May 13 2004
At least 155 million school-age children worldwide are overweight or obese, according to a major new report from the International ObesityTaskForce.
In a comprehensive dossier revealing how the global obesity epidemic is affecting children, the International ObesityTaskForce says that one in 10 children is overweight, a total of 155 million. Around 30-45 million within that figure are classified as obese - accounting for 2-3% of the world’s children aged 5-17. A further 22 million younger children are also affected according to previous IOTF global estimates based on WHO data for under fives.
The report, Obesityin children and young people: A crisis in public health, was delivered to the World Health Organization on the eve of a critical decision by government ministers in Geneva on adopting a global strategy on diet, activity and health, and warned that childhood obesity was “increasing in both developed and developing countries,” with significantly increased risks that children may develop type 2 diabetes, heart disease and a variety of other co-morbidities.
South Africa was an example of a developing country where the prevalence of overweight (including obesity) was found to affect 25% of girls in the 13–19 year age range, similar to the USAaverage, using IOTF criteria, although the figure for boys in South Africawas lower at 7%.
In Europechildhood obesity has increased steadily in this region with the highest prevalence in southern European countries. In northern European overweight prevalence of 10–20% was found for children, while in southern Europethe prevalence was 20–35%. Recent surveys found that 36% of 9-year-olds in mainland Italyand Sicilywere overweight or obese, while in Greecethe prevalence was 26% in boys and 19% in girls aged 6–17 years. In Spain, 27% of children and adolescents were affected while in Crete39% of children aged 12 were found to be overweight. In the UKthe figure reached 20% of children in 1998 using the IOTF’s strict reference assessment methods.
The report was prepared by a special IOTF childhood obesity working group chaired by Professors Ricardo Uauy and Louise Baur, and coordinated by Dr Tim Lobsteinwith the help of expert groups including the Federation of International Societies for Paediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN) and backed by the International Paediatrics Association (IPA). It identifies examples of problematic social trends:
- Increase in use of motorized transport, e.g. to school.
- Fall in opportunities for recreational physical activity.
- Increased sedentary recreation.
- Multiple TV channels around the clock.
- Greater quantities and variety of energy dense foods available.
- Rising levels of promotion and marketing of energy-dense foods.
- More frequent and widespread food purchasing opportunities.
- More use of restaurants and fast food stores.
- Larger portions of food offering better ‘value’ for money.
- Increased frequency of eating occasions.
- Rising use of soft drinks to replace water, e.g. in schools.
The report concludes that the domination of ‘obesogenic’ or obesity-promoting environmental factors means that treatment is unlikely to succeed without strategies to deal only the prevailing environment through a broad-based, public health programme, and urges policy-makers to develop strong policies to stem the rising problem.
“It must be concluded that interventions at the family or school level will need to be matched by changes in the social and cultural context so that the benefits can be sustained and enhanced. Such prevention strategies will require a co-ordinated effort between the medical community, health administrators, teachers, parents, food producers and processors, retailers and caterers, advertisers and the media, recreation and sport planners, urban architects, city planners, politicians and legislators,” the report states.
While in some developing countries childhood obesity was most dominant in wealthier social groups, it is also rising among the urban poor “possibly due to their exposure to Westernized diets coinciding with a history of undernutrition.” Children in lower-income families in developed countries are particularly vulnerable because of poor diet and limited opportunities for physical activity. The report found that in the USAoverweight rose twice as fast in Hispanic and African–American pre-teenage children compared to white children during the 1990s.
Calling on the WHO to help countries to develop National Obesity Action Plans with a high priority set for tackling the prevention of childhood obesity, the report says action is needed to:
- provide clear and consistent consumer information, e.g. on food labels;
- encourage food companies to provide lower energy, more nutritious foods marketed for children;
- develop criteria for advertising that promotes healthier eating;
- improve maternal nutrition and encourage breast-feeding of infants;
- design secure play facilities and safe local neighbourhoods;
- encourage schools to enact coherent food, nutrition and physical activity policies;
- encourage medical and health professionals to participate in the development of public health programmes.
Co-chair Prof Louise Baur, who is based at University of Sydney Department of Paediatrics and Child Health, in Australia, commented: “Almost daily we receive new reports of the impact of type 2 diabetesaffecting younger and younger children because of obesity. That alone should make it imperative that all nations take urgent action to address the key issues affecting the growth of obesity.
Prof Ricardo Uauy, from Chile, chair of public health at the London School of Hygiene and Tropical Medicine, added: “This report is the result of one of the most comprehensive collaborations between experts in the pediatric field, all seriously concerned about what is happening to children throughout the world.
We really cannot afford delay any longer. We need to address this challenge with an effective global strategy on diet, activity and health. We must act quickly. The world’s children deserve no less.”
The report is available upon request from
Childhood ReportIASO International ObesityTaskForce231 North Gower StreetLondonNW1 2NSTel +44 2076911907Fax +44 2073876033Email: [email protected]