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Childhood Obesity and Nutrition

Summary

The prevalence of childhood obesity in schools can be compared to an epidemic of a virulent disease on a global scale. Research statistics have shown that on average 15.5% of children aged between five to fifteen in school have body mass indexes reaching 30 or higher, far above the norm of 25 or below. In total, nearly 25 million children around the world can be considered overweight, obese or morbidly obese. In the U.S. and U.K. populations alone the sheer rate of childhood obesity has caused an upsurge in cases associated with diabetes, high blood pressure, heart problems and other maladies associated with being overweight. The source of these problems is threefold namely: eating habits, the sedentary lifestyle of children in the modern era and the lack of proper education on the future problems associated with obesity. Insights into the degree of the problem reveal that on average only 42% of children who come to school actually opt to eat at the school’s cafeteria. The remainder chooses to either bring their own lunches or have their lunches handed over the fence to them by their parents. Unfortunately, a vast majority of these lunches are composed of unhealthy fast food options which can cause serious health problems when consumed consistently over a long period of time. Lunches that are brought from off-campus sources usually consist of various unhealthy food options such as burgers, fries, soft drinks and chips bought from the local Mc Donald’s or a variety of other establishments scattered around the surrounding neighborhood. America has an obesity problem that is certain, nearly 33% of adults within the U.S. are obese which represents a 60% increase over a 20 year period with the rate for child obesity not far behind at nearly triple what it was 30 years ago (Chappell, 2010). What these figures represent is nearly 300,000 deaths a year from obesity-related illnesses and maladies, billions of dollars spent on health problems such as high cholesterol, diabetes, high blood pressure, etc (Obesity in America, 2006). It is a growing epidemic that is continuing to proliferate throughout the nation affecting not only adults but children as well. International popular culture representations of the U.S. have depicted an unflattering image of the U.S. population as being culture for the morbidly obese with cartoonish representations often showing an obese man using a tiny scooter in order to line up at the nearest McDonald’s. Unfortunately, this representation of the American people is closer to the truth than most people realize Junk food is the primary contributor to the obesity problem in America’s child population due to its convenience and prevalence which has resulted in the current obesity problem that children in the U.S. now face. As such this paper will investigate the different causes behind the prevalence of childhood obesity in schools, examine current policies aimed at reducing child obesity, examine the behavioral predilections which cause children to excessively eat, determine how to identify early-onset childhood obesity and propose a policy in which the problem can be overcome within the next few years in order to safeguard the future of our nation’s children.

Literature Review

Introduction to Literature

This section reviews and evaluates literature and theories on childhood obesity and nutrition. The literature in this review is drawn from the following EBSCO databases: Academic Search Premier, MasterFILE Premier, Psychological Database, ERIC, and Professional Development Collection. Other sources of information utilized in this section are drawn from various online resources when needed. Keywords used either individually or in conjunction include junk food, childhood obesity, the prevalence of childhood obesity, policies on obesity intervention, trends in childhood obesity, detecting obesity in children, popular culture and obesity, the effect of junk food on children, nutrition and obesity, obesity intervention and the effects of excess consumption.

The Age of the Junk Food Culture

Junk food in the form of chips, dips, burgers, fries, sodas, candies and ice cream have become such a part of America’s culture that the most prevalent cultural distinction for Americans today is that of the “Junk Food” culture (Burner, n.d.). In nearly every town, city and state groceries, shopping malls and fast-food restaurants carry some form of junk food that is rapidly consumed by a voracious public that enjoys the taste and convenience of such products. Unfortunately, this cultural distinction is actually slowly killing the American population due to resulting effects such food types have on the body. The recommended daily allowance of nutritional calories that a body should have in a single day as recommended by the American Medical Association is roughly 2,500 to 3,000 calories a day (Burner, n.d.). The problem with junk food is that due to their convenience and serving size most people aren’t away that on average they consume more than 3,000 calories a day from the various forms of junk food they eat (Menifield et al., 2008). An average adult male in the U.S. should consume only 65 grams of fat and 2,500 calories in a single day yet a burger and fries combo meal with a large coke available at the local McDonald’s is equivalent to more than 50 grams of fat and 1500 calories within a single sitting (Menifield et al., 2008). This would not be a problem should that be the only large meal they eat throughout the day however this meal is supplemented by various chips, sodas and various other unhealthy options throughout the day which brings the total calorie count to 4,000 calories or more.

