Annotated Bibliography in Review of Childhood Obesity

Haslam, D. W., & James, W. P. (2005). Obesity. The Lancet, 366 (9492), 1197-1209.

David Haslam and Philip James’ article titled Obesity, is an overview of the state of obesity in the world today, as well as an in-depth look into some of the major causes of the epidemic. In relation to obesity in childhood specifically, the article looks into the effects of the imprinting of metabolic control via genetic traits gained from family history.

The article begins with an overview of the health issue of obesity, stating that of all diseases affecting humankind worldwide, obesity and excess body weight is the sixth-largest factor for risk in the burden of all diseases. With this, we see that 10 percent of the world’s children can be classified as either obese or overweight, as well as 1.1 billion of the world’s adult population (about 1 in 7). Obesity and the state of being overweight both serve to decrease the world’s average life expectancy by means of the promotion of numerous types of cancer, type 2 diabetes, and cardiovascular disease. Haslam and James continue by explaining that obesity’s cause is very complex, and has its roots in both genetic and environmental causes. Environmental causes are more present in those in poorer, disadvantaged areas than in richer, more affluent areas because of a process called postnatal imprinting (as well as fetal imprinting).

Haslam and James explain that ethnic differences in diabetes and glucose intolerance (in which we see that four of the five countries with the highest incidences of diabetes can be found in Asia) can be explained by past familial generations of fetal and early childhood malnutrition in these areas which “imprints” a susceptibility of insulin resistance and metabolic syndrome on modern children who experience rapid weight gain. Further detail of this process lies in evidence found that “poor maternal feeding leads to profound changes in the development of hepatic and pancreatic tissue in the offspring with altered expression of various metabolic pathways…”1

This suggests that the past malnutrition experienced by members of a family can alter future generations’ genetic susceptibility to metabolic disorders and insulin resistance, which can lead to higher rates of diabetes and obesity. As such, childhood obesity in such instances can be considered to be almost entirely a genetic and/or social issue for those experiencing this phenomenon, as the experience can be said to be largely outside of the child’s control and be due to the social phenomenon of malnutrition experienced by both parents and grandparents. However, Haslam and James do emphasize that the development of obesity and metabolic disorder due to these increased risks can still be prevented through the implementation of moderate exercise and dietary changes. This suggestion is very useful advice for those concerned with the seeming lack of control Haslam and James’ evidence seems to relate to families, as despite the increased probabilities such social factors may contribute to obesity rates, these are still only probabilities, which can be overcome using healthy habits to overcome effectively.

Wright, S. M., & Aronne, L. J. (2012). Causes of obesity. Abdominal Imaging, 37(5), 730-2.

An article by Suzanne Wright and Louis Aronne outlines the current accelerating state of the obesity epidemic throughout the world. First, Wright and Aronne outline the problem and the potential negative outcomes if the current trend is allowed to continue. Then, the article goes into more detail concerning the causes of the epidemic, including a section relating to the social influences on obesity, especially in relation to childhood weight gain and obesity factors.

Wright and Aronne explain that not only is obesity currently at the highest levels the world has ever seen, but the rate at which obesity is developing and increasing is also quickening throughout the world. This is especially worrying since this increase in obesity rate is occurring across every category of individual, including sex, race, age, and smoking status. Additionally, Wright and Aronne explain that those that are already in the highest category of body mass index (with a BMI of greater than 40kg/m2) have increased their respective BMI proportionately more than those in categories of body mass index that are lower (defined by Wright and Aronne as less than 35 kg/m2). This increase is not confined to any single nation or Australia alone, but rather is a phenomenon occurring worldwide.

According to Wright and Aronne, part of the cause of this increasing rate of worldwide obesity is due to the effect of social networking on both children and adults. For example, the article portrays a study that shows “that a person’s chance of becoming obese increased by 57% if he or she had a friend who became obese in a given interval.”2 Further studies have shown that similar or higher increased possibilities of a weight gain are seen amongst siblings, married couples, and especially amongst children of overweight parents. In the cases of siblings and married couples specifically, the odds of one sibling becoming obese if the other does is increased by over 40%, while the odds of one spouse becoming obese if the other does is increased by about 37% 2.

These probability increases portray yet another social factor that contributes to the rate of childhood obesity. The fact that one’s parents, siblings, and friends’ weight has so large an effect on children is shown to be well-studied, and thus the concept is a reliable one, as multiple, credible studies have all shown a similar effect in this article.

Anderson, P. M., & Butcher, K. F. (2006). Childhood Obesity: Trends and Potential Causes.

