ROLE OF PARENTS IN PREVENTING CHILDHOOD OBESITY 9
Childhood obesity is a public health problem recognized all over theworld. Prevalence of childhood obesity in America is alarming andimmediate and sustainable action is needed to prevent the severediseases that are associated with obesity (Frontini, Moreira &Canavarro, 2015). One in every 6 American children is obese (CDC,2015). According to CDC (2015) about 17% of children and adolescentsof between 2-19 years, which is approximately 12.7 million, wereobese in the year 2011-12. Obesity has been defined by body massindex at and above 95th percentile in the sex specific BMI-for-agecharts by CDC for children between 2-19 years. Prevalence is alsocommon along ethnic line with Hispanics recording a prevalence of22.4% in 2011-2012, followed by non-Hispanic blacks at 20.2% andnon-Hispanic whites at 14.1% (CDC, 2015).
Risk Factors for Childhood Obesity
Many studies and experiments have shown same results on a number ofrisk factors for childhood obesity. Top on the list is the geneticpredisposition of obesity (Golan & Crow, 2004). Family memberswith a history of obesity are likely to pass the same gene mutationsto their offsprings. Physical inactivity is a nidus for accumulationof fat in various body parts especially the heart, liver and adiposetissue (Golan & Crow, 2004). Increased sedentary lifestylecharacterized by consumption of high caloric and high fat diet is arisk factor for obesity especially due to overreliance on fast foodsand carbonated beverages (Golan & Crow, 2004).
Too much of high caloric feeds like carbohydrates and high fat/cholesterol containing feeds cause conversion of excess glucose andtriglycerides into lipids that are stored in adipose tissues, heartmuscles and liver. Free fat circulating in the blood can accumulatein the blood vessels too causing atherosclerosis. Atheroscleroticplaques can rupture causing emboli in vessels such as pulmonary andcarotid vessels impeding blood flow (Davis et al., 2007).
Behavioral factors in children such as prolonged TV watching andvideo games addiction can lead to physical inactivity and henceobesity (Anderson & Butcher, 2006). Poor parentage and hostilehome environment can force children into eating disorders as a copingmechanism leading to overweight and obese statuses (Davis et al.2007). Broken families and those undergoing divorce or domesticviolence are the notable cases. Ignorance on the part of parents onthe child’s weight, meal structures and child’s development isalso a key factor. Change in home eating patterns and reliance ontake-away foods from outside has encouraged many children to becomeoverweight and obese (Anderson & Butcher, 2006).
Environmental influences, race and ethnicity as social constructsalso determine the weight status of children (Kumanyika, 2008). Thisis mostly determined by physiology, genetics, culture, socioeconomicstatus and environment as well as interactions among these variables(Caprio et al., 2008). Non- white population has higher prevalence ofobesity including those from African Americans and Hispanic descent(Caprio et al., 2008).
Role of Parents
Parents play an important role in curbing obesity and other lifestylediseases in their children (Davis et al., 2007). Parents are involvedin all aspects of risk reduction activities that can lead to obesity.According to Davies et al., (2007), the main domains to consider inprevention of childhood obesity are types of food and nutrientsconsumed children eating behaviors family interactions duringmeals physical activity and sedentary behaviors as well as forming aworking schedule with parents to advocate for children’s eating andactivity behaviors.
Parents play a key role in family based methods of therapy whichinvolve dietary planning and guidance as well as behaviormodifications. Dietary guidance involves planning the choice of dietsthe children undertake that comprises of vitamins, proteins,carbohydrates, lipids and micronutrients in their recommendedquantities (Davis et al., 2007).
The study also recommends other ways of combating obesity. Parentsshould play a key role in behavior modification patterns thatregulate how their children lifestyles proceed (Davis et al., 2007).They should play a key role in physical exercise patterns to burnextra calories therefore, preventing any adverse accumulations in thebody. They should also regulate leisure activities like TV watching,video games and time spent on the computers and phones. Many childrentake a lot of their time in leisure activities at the expense ofhealthy lifestyles like jogging, sporting activities, mental triviaand community service. Parents should also offer moral support andpositive reinforcement, keen monitoring and cognitive restructuringto their children to encourage them to change their lifestyles(Frontini, Moreira & Canavarro, 2015).
According to Sussner et al (2006), parents have a role in preventingchildhood obesity through their roles in growth and development ofchildren from infancy to adulthood. Their study analyses parentalrole in all stages of development, that is, infancy, toddler age andearly childhood, school age and youth/adolescent age. The literatureshows that most of the strategies employed to prevent obesity arehealthy eating habits, physical exercises, controlled leisureactivities and restriction of sedentary lifestyles. The study notesthe lack of parental involvement and family based programs in allaspects of children growth and development especially in schoolsettings. Cost implications of family based programs have not beenelucidated and further studies are needed to show the cost burden aswell as effectiveness of these programs (Sussner et al., 2006).
According to Crawford et al. (2006), parents have a lot of concernsabout childhood obesity and have employed many mechanisms to preventweight gain in children. Their cross-sectional study was conducted inMelbourne Australia involving 5-6 year-old children of 291 familiesand 10-12 years old children of 919 families. They found out that 89%of parents of overweight children of 5-6 years old and 63% of parentsof 10-12 years old were unaware of their children’s overweightstatus (Crawford et al., 2006). 71 % and 43% of parents of 5-6 yearolds and 10-12 year olds respectively, were not concerned about theirchildren’s current weights.
