Low and middle income countries have seen the greatest rise in the number of children being obese or over-weight between 1990 and 2014, says the final report of the Commission on Ending Childhood Obesity (ECHO). The report also revealed that at least 41 million children under the age of five years are obese or overweight across the world. In absolute numbers, there are more children who are overweight and obese in low- and middle-income countries than in high-income countries.
The report was submitted to the World Health Organization (WHO). The Commission was established in 2014 and consulted with over 100 WHO member states and reviewed nearly 180 online comments to develop a set of recommendations to tackle childhood and adolescent obesity around the world.
Overweight prevalence among children aged under five years has risen between 1990 and 2014, from 4.8 per cent to 6.1 per cent, with numbers of affected children rising from 31 million to 41 million. The number of overweight children in lower middle-income countries has more than doubled over that period, from 7.5 million to 15.5 million. In 2014, almost half (48 per cent) of all overweight and obese children aged under five lived in Asia and one-quarter (25 per cent) in Africa. The number of overweight children aged under five in Africa has nearly doubled since 1990 (5.4 million to 10.3 million).
The commission found that many children are exposed to environments that encourage weight gain and obesity. They identified marketing of unhealthy foods and non-alcoholic beverages as a major factor in the increase in childhood obesity particularly in the developing world.
Overweight and obesity impact on a child’s quality of life and they face physical, psychological and health consequences. "We know that obesity can impact on educational attainment too and this, combined with the likelihood that they will remain obese into adulthood, poses major health and economic consequences for them, their families and society as a whole," says Commission co-chair, Sania Nishtar. The Sustainable Development Goals, set by the United Nations in 2015, too identify prevention and control of non-communicable diseases as core priorities. “Increased political commitment is needed to tackle the global challenge of childhood overweight and obesity,” says Peter Gluckman, Commission co-chair. To media, he said childhood obesity had become “an exploding nightmare” in the developing world. He added: “It is not the kids’ fault. You can’t blame a two-year-old child for being fat and lazy and eating too much.”
The report suggests that WHO needs to work with governments to address the environmental causes of obesity and overweight, and help give children the healthy start to life. Environmental context during preconception and pregnancy; infancy and early childhood; and older childhood and adolescence need to be improved. There should an effort to support healthy diet, sleep and physical activity in early childhood. These measures include promotion of breastfeeding, limiting consumption of foods high in fat, sugar and salt, ensuring availability of healthy foods and physical activity in the early child care settings. The school environment should provide standard school meals; eliminate the sale of unhealthy foods and drinks and include health and nutrition and quality physical education in the curriculum. There should also be efforts to provide family-based, multi component, lifestyle weight management services for children and young people who are obese.
Specifically, the report suggested taxing sugar sweetened soft drinks and curbing the marketing of unhealthy foods.
-Implement comprehensive programmes that promote the intake of healthy foods and reduce intake of unhealthy foods and sugar sweetened beverages by children and adolescents
-Implement comprehensive programmes that promote physical activity and reduce sedentary behaviours in children and adolescents
-Integrate and strengthen guidance for noncommunicable disease prevention with current guidance for preconception and antenatal care, to reduce the risk of childhood obesity
-Provide guidance on, and support for, healthy diet, sleep and physical activity in early childhood to ensure children grow appropriately and develop healthy habits
-Implement comprehensive programmes that promote healthy school environments, health and nutrition literacy and physical activity among school-age children and adolescents
-Provide family-based, multicomponent, lifestyle weight management services for children and young people who are obese
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