Anderson and Butcher’s article titled Childhood Obesity: Trends and Potential Causes is a look into the increase in obesity rates in children specifically. The article looks at the increased health risks and disease associated with obesity, much like the previous two articles in this bibliography, but additionally takes a more in-depth look at what social changes have occurred in recent history that can be held accountable for much of the increase in childhood obesity rates. This analysis looks specifically at the changing roles and attitudes of parents, and how these changes can be accountable for the change in the eating habits of children worldwide - ultimately, leaving parents to blame for their child's' obesity.

Anderson and Butcher begin their article by explaining and reviewing research that indicates that “children who eat more ‘empty calories’ and expend fewer calories through physical activity are more likely to be obese than other children.” 3 This phenomenon is then explained to be occurring because of recent history’s changes in the availability of such foods to children, especially in the home and school setting.

While the availability of such foods on the world market have increased, changes in family can also be a cause of the greater intake of such foods, as Anderson and Butcher explain that an increase in “dual-career” and single-parent families have decreased the amount of time available for home cooking, and with that increased the demand for pre-prepared foods which tend to be of the “empty calorie” variety. Besides the increase in this kind of food intake, the article also explains that the amount of exercise that children partake in has decreased. This has a variety of social factors as well, including changes in the environment that allow for less time walking (more time on buses or in cars), and more time spent on computers and in front of televisions. Anderson and Butcher argue that these two factors (increased empty calorie intake due to a change in family dynamics and a decrease in overall exercise due to environmental shifts) account for the increase in the obesity epidemic in children.

The article’s extensive research and reliance upon peer-reviewed academic studies give this conclusion credibility, as well as usefulness in understanding the major causes of the problem of childhood obesity. With such a complete understanding of the whole picture of the cause of childhood obesity, families can take such information into account in order to lower the risk of childhood obesity in their respective households. For instance, time spent in front of a television and computer can be limited, so as to allow for additional time participating in moderate exercise. Additionally, the importance of avoiding “empty calories” as much as possible can be implemented, and extra effort can be made to cook healthier options in the home.

Garasky, S., Stewart, S. D., Gundersen, C., Lohman, B. J., & Eisenmann, J. C. (2009). Family Stressors And Child Obesity.

Garasky et. al. introduces their article titled Family Stressors and Child Obesity with a particular study that examines the effect of stress specifically on families, especially in relation to childhood obesity rates. While previous articles have shown causation due to social aspects of past parent behavior, socioeconomic status, social networking identity, and modern technology/infrastructure as causes of increased rates of childhood obesity, stress itself as a social factor had not been examined.

Garasky et. al. examined data collected by the Child Development Supplement of the Panel Study of Income Dynamics for two distinct age groups of children, namely those ages 5 to 11, and those ages 12 to 17 years old. The study’s results indicated that weight categories (of either obese weight, overweight, or healthy weight) could be associated causally with a range of stress factors upon the child’s family. These stress factors included “lack of cognitive stimulation and emotional support in the household among younger children, and mental and physical health problems and financial strain in the household among older children. With this information in mind, these stress factors can be more actively attended to and avoided in order to effectively decrease the rate of obesity in households.

What is of particular use in the conclusions of the study performed by Garasky et. al. is the conclusion that different types of stressors affect different age groups of children more than others. The study concluded that in the younger age group (ages 5 to 11), the main stressors that caused increases in obesity rates were “a lack of cognitive stimulation and emotional support”, while amongst the older group of children (ages 12 to 17 years) the main causes of increased obesity rates were “mental and physical health problems and financial strain” 4. This suggests that families with younger children would do best to focus on the creation of a mentally stimulating environment with the intent of creating a healthy weight in their children: a conclusion that is not necessarily obvious or immediately of common sense. Additionally, families with younger children would do well to ensure a strong emotional connection is created with their children, so as to ensure a healthier weight: again, not an immediately obvious conclusion that one may make. Also, in families with older children, it may be best to do one’s best to ensure the most financial stability possible, which may be a very difficult suggestion for many families to take into account. However, the attendance to mental and physical health problems, while still a difficult strategy depending upon the country and socio-economic status of a family is also important for decreasing the odds of obesity in late childhood.

All four of the referenced sources in this bibliography attended to the health issues associated with childhood obesity, and the problem of the increasing rate of childhood obesity throughout the world. After addressing these issues, each article offered well-researched causes of this epidemic which can be readily taken into account and be made useful by the reader. These social causes included the past nutrition of family members (the authors of which stressed could be overcome with exercise and dietary management), social influence amongst family members and friends, family dynamics in modern society (including pre-made meals and television/computer time), and family stressors such as a lack of stimulation for younger children and financial instability in older children.