Ending Childhood Obesity… or Avoiding it Completely?

May 11, 2016

As a researcher with particular interest in childhood overweight/obesity and the role of physical activity in preventing or controlling it, I find it puzzling that, in general, most Kenyans respond to the issue with a dismissive… “Well, that’s not really a problem here”. I find this perplexing because, contrary to this, there is a general consensus that among Kenya’s adult population, a considerable overweight and obesity problem exists. So where does the shift happen?

The World Health Organization (WHO) defines overweight and obesity among 5-19-year-olds as the proportion whose body mass index (BMI)-for-age is more than one standard deviation above the reference median or a BMI of 25 kg/m2 or higher at 19 years. Obesity is classified as more than two standard deviations above the reference median or a BMI of 30 kg/m2 or higher at 19 years.

A study conducted by Muthuri et al. (2014) in Nairobi as part of a larger International Study of Childhood Obesity, Lifestyle and Environment (ISCOLE), which was completed in 11 other countries in five major regions of the world showed that, of the 563 children aged 9 to 11 years recruited from public and private schools of varying socioeconomic status in the city, nearly one in seven children was overweight, and one in 16 was obese. In addition, fewer than 13% were meeting the WHO recommendation of a minimum of 60 minutes a day of moderate to vigorous physical activity for children in this age group. Children who were overweight or obese were also significantly less active and spent more time in sedentary pursuits such as sitting or watching television than their age-mates.

School-aged children in Kenya are not alone in facing this creeping phenomenon, which has great potential to affect health, education, and quality of life among children worldwide. This is a sobering finding from the Report of the Commission on Ending Childhood Obesity, released in January 2016.

Being overweight/obese is one of four physiological risk factors that increases a person’s chance of developing a non-communicable disease: cardiovascular disease, certain types of cancer, chronic respiratory disease, diabetes, or even a mental disorder, which may result in long-term illness or disability, and premature death. The other risks include high blood pressure, high blood glucose, and high blood fat. It is interesting to note that these four physiological risk facts have four shared behavioral risks, which include inadequate physical activity and sedentary lifestyles, unhealthy diets, overuse of alcohol, and smoking.

The Commission calls for international organizations, member states, non-governmental organizations, the private sector, philanthropic foundations, and academic institutions to work together, recognizing their moral responsibility to act on behalf of children, to reduce the risk of obesity by implementing six recommendations:

  • Promote healthy eating through programs that also reduce the intake of unhealthy foods such as sugar-sweetened beverages by children and adolescents, including product nutrient labeling and healthy school initiatives;
  • Promote physical activity through programs that also reduce sedentary behaviors, including education of the children and their caregivers, and provision of adequate facilities for healthy activity;
  • Provide pregnant women with knowledge on how to care for themselves before giving birth, with information on healthy diets, avoidance of alcohol and tobacco, and other recommendations for non-communicable disease prevention;
  • Guide early childhood diet and activity, with support for breastfeeding, sleep, and good nutrition;
  • Develop school-level programs that promote health, nutrition, and physical activity; and,
  • Provide weight-management services for those that are obese, which are inclusive of other family members.

These recommendations from the Commission reflect the importance of good health and well-being at all ages, as a development priority that is at the core of the Sustainable Development Goal (SDG) 3, which asks member states and other stakeholders to recognize that our health affects everything – from the extent to which we enjoy life to our performance at work.

African stakeholders have hailed the SDGs as inclusive, and in many ways, more reflective of their own priorities. Implementing evidence-based policy recommendations such as those presented by the Commission will be an effective way to achieve SDG targets and help children lead healthier, better lives that can help drive growth and development in their countries.