Evaluating Approaches To Tackling Childhood Obesity in the Early Years - Essay Example

Evaluating Approaches to Tackling Childhood Obesity in the Early Years The World Health Organization reports that as of more than 43 million children worldwide below the age of five, were diagnosed as overweight. These overweight children have a greater probability to go on to be obese in later life if their weight is not managed well. Wadden et al (2002) define obesity as excess of body fat measured by an estimate of the body mass index (BMI). A BMI over 25 kg/m2 is classified as overweight while a BMI 30 kg/m2 is classified as obese. Obesity is becoming a major public health problem that poses great risks to affected individuals, one of which is cardiovascular disease (Poston & Foreyt, 2000). Donnelly et al (2000) detail the conditions associated with obesity such as hypertension, dyslipidemia and type 2 diabetes. According to Snorof et al (2004) obese children are physically at risk also for high cholesterol, high blood pressure, cancer, orthopedic problems, sleep apnea, gallbladder disease and other debilitating diseases. These authors also suggest that obese children are prone to psychological and social discrimination. Being obese makes a child a target for taunts from peers and negative reactions from others, leaving the child with hurt feelings and possibly, low self-esteem and depression (Holmes, 1998). The negative effects of obesity can be detrimental to a child’s growth and development, thus, the problem of obesity needs to be confronted early in life and solutions provided. Clearly, overweight children have the potential to become overweight or obese adults and early intervention is needed to reverse this trend (Barnes, 2011). If childhood obesity is ignored or tolerated because parents do not see the seriousness of its consequences, the health risks are more likely to affect these children, and as they grow into obese adults, the health problems will escalate. Parents need to realize that ignoring the problem of their overweight and obese children may have a great societal impact. This poses as a huge concern for NHS due to the burden that will befall them in terms of costs of caring for obese people with various health complications (NHS, 2011). This strengthens the need for more approaches in handling childhood obesity in order to reduce and prevent the problem from its onset. Possible Roots of Childhood Obesity Before solutions and strategies for tackling obesity can be developed, it is important to know the causes of the problem so these causes are addressed and challenged through the different approaches. Apart from the proliferation of junk food and the media that endorses consumption of it, technology may also be one culprit in the growing problem of childhood obesity. The most common cause of the decrease in children’s physical activity is that technology has made it more attractive for children to lead a sedentary life. Children are more than adequately entertained by the multitude of choices on television shows, internet sites and computer games. Furedi (2006) explains the cause of obesity to be consumption of too much food eaten throughout the day coupled with a lack of activity to burn the calories ingested. One theory that would help analyse childhood obesity in an organized manner is Brofenbrenner’s Ecological Model (1979). This explains that the individual’s biological and personality factors, environment and the society and culture he was born into all interplay in his development. Brofenbrenner (1979) also claims that the effects of interactions between the individual and his environment are two-directional or characterised by reciprocity. This means that while a child’s development is influenced and moulded by his family, school and peers, he likewise influences and moulds the behaviour of others around him. This is reflective of the child’s lifestyle practices with regards to diet and exercise; a child’s health depends on his family’s attitude to healthy eating and exercise and the provisions of society. The Ecological model explains that the growing child moves through five systems that inter-relate and affect his development. Each of these levels shall be analysed to see how obesity may develop in the child and likewise strategies should aim to fit in to one or more of these systems in order to be effective. The first level is the microsystem, where a child first learns various behaviours such as health practices. The child’s family is part of this microsystem, and his primary providers of his basic needs. The psychological and sociological influences of the microsystem imprints an effect on the young child because lifestyle factors of families may greatly influence the child’s tendency for obesity since families share dietary habits and lifestyle choices (Sallies & Glanz, 2006). For example, if families enjoy eating fast food, which are mostly fatty, then the child is trained to prefer such tastes. Also, if the family does not value exercise, then the child adopts the same view. The next system is the mesosystem which focuses on all of the different environments which the child interacts with. For example, to combat the problem of childhood obesity, one of the government’s initiative is The National Child Measurement Programme (NCMP) which aims to ensure children’s health through implementing child-friendly activities in the school environment to educate them on good health and nutrition. These activities, of course, affect the child’s health positively. However, the child also interacts with other environments where there are more negative influences. For example the prevalence of media advertising of delectable fast food may condition children to consume them unaware that it is filled with unhealthy preservatives, additives and bad cholesterol. When they are out shopping in the mall, the lure of these fast food establishments become stronger, and this attraction has been previously implanted in their consciousness by the attractive advertisements they see on television and all around them. The third level in the Ecological model (exosystem) comprises