The Human Body and Excess Consumption

On average the human body only requires 2,000 to 2,500 calories within a single day to properly function any excess calories are usually stored as fat by the body for future use. With diets often exceeding the daily allotted calories needed by the body this results in a large proportion of the consumed calories being turned into fat (Obesity in America, 2006). Not only that habits developed early on in childhood have been shown to carry well into adulthood. As such children who are currently overweight now will be at risk for obesity as they grow older (Chappell, 2010), K. (2010). It is the combination of these factors that are behind the current problems regarding obesity in the U.S. today.

Obesity and Popular Culture

While many people state that an obese person becomes that way by choice this paper states that they are made that way due to external influences that affect their ability to think. On average nearly 10,000 TV ads appear within a given year which focuses on promoting the products of various restaurants and companies (Burner, n.d.). Children in particular are targeted by fancy commercials advertising sugary sweets through the use of cleverly crafted cartoonish elements in the commercial itself. Since TV advertisements are an extension of popular culture it can be seen that popular culture is one of the primary reasons behind the obesity problem America now faces due to this patronage of products that are not only unhealthy but cause people to become obese as a result of their consumption (Burner, n.d.). The power of advertising should not be underestimated since it has been shown that TV ads are one of the best ways to convince people to buy a certain product. From this, it can be seen that the causes behind obesity are not merely the fast-food culture that Americans find themselves in but also the actions of various corporations that promote with wild abandon their products without taking into consideration the possible ramification on the population.

Policy Approaches towards Preventing Obesity

The current problem with regulatory approaches in creating an effective policy in reducing childhood obesity in schools is that there is actually no effective method to prevent a child from eating unhealthy foods. Various policies enacted in the past have included healthy food options to be utilized in school cafeterias, the addition of caloric and nutritional guidelines on various types of food, restricting certain types of food marketing to children as well as the reduction of ingredients multinational corporations use in the types of food they create which have been connected to obesity. Unfortunately, though these policy initiatives were enacted years ago the fact remains that the prevalence of childhood obesity continues to grow. At a national level, there is a distinct lack of regular monitoring and prevalent action on preventing obesity and as a result, it has been allowed to run rampant. An examination of various obesity prevention programs enacted on the local level has shown relatively limited success in actually sustaining an effective program that curbs the growing rate of childhood obesity in local and urban areas. It must be noted though that the reason such efforts are failing is due to the fact that commercial influences in the form of popular culture and the media are just more popular among children and adults as compared to the policies enacted by the government. The problem really is not due to ineffective policies but rather a cultural one where commercial influences and convenience have created the problem that various schools in the U.S. now face. Various studies on the prevalence of childhood obesity state that effective policy-making for this particular problem is still in its infancy and that given time an adequate solution will present itself. One example seen in Australia was a policy response to prevent childhood obesity which was in the 1997 report “Acting on Australia’s weight” from the National Health and Medical Research Council and the 2002 NSW Childhood Obesity Summit. Such institutions attempted to enact effective policies in obesity prevention which inevitably failed due to most of the findings, reports and initiatives being promptly ignored in the coming years. What these initiatives fail to take note of is that society is currently in the “junk food era” where the convenience and prevalence of fast food establishments, grocery stores and mini-marts have made the availability of calorie-rich easy to eat food all too prevalent. The fact is there is no policy that can be effectively enacted that can prevent a manufacturer from selling a type of food that is safe for consumption, albeit high in calories, to the general public. Companies such as Hershey’s, McDonald’s, Dairy Queen, Coca Cola and various other companies are all clear evidence of the ineffectiveness of policies aimed at preventing childhood obesity when the products that cause them cannot be prevented from going on the market. The manufacturer is not at fault should a consumer eat more than what is necessary, there is always the defense that it was the consumer’s fault for eating so much and that the manufacturer did not force them to eat such large amounts. Continued policy initiatives to prevent childhood obesity will continue to fail unless the cultural aspect of the causes behind obesity is taken into consideration when creating policy measures. The only effective policy that comes to mind would be to prevent the sale of certain high-calorie products to children yet without proper justification as to the supposed dangers of a particular product when no danger is evident in its consumption will result in such a policy never being able to be implemented.

