Obesity is a complicated contemporary disease that can be simply defined as having an excessive amount of body fat to the point it starts to cause health problems. Therefore, obesity is not only a superficial or beauty concern as one may contemplate, but it also encompasses hidden dangerous health problems, such as heart disease, diabetes, high blood pressure and certain types of cancers. In fact, obesity has become a huge problem to the point it is considered a global epidemic (Barness, Opitz, & Gilbert‐Barness, 2007). According to World Health Organization (WHO) obesity is identified when the Body Mass Index (BMI) of a person is 30 or higher; and in order to calculate person’s (BMI) you have to divide the weight in kilograms by the square of height in meters. The BMI accuracy is derived from the charts that take into account the gender and age of a person and compare them to their peers (Barness, Opitz, & Gilbert‐Barness, 2007), more specifically, when we are talking about the obesity problem in children we are talking about one of the most critical and important global health concern of the 21th century that threaten current and future generations. Childhood obesity is a multifaceted health issue. It arises when a child is well above the normal or healthy weight for his or her age and height. Furthermore, childhood obesity can have long lasting adverse health effects as well as short term adverse health effects on the children’s life as they will be in danger of suffering from various health complications and diseases such as nonalcoholic fatty liver disease, sleep apnea, type 2 diabetes, asthma, cardiovascular disease and poor learning skills, The World Health Organization (WHO) experts have estimated that there are 43 million overweight children under the age of five around the world, and by 2025 more than 60% of global disease burden will be the direct result of obesity and obesity related complications. There is an ongoing debate as to what causes obesity exactly. However, according to Ells et al, (2005) obesity is a result from several factors that exist in the same person and contribute to causing obesity, factors like; socioeconomic status, special educational needs, environmental factors, genetics, personal lifestyle and health care services.
Causes of obesity
To put it in simple terms; obesity can happen when you consume more calories (unit of energy people get from the food and drink they consume on a daily basis) than it is required to perform your daily activities. However, obesity usually results from a combination of factors like; genetic factors, behavioral factors, metabolic factors, hormonal factors and socioeconomic factors. The genes you inherit from your parents may directly affect the amount of fat your body store, and where that fat is distributed within your body (Hewitt, 1997). Genetics may also determine how effectively your body converts food into energy (metabolic rate), how your body regulates your appetite and how your body burns calories during physical exercise (Faith, Johnson & Allison, 1997). Therefore, obesity tends to run within the same family and that’s not just because of the shared genes but also family member usually share similar lifestyle (eating habits and exercising). On the other hand, there is a saying that “you can’t outwork an unhealthy diet”. A diet that’s high in calories, and based mainly on junk food like; fast food and sugared soft drinks can lead directly to weight gain and ultimately obesity. Moreover, the screen time (numbers of hour spent looking at computer, tablet and phone screens) is highly associated with weight gain as you can easily without paying much attention consume more calories every day than you burn through exercise and daily activities. Furthermore, several social and economic factors are linked directly to obesity, as it’s very challenging to avoid obesity if you don’t have safe areas to walk or exercise in. Similarly, you may not have been even taught how to consume healthy food and exercise regularly, or you don’t even have access to healthier foods or training equopments (Variyam, 2005). In addition to that, the people you spend your time with may influence your weight; therefore, you’re more likely to develop obesity if you have friends or relatives that suffer from obesity themselves (Cutler, Glaeser & Shapiro, 2003).
Obesity in Mexico
Mexico is one of the emerging Latin American countries and is ranked 11th of the most populated countries in the world (UN, 2012). The capital of Mexico, “Mexico City” represents fast evolving economies which lead to population growth from 1.6 million back in 1940 to 14.8 million in 1990, as people move from countryside areas to urban areas in search of better work environment and better life conditions (Arredondo, 2007). However, almost half of the population is classified as poor or directly prone to poverty (Barquera, Campos & Rivera, 2013). Moreover, Mexico is currently the second most obese country in the world and researchers predicted that by the year 2030, 39% of the Mexican population will be obese (OCED, 2017). Furthermore, about 28% of all the yearly fatalities in Mexico are caused by obesity and obesity-related diseases a total of 170,000 people (Gomez, 2015). In addition to that, according to the World Health Organization (2016) reports, Mexico registers the highest global frequency increase of children who are overweight or obese. As between 1999 and 2012, the frequency of obesity among children age five to eleven year-olds has increased from 28.2% to 36.9% (0.7 percentage points/year) in boys, and from 25.5% to 32.0% (0.5 percentage points/year) in girls (Barquera, Campos & Rivera, 2013). Once established, obesity is very challenging to treat, and the excess body weight in childhood increases the risk of presenting obesity during adulthood; as well as increase the risk of obesity related complications and diseases (Ben-Sefer, Ben-Natan & Ehrenfeld, 2009).
