Definition of Childhood Obesity

BMI is not used for children and adolescents age 2 to 18 years;

instead, it is recommended that a percentile scale based on the
child’s sex and age be used.

 overweight is defined as a BMI in the 85th to 94th percentile,

 obesity is a BMI at or above the 95th percentile.

The Center for Disease Control and Prevention defined overweight as

at or above the 95 percentile of body mass index (BMI) for age and
“at risk for overweight” as between 85 to 95 percentile of BMI for
age.

European researchers classified overweight as at or above 85

percentile and obesity as at or above 95 percentile of BMI.

An Indian research study has defined overweight and obesity as

overweight (between ≥85 and <95 percentile) and obesity (≥95
percentile).

In research, techniques include underwater weighing (densitometry),

multi-frequency bioelectrical impedance analysis (BIA), and magnetic
resonance imaging (MRI).

Causes of childhood obesity:

 Consuming excessive calorie-rich food
 Lack of physical activities and exercise
 Genetic factors
 Environmental factors
 Socio-cultural factors
 Eating disorder symptoms (i.e. Anorexia, Bulimia Nervosa, and
impulse regulation)
 Psychological aspects
 Age, gender & lifestyle
Risks associated with childhood obesity

Many co-morbid conditions like metabolic, cardiovascular,

orthopedic, neurological, hepatic, pulmonary, Hypothyroidism,
Cushing’s syndrome, and renal disorders are also seen in association
with childhood obesity.

High blood pressure & cholesterol – Poor dietary habits and lack of
exercise can lead to the plaque buildup in the arteries. These
conditions can result in the narrowing and hardening of arteries. This
can then lead to a stroke or heart attack, once when the child grows
up.

Type 2 Diabetes – It is a chronic condition which has a severe impact

on glucose utilization process of the child’s body. Being overweight
and leading a sedentary lifestyle can intensify this health issue.

Sleep disorders and Asthma – Breathing problems and obstructive

sleep apnea can be serious disorders which can affect overweight
children.

Depression – With obesity comes the problem of depression and low

self-esteem. This can further lead to learning and behavioral
problems. Overweight children suffer from poor social skills and
anxiety issues.

Socio-emotional consequences: In addition to being implicated in

numerous medical concerns, childhood obesity affects children's and
adolescent's social and emotional health. Obesity has been described
as being one of the most stigmatizing and least socially acceptable
conditions in childhood.

Academic consequences: Childhood obesity has also been found to

negatively affect school performance. A research study concluded
that overweight and obese children were four times more likely to
report having problems at school than their normal weight peers.
They are also more likely to miss school more frequently, especially
those with chronic health conditions such as diabetes and asthma,
which can also affect academic performance.

WHO recommended levels of physical activity for children

Infants (less than 1 year) should:

 Be physically active several times a day in a variety of ways,
particularly through interactive floor-based play; more is better.
For those not yet mobile, this includes at least 30 minutes in
prone position (tummy time) spread throughout the day while
awake.
 Not be restrained for more than 1 hour at a time (e.g.
prams/strollers, high chairs, or strapped on a caregiver’s back).
Screen time is not recommended.
 When sedentary, engaging in reading and storytelling with a
caregiver is encouraged.
 Have 14–17h (0–3 months of age) or 12–16h (4–11 months of
age) of good quality sleep, including naps.

Children 1-2 years of age should:

 Spend at least 180 minutes in a variety of types of physical
activities at any intensity, including moderate-to-vigorous-
intensity physical activity, spread throughout the day; more is
better.
 Not be restrained for more than 1 hour at a time (e.g.,
prams/strollers, high chairs, or strapped on a caregiver’s back)
or sit for extended periods of time. For 1-year-olds, sedentary
screen time (such as watching TV or videos, playing computer
games) is not recommended. For those aged 2 years, sedentary
screen time should be no more than 1 hour; less is better.
 When sedentary, engaging in reading and storytelling with a
caregiver is encouraged.
 Have 11-14 hours of good quality sleep, including naps, with
regular sleep and wake-up times.

Children 3-4 years of age should:

Spend at least 180 minutes in a variety of types of physical activities
at any intensity, of which at least 60 minutes is moderate- to
vigorous intensity physical activity, spread throughout the day; more
is better.
Not be restrained for more than 1 hour at a time (e.g.,
prams/strollers) or sit for extended periods of time. Sedentary screen
time should be no more than 1 hour; less is better. When sedentary,
engaging in reading and storytelling with a caregiver is encouraged.
Have 10–13h of good quality sleep, which may include a nap, with
regular sleep and wake-up times.

WHO Recommended levels of physical activity for children aged 5 -

17 years
For children and young people, physical activity includes play, games,
sports, transportation, chores, recreation, physical education, or
planned exercise, in the context of family, school, and community
activities. In order to improve cardiorespiratory and muscular fitness,
bone health, and cardiovascular and metabolic health biomarkers:
 Children and youth aged 5–17 should accumulate at least 60
minutes of moderate- to vigorous-intensity physical activity
daily.
 Amounts of physical activity greater than 60 minutes provide
additional health benefits.
 Most of the daily physical activity should be aerobic. Vigorous-
intensity activities should be incorporated, including those that
strengthen muscle and bone, at least 3 times per week.