Analysis of Policy Settings

One of the stakeholders in pushing through with proposed policies to address childhood obesity has been the National Health and Medical Research Councils based not only in the U.S. but in various countries around the world such as the U.K., and Australia. Their arguments towards the implementation of policies to prevent obesity mainly concentrate on lifestyle and environmental factors. As of late most of their policy initiatives have proven largely ineffective with very few groups actually listening to them. It must be noted that the NH & MRC neglects to take into account the fact that basic economics dictates that so long as there is a demand for food that is high in caloric content yet tasty there will always be someone to supply it. On the other hand, several policy initiatives that have been attempted such as preventing certain advertising campaigns from being aimed at children have resulted in a certain degree of resistance from various manufacturing companies. The inherent problem is that companies such as Coca-Cola, Pepsi, Hershey’s, Magnolia, etc., do not perceive their products as actually causing harm to people. Such companies state that if eaten in moderation their products would not result in the prevalence of obesity today and that it is up to the consumer to rein back their level of consumption. Such arguments have actually been effective in preventing policies that would in effect limit the access of such companies to child markets by deflecting the responsibility of the proper consumption of food to parents and schools. As for what government agencies are directly relevant to the proposed policy, the health sector in government operations is the most likely set of agencies needed to ensure that any proposed policy in reducing child obesity is carried out. The only inherent problem with this though is the fact that many of the necessary methods of response needed in order to ensure compliance are outside of the control of the health sector which creates problems in ensuring that policies are effectively carried out.

Detection of Early Onset Obesity in Children

The studies of Foreyt et al. (1999) and Olstad and McCargar (2009) both present the idea that childhood obesity begins from the ages of 2 to 5 and can actually be prevented provided that it be detected early on and proper methods of behavioral, physical and nutritional intervention are put into practice before early-onset obesity takes hold. One interesting aspect of the Foreyt et al. (1999) study is that it actually compliments the study of Olstad and McCargar (2009) in the sense that Foreyt et al. present methods on how to detect whether a particular child was at risk of becoming obese in the future while Olstad and McCargar present various methods on how to prevent early-onset obesity through dietary, physical and parental intervention (Foreyt et al, 1 – 5) (Olstand and McCarger, 1 – 5). By combining both studies a distinct procedural methodology actually emerges wherein early detection and methods of prevention can be combined in order to prevent a child from becoming obese.

The hypothesis of both Studies

From the perspective of Foreyt et al. (1999) detecting whether or not a child will become obese in the future can actually be accomplished utilizing a combination of BMI, logistic regression parameters, and cross-sectional samples of data over a period of several years (Foreyt et al., 1999). By utilizing their proposed method of probability calculation Foreyt et al. presented a procedure that hypothesized all children between 2 to 5 years old can actually be tested in order to determine whether or not they will become obese. The study of Olstad and McCargar (2009) also presented a similar hypothesis yet included in their study the idea that by adjusting parental involvement in a child’s health practices which include adhering to proper diets, physical activity and presenting oneself as a proper role model, early-onset child obesity can be constrained and prevented (Olstand and McCargar, 2009).

Participants and Data Collection Methods

The participants for the Foreyt et al. (1999) study were primarily Mexican-Americans aged 2 – 5 within an elementary school in the U.S. While the Olstand and McCargar (2009) study didn’t use any participants they did however focus on the prevalence of childhood obesity within children in Canada. As such both studies when combined produced an array of different perspectives from two different countries regarding childhood obesity. Data collection for the Olstand and McCargar study consisted primarily of academic research utilizing, statistics, books and journal articles while the Foreyt et al. study utilized raw data collected from school records dating back to 1996 and used in 1999 (Foreyt et al, 1999).

