Where need be, seek professional help from a registered dietician. Children should also be allowed to do more outdoor games than indoors.
The writers are with the Department of Dietetics,
University of Ghana.