According to WHO, in 2020, there were 39 million under-five children who were overweight or obese worldwide. The corresponding figure for children aged 5-19 is 340 million. The high burden of overweight and obesity among children is huge due to nutritional transition. Obesity is linked to several clinical outcomes and hence warrants special attention. On June 17th, 2021, i3L Food Science and Nutrition held a PowerTalk discussing obesity in children as a growing crisis with the speaker Assoc. Prof. Serene Tung En Hui, the Head Nutrition with Wellness Program at the UCSI Malaysia. Among 10 ASEAN countries, Malaysia is the second-highest in terms of the childhood overweight and obesity prevalence.
Overweight and obesity is defined as an abnormal or excessive accumulation of fat that can be harmful toward one’s health (WHO, 2017). There are various methods to assess body fat or its surrogate. The most known method is body mass index (BMI). While its measurement is relatively simple and robust, BMI cannot differentiate between fat mass and fat-free mass and it cannot give indication on fat distribution. Other methods to measure overweight and obesity are body fat percentage using bioimpedance analysis, waist circumference, etc. For children, those measurements should be standardized to age and gender to account for differences in growth rate and pattern according to age and gender.
Child overweight and obesity leads to several consequences. From the several studies conducted in Malaysia, Ass. Prof Serene Tung En Hui revealed that overweight and obesity are related with high prevalence of insulin resistance and inflammation. Insulin resistance and inflammation are early markers of metabolic syndromes. In addition to that, overweight and obese children have lower cognition compare to those non-overweight/non-obese children.
Imbalances between food intake and expenditure is the most direct cause of overweight and obesity. However, the causes of overweight and obesity among children are complex and interrelated. For example, the causes of overweight and obesity could be categorized into modifiable (such as food intake, life style, etc) and non-modifiable factors (such as intrauterine growth condition, gender, etc). Causes of overweight and obesity could also be grouped according to its level; i.e. child behavior (such as child eating, physical activity behaviour, screen time), parental characteristics (such as food availability at home, parents’ eating behaviour,) and community/demography (such as socioeconomic status, school program, food establishments etc). Current recommendation to prevent overweight and obesity includes diets rich in fruits and vegetables, structured physical activity, lowering screen time, and to move more (to have at least 5,000 – 6,000 steps daily). Overweight and obesity is preventable, but it requires concerted actions from all stakeholders.