Results of both Studies

As mentioned in the introduction of this particular section, the statistical results of both studies show that early-onset childhood obesity develops from ages 2 to 5 and as such prevention at this particular age is critical in ensuring a child doesn’t become obese. From the data obtained from Foreyt et al. (1999), it becomes clear that from ages 2 to 5 subsequent abnormal weight gain and the propensity to become obese can be detected which when combined with historic data actually becomes an accurate method of calculating the probability of a child becoming obese as proven by the results of their study. In fact, when comparing both studies it becomes clear that both have nearly the exact same conclusions and assumptions regarding the reasons behind childhood obesity, when it occurs and how it can be prevented. It is only in the case of Olstand and McCargar (2009) that the methods of prevention and solutions to the problem are further expounded upon.

Discussion of Importance and Application of Results

The application of both studies in the realm of parental awareness should not be underestimated. By informing parents of their roles as nutritional role models as described by Olstand and McCargar (2009) preventive practices involving proper nutrition, exercise and behavioral attitudes can be adopted early on so as to prevent obesity. Furthermore, based on the data from Foreyt et al. (1999) children at risk for developing obesity can be detected and parents can be informed as to what particular age they should implement methods of obesity prevention so as to safeguard their children from this debilitating condition that has claimed the lives of millions of adults so far.

Examining the Correlation between Eating Behaviors, Food Cues and Obesity in Children

Studies examining the eating behaviors of various children showed that the amount of food consumed is directly affected by outside environmental food cues which trigger a response that causes the feeling of hunger which in turn causes a person to eat (Hepworth et al, 2010). Not only that, the amount of food consumed has been shown to marginally increase depending on the type and level of the environmental attribute attempting to influence an individual (Cohen, 2008). This can come in the form of appearance, smell or even personal preference towards a particular food type which triggers the response for the body to get hungry (Van der Laan et al., 2011) (Radnitz et al., 2009). It must be noted that food cues can be considered a form of conditioned stimuli for the body wherein after a certain degree of exposure the body reacts through the production of increased salivation and changes in blood glucose levels in order to prepare the body for the intake of food (Hou et al., 2011). Such a reaction is similar to what is seen in various Pavlovian conditioning mechanisms wherein after a certain time the body reacts in a predetermined fashion after continuous environmental cues which creates the behavior (Boggiano et al., 2009). In this particular case, it is the exposure to food cues that in turn causes the body to react as a result of an inherent conditioning mechanism. It can even be assumed that the sudden feeling of hunger individuals experience after being exposed to a food cue can thus be attributed to the body’s inherent Pavlovian conditioning mechanism wherein in expectation of the consumption of food the body reacts in a predetermined fashion such as changes in blood glucose levels, the increased release of stomach acids and greater degrees of salivation (Galarce et al., 2010). As such, this reaction is attributed to the condition of being hungry when in fact it was the result of a food cue and not a denial of earlier sustenance that caused the reaction. On the other hand, such a reaction does not happen on a continuous case-to-case basis, in fact in some cases wherein despite the level of exposure involved the desire to eat does not manifest itself as readily in some children compared to others (Polivy et al., 2008). This lack of desire or rather behavioral resistance to the compulsion of eating is thus attributed to the concept of restraint which refers to a child’s concern over their food intake versus the amount their body actually needs (Geyskens et al, 2010) (Cornier et al., 2009). It must be noted that the concept of restraint varies per child as evidenced by the rising rates of obese children within the U.S., Europe and various other countries (Hollitt et al., 2010) (Ouwehand & Papies, 2010). It has been shown by various studies that distinct behavioral traits, of which restraint is included, directly factor into the caloric intake of a child however various studies have been inconclusive as to how a factor such as restraint adequately develops in a child so as to resist the compulsion to eat when presented with a food cue (Loxton et al., 2011).