Factors contributing to childhood obesity in Mexico
In 2012 the Mexican government conducted a nationwide health and nutrition Survey which displayed that around 58.6% of children between the ages of 10 to 14 don’t practice any type of physical activity, while in comparison around 67% of children between the ages of 10 to 14 spent more than two hours per day on screen time (in front of a television screen, a computer screen, and/or a gaming console) (ENSANUT, 2012). Furthermore, within the school environment, only one hour per week of physical education is mandatory in Mexican schools; and around of 96% of the teachers in charge of the school physical education programs do not have a clear program to plan their classes accordingly; furthermore, there is a deficiency in open spaces and playgrounds in most schools that allows children to perform any type of physical activity (Ortega, 2014). On the other hand, low income households; often believe that healthy food is more expensive alternative to the other (cheaper) diets (Aggarwal, Monsivais & Drewnowski, 2012). Furthermore, illiteracy in some parts of Mexico contribute to constant mistaken views and misunderstandings about health and nutrition, where many mothers and grandmothers from previous generations still believe that overweight or obese children are reflection of health, thus lead to overfeeding these children by their parents or grandparents with all sorts of unhealthy food at all times (Martínez-Munguía & Navarro-Contreras, 2014). In addition to that, around 42% of TV commercials in Mexico are focused on the consumption of food and food items that directly leads to obesity (Ortega, 2014). These products can be easily purchased by children and are available everywhere (outside schools, cinemas, theatres, and recreational sites). On the other hand, genetic and hormonal factors are also contributors to children obesity in Mexico; however they are less predominant factors than lifestyles and habits (Gupta, Goel, Shah & Misra, 2012). Approximately 73% of Mexican adult females and 69.4% of Mexican adult males are considered overweight or obese (ENSANUT, 2012), and they play a vital role in the quantity and quality of food consumed on a daily basis and the amount of activity of their children. In addition to that, only 14.4% of Mexican mothers breastfeed their children through the first 6 months of life (ENSANUT, 2012). And according to Horta and Victora (2013) children who are breastfed have an approximate 24% less chance of developing obesity later on compared to non-breastfed children. Health care services are essential partner for prevention and management of childhood obesity in Mexico. As regular contacts during childhood for immunizations and checkup visits allow the chance for both early detection of elevated weight in the child as well as offer opportunities for prevention and treatment early on (MOH, 2008). However, in order to achieve effective health interventions for these children, Doctors must ensure to change their families’ behaviors and perspective about obesity, by educating them about the potential dangers of obesity and the role that they can play (Taveras, Mitchell & Gortmaker, 2009).
Mexican government intervention attempts to counter childhood obesity
Interventions that aim to reducing obesity in Mexico are typically focused around individual’s lifestyle choices (food consumption habits and physical exercising habits) (Jiménez-Cruz, 2006). Many of the government intervention programs fail because they ignore the environmental impacts on food consumption and physical activity and neglect to look at social relationships between them (Christakis & Fowler, 2007). Furthermore, many studies suggest that obesity is caused largely by an environment that view excessive food consumption as social norm as well as discourages physical activity (Cohen-Cole & Fletcher, 2008). In addition to that, Anderson and Butcher (2006) study suggests that children’s physical activity can be directly influenced by how active or inactive their parents are and tend to mimic the eating behavior of them as well. Therefore the right intervention approach requires approaching obesity not only as a clinical problem but also as a public health problem (Cohen-Cole & Fletcher, 2008). A recent intervention attempt by the Mexican government introduced taxes on sugar-sweetened soft drinks of about 1 peso (US$0.06) per liter (Aceves-Martins et al., 2016), the intervention was derived by the increased consumption of high calories beverages among pre-school and school children in Mexico which was directly linked to obesity among them (Barquera et al., 2010).
In order to find a realistic and working solution to address childhood obesity problem in Mexico, there is a need for real partnerships and cooperation among key sectors within the country, such as public health agencies, communities, government, private and public health organizations, the media as well as the food and health industry (French et al., 2001). In addition to that, the interventions program should be multidisciplinary and should be school-based, family-based, and clinic-based approach in order to achieve success. Students spend a considerable amount of their time in school (Mcmurray et al., 2002). Moreover, the engagement of teachers and peers in these kinds of programs can improve health behaviors in a large target group and can play an important role in educating these children from a very young age about obesity, the danger of obesity and the how to make smart lifestyle choices in terms of food and exercise. Next to schools, children spend most of their times at home, and reaching a healthy weight for these kids can’t be achieved unless they have full support from their parents at home which enable them to make healthy life choices. In addition to that, family-based intervention programs are considered to be one of the most successful methods for obesity treatment or prevention (Gruber & Haldeman, 2006). Engaging parents in childhood obesity prevention programs make weight loss easier for children; as they can provide moral support as well as enable children to make healthy life choices. On the other hand, Clinic-based programs can work as a diagnostic and educational tool, in a sense it will help detect children who are at risk pf developing obesity and work with their parents to implement a nutritional and physical program to help these kids return to normal weight.
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