Only 31% and 43 % of parents of 5-6 year olds and 10-12 year oldsrespectively, were taking action to prevent obesity and unhealthyweight gain in their children (Crawford et al., 2006).Some of thestrategies they employed included promotion of a balanced and healthydiet promotion of physical exercises reduction of junk foodslimitation on fat and sugar contents in diet promotion of fruitsintake provision of education about healthy lifestyles restrictionof excessive food intake encouraging water intake and limiting softdrinks intake (Crawford et al., 2006).
They recommended more public health programs to raise parentalawareness of childhood obesity and other concomitant risky behaviorsthat lead to obesity (Crawford et al., 2006). The study did notcapture the effects the various methods of obesity prevention had onthe parents and children’s psychological and physical statuses.Parental parenting style is also an important phenomenon that wasomitted as depicted by Frontini, Moreira & Canavarro (2016) intheir study.
According to Frontini, Moreira & Canavarro (2016), parentingstyle is critical in determining children’s response to behavioralchanges and obesity prevention mechanisms. In the study childrenbetween 8-12 and 13-18 years were used to elicit the effects ofparenting styles (authoritative, authoritarian and permissive) onparental stress and the children obesity prevention strategies. Thesechildren were either obese or healthy and both groups were devoid ofrisk factors like chronic illnesses, genetic syndromes and mental ordevelopmental delays. The findings were that mothers of obesechildren had higher parenting stress levels those with normal weightchildren and used the authoritarian parenting style more (Frontini,Moreira & Canavarro, 2016). These parents with obese children hadmore tasks and worries about their children’s health due to thestigma, depression and anxiety that came with it. Physiologicalsupport is needed to enable such parents to create a better copingenvironment for their children.
Over the years the convectional dietary and behavioral modificationshave failed to yield positive results in reduction of obesity andtherefore, a more potent family-based approach should be taken.According to Golan et al (1998), parenting is a very important issuein combating obesity as parents play a vital role as agents of changefor their children. Parents are the right agents of change instead ofchildren because obese children suffer from self-esteem issues andbecome resistant to change if used as direct agents (Golan et al,.1998). Parental guidance and role in development of right eatinghabits, physical activity patterns and proper lifestyle behavior fortheir children has contributed greatly in reducing obesity inchildren (Golan et al,. 1998).
The study noted that the dropout rate of overweight children fromobesity prevention programs and strategies in the randomizedlongitudinal study was minimal when parents were exclusively used asagents of change (Golan et al,. 1998). The recommended approachshould, therefore, be based on such family based methods whichencourage parents to be engages in behavior modification. Accordingto Sussner et al (2006), parents should be the ones playing the roleof reinforcing behavior modification in their overweight childrenrather than targeting the children directly. Other factors that needto be considered to achieve this include good family care settingsand positive ethnic and cultural influences on childhood obesity(Golan et al,. 1998).
All these studies and available data have shown that there are manysimilar strategies that can be employed to achieve sustainable weightcontrol in children with or without obesity. The best strategies,according to the available data, encourage family-based programs withparents as the sole agents of change (Golan et al,. 1998). Availabledata have various shortcomings that need further research toelucidate the missing links and gaps. Major shortcomings include,lack of credible data on effectiveness of each of the obesityprevention activities as well as the cost implications of each ofthem.
Most of the parents shun away from these important programs due tofinancial and psychosocial constraints that accompany them hencefailing to achieve the set targets (Crawford et al., 2006). Theeffectiveness of each method has not been studied well and therefore,only recommendations on the few methods have been adopted. Moreattention need to be put on funding research in order to come up withevidence based data on the best methods to curb obesity in childrenthrough parental involvement.
Anderson, P. M., & Butcher, K. F. (2006). Childhood obesity:trends and potential causes. The Future of children, 19-45.
Caprio, S., Daniels, S. R., Drewnowski, A., Kaufman, F. R., Palinkas,L. A., Rosenbloom, A. L., &Kirkman, M. S. (2008). Influence ofrace, ethnicity, and culture on childhood obesity: implications forprevention and treatment. Obesity, 16 (12), 2566-2577
CDC. (2015). Childhood obesity facts. Center for DiseaseControl and Prevention. Retrieved from,<http://www.cdc.gov/obesity/data/childhood.html>
Crawford, D., Timperio, A., Telford, A., & Salmon, J. (2006).Parental concerns about childhood obesity and the strategies employedto prevent unhealthy weight gain in children. Public healthnutrition, 9 (07), 889-895
Davis, M. M., Gance-Cleveland, B., Hassink, S., Johnson, R., Paradis,G., & Resnicow, K. (2007). Recommendations for prevention ofchildhood obesity. Pediatrics, 120 (Supplement 4), S229-S253
Frontini, R., Moreira, H., & Canavarro, M. C. (2016). ParentingStress and Quality of Life in Pediatric Obesity: The Mediating Roleof Parenting Styles. Journal of Child and Family Studies, 25(3), 1011-1023
Golan, M., & Crow, S. (2004). Targeting Parents Exclusively inthe Treatment of Childhood Obesity: Long‐TermResults. Obesity research, 12 (2), 357-361.
Golan, M., Weizmann, A., Apter, A., &Fainaru, M. (1998). Parentsas the exclusive agents of change in the treatment of childhoodobesity. The American Journal of Clinical Nutrition, 67(6),1130-1135.
Kumanyika, S. K. (2008). Environmental influences on childhoodobesity: ethnic and cultural influences in context. Physiology &behavior, 94(1), 61-70
Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. (2006).The role of parents in preventing childhood obesity. The Future ofchildren, 169-186
Sussner, K. M., Lindsay, A. C., Gortmaker, S. L., & Kim, J.(2006). The role of parents in preventing childhood obesity. TheFuture of children, 16 (1), 169-186.