Topic Editor: Jennifer Orlet Fisher, PhD, Temple University, Center for Obesity Research and Education, USA
Topic funded by: The Lawson Foundation
Intervention studies aim to find strategies that would mitigate the risks and reduce the impact of obesity on children’s health. It is worth noting that so far, no intervention strategies has ever proven to reduce body weight on a long-term basis for a significant number of individuals. An emphasis on weight loss can create more problems, including repeating cycles of weight loss and gain, eating disorders, and reduced self-esteem, whereas inducing healthy behaviours may improve health regardless of weight loss. Therefore, even if treatment is important, prevention of overweight and obesity should be the primary target of intervention programs.
Prevention of obesity should begin before birth and account for genetic and prenatal conditions. Intervention with overweight women before and during pregnancy aiming at diet and behaviour change could reduce exposition of the foetus to smoking, obesity and diabetes. Current policy recommendations should be examined regarding the monitoring of weight gain by pregnant women and infants. The focus of this monitoring should shift from ensuring adequate weight gain to prevention of obesity. For example, although it is recommended to wake up newborns for feeding every three to four hours, this practice should be stopped when the baby has regained his or her birth weight and is growing steadily. Training new mothers in the introduction of solid food and appropriate soothing/sleeping behaviours could also help control infants’ weight gain.
Prevention programs can be extended throughout the preschool years by targeting the activity level and dietary habits of children. Some studies showed that short-term reduction in saturated fat intake can be achieved, although the effect disappeared after two years and effectiveness seemed to vary among ethnic groups. The combined results of studies showed that intervention directed at young children can result in a decrease of weight-for-length as measured by the Body Mass Index (BMI). Interventions aimed at preventing obesity should also promote sufficient sleep.
Prevention programs can also target the aspects of children’s environment that increase the risk of developing obesity, such as the availability of passive entertainment and high-calorie food. Children should be encouraged to play outside, but introducing new play equipment is not enough to induce more physical activity. Parents can play an important role and improve their family environment by setting rules, modelling healthy behaviours and limiting the use of screen-based entertainment. Schools could also help reduce the risk of developing obesity by leaving children more time for active physical play.
In short, the current epidemic of obesity must be addressed by the following multifaceted interventions:
Changing the medical monitoring of infants’ weight gain in a way that emphasizes obesity prevention;
Encouraging physical activity in young children;
Improving children’s sleep habits and eating behaviours;
Emphasizing health improvement rather than weight loss when treating obesity.
Taking into consideration genetic conditions that render children more or less vulnerable to obesity.