Discussion

Based on the given information it can be seen that while junk food is behind the current obesity problem in the U.S. it is not the only cause. The unmitigated marketing practices employed by various corporations that seek to influence Americans to buy their products is actually a prime contributing factor to the problem of obesity that America now faces due to its prevalence in popular culture which influences people to such an extent that it causes them to buy the products of these companies. The combination of these factors is actually the primary reason behind the prevalence of obesity and as such, they must be controlled in order to prevent the problem of obesity from getting worse. Of particular interest is the data presented regarding food cues and their resulting behavioral influence on children. Based on the data provided in that particular section it can be assumed that when an individual is presented with either a static representation or a moving graphic visualization regarding a particular food product that looks enticing it can be expected that this will draw out a hunger response despite that person or child being full (Van der Laan et al., 2011). This is particularly interesting to take note of due to the sheer prevalence of advertising that specifically targets children of which food advertisements involving cereal, fast food, and candy make up a vast majority. Taking this into consideration it can be seen that popular culture advertisements actually play a distinct role in influencing the eating habits of children since they in effect entice children to eat more than they should. What must be understood is that the basis of all advertising campaigns is to increase the consumption of a particular product. The only problem with the current situation is that the increased consumption of junk food is in no way positive due to the high caloric content and low nutritional value of a vast majority of junk foods currently being advertised on television and in print ads today. Another way of looking at this problem is from the perspective of the Foreyt et al. (1999) and Olstad and McCargar (2009) studies, while both studies indicate that propensity for childhood obesity starts from the ages of 2 – 5 both neglect to show the effects of the junk food culture on not only the consumption of children of junk food but the effect this has on parents as well. What must be understood is that just as children can be influenced by advertisements so can parents be influenced as well and this can affect a child’s early behavioral development regarding proper eating habits. Olstad and McCargar (2009) do indicate in their study that parental eating habits do indeed affect children but they don’t specifically indicate junk food nor do they mention advertising campaigns by food companies. It is in the opinion of this paper that the exposure of parents to such advertisements actually creates an adverse effect on children as well since parents would take their children to fast food establishments or buy junk food due to the enticing commercials they themselves see. Since eating junk food isn’t limited to a specific age this paper believes that due to advertising campaigns and the overall convenience fast food and junk food gives parents who are struggling to raise young kids the end result is a greater propensity to introduce these unhealthy foods to children at an early age. As such, this could be one of the factors that Olstad and McCargar (2009) and Foreyt et al. (1999) neglect to take into account and could explain why the ages of 2 to 5 are considered to be a critical period for the development of early-onset childhood obesity. Not only is this the age where behavioral predilections regarding eating behavior occur but it is also the age where parents feel comfortable in introducing their children to junk food due to its convenience. It was also mentioned in the literature review that was no effective means of actually preventing a child from eating junk food in school and as such this was one of the contributing causes to cases of child obesity. While it may be true that schools can implement new health regulations regarding healthy lunches in school cafeterias (as seen in the recent trend in lunch improvements across various school districts in the U.S.) the fact remains that schools cannot truly implement measures of “forced” acceptance for children to eat particular lunches. This is due to the fact that even attempting to implement such rules would cause a parental uproar from numerous parental groups the least of which would-be parents that depend on the quick and easy lunches that fast food restaurants are able to provide their children with. On the other hand, it must be noted that advocates of policy changes in the type of food parents provide their children say that the problem lies in the fact that parents have gotten so used to providing their children with quick and easy junk food lunches that other alternatives just seem too tedious and tiresome despite the fact that they are just as affordable, if not cheaper. Contributing to this problem is the fact that some children have basically gotten so used to eating fast food that they refuse to eat other alternatives which create even more problems in having them pursue other food alternatives.

Recommended Policy Implementation

The best method of resolving this issue is not to target the state of obesity directly since there is no way to prevent a person from eating rather a more effective method would be to discourage the process of eating high caloric food. Taxes have always been a way in which governments have controlled the flow of imported goods into the country in order to give local producers a chance against cheap foreign imports, an enacted policy that levels a specific type of tax on foods identified as being the cause of obesity would raise their prices sufficiently so as to limit their consumption. The advantages of this method are simple, the parents of children have a limited amount of income which they can supply to their kids, by having a high-calorie product that leads to obesity cost more children can only eat a specific amount of that particular type of food due to limitations in income. Other policy initiatives have focused on dealing with the problem of obesity when it has already occurred, this policy initiative specifically targets the cause of obesity (commercialized goods i.e. fast food, chips, ice cream, etc.) and ensures that it has a limited impact on how it is consumed. While there would be a definite backlash from various companies and consumer groups the fact remains that should such a policy be put into practice the rate of obesity would definitely decrease.

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