links between two or more environments and include at least one setting that does not directly involve the child. An example is the eradication of parks and natural play grounds for children in order to build buildings for industry and residences. At first sight, such moves may not seem to affect children’s health, but in the long the children have less access to locations where they can expend their excess physical energy. Frieden et al. (2003) contend that the environment affects the health, growth and development of individuals. One strategy in which initiatives have tried to compensate for this is through the Growing school programme which encourages ‘outdoor classroom’. The fourth system is the macrosystem which includes the customs, values and laws considered important in the child’s culture and upbringing. The child’s attitude towards food may be greatly influenced by his experiences while growing up, which are based on his cultural practices. Food becomes associated with positive feelings such as having food as a reward for good behaviour or with happy memories such as celebrations and feasts with one’s loved ones. It then follows that the child will then seek food in times when he needs to feel good. On the other hand, children may also eat as a response to negative emotions such as boredom, anger, fear, anxiety, or pain (Holmes, 1998). Coping with such emotions may lead to disordered eating, which is a "multifaceted problem that is characterized by distorted or disturbed attitudes or behaviours surrounding food" (Shafer, 2002, p.1). Symptoms of disordered eating may be a preoccupation with body image, quirky eating habits, an overemphasis on athleticism or extreme exercise, excessive or sporadic bursts of exercise, and lack of routine eating patterns, to name a few. Therefore strategies need to be sensitive to promoting healthy lifestyle practices but not encourage disordered eating. Lastly, the chronosystem in Brofenbrenner’s Ecological model refers to the time that transpires as the child relates in his various environments. An example is the transition periods as a child grows up and moves from one system to another. How do his family, other social circles and society in general affect his tendency towards obesity? Brofenbrenner’s Ecological model implies that the interplay and quality of the child’s various systems and environments will play different roles in influencing his attitude to eating, weight and health. Therefore intervention strategies need to consider all the various environments a child is in, such as home and school in order to support a healthy lifestyle (Brofenbrenner, 1979). Possible Solutions to this Contemporary Childhood Problem In order to tackle childhood obesity in the Early Years, health promotion programmes need to be established and a good health programme takes into account all dimensions of a child’s development. A holistic view includes all the following aspects: the physical or how the body functions; mental or how the child thinks and makes judgments; social or how one maintains relationships; emotional or how a child manages their emotions and how s/he expresses it appropriately; societal or how a person relates to his society in terms of shelter, food, income and his own contribution to society and finally, environmental or his physical environment which includes his housing, transport and access to spaces to run around in (Ewles & Simnett, 2004). A health promotion strategy should include health education and consider public policy. Health education includes the communication of information concerning the underlying social, economic and environmental conditions impacting on health and is about enabling and supporting people to set their own health agendas (French, 1990). The empowerment approach helps individuals make healthy choices by increasing their control over their physical, social and internal environments and could be applicable to children and their parents. According to Homans and Aggleton (1988), participatory learning techniques help people examine their own values and beliefs and explore the extent to which factors such as past socialisation as well as social location affect the choices they make. For a child in Early Years, it will be their parents and carers who will need to examine their own beliefs and values as these will directly influence the child. Most of the approaches that the government have launched to tackle childhood obesity are school based programmes such as the National Healthy School Programmes and the Healthy school standard status. While there are many positive aspects to this, including taking a whole school approach and including health promotion as part of the curriculum (educational approach), they do not address the other environments in the child’s mesosystem such as home and parental influences. These strategies would be seen as level 1 (strengthen individuals) in terms of Whitehead’s (1995) policy intervention. Schools should be able to include the children’s parents in the education towards better health habits for the children and the whole family. The key outcomes for all children targeted by the Every Child Matters report are being healthy, staying safe, enjoying and achieving, making a positive contribution and economic well-being (Ofsted, 2004). The first outcome of being healthy may be realised with some of the government initiative programmes such as The National Child Measurement Programme (NCMP). This programme aims to reduce the proportion of overweight and obese children to year 2000 levels by year 2020. The Healthy Weight, Healthy Lives Strategy is part of the NCMP. It mandates the weighing and measurement of children for continuous monitoring of their health in Reception and Year 6 as part of the Healthy Child Programme that serves children from 5-19 years old (NHS West Sussex, n.d.). It is not established if weight is enough evidence to prove that one is healthy, and the programme should be able to assess each child’s health condition rather than just his or her weight. However, being overweight is an easy indication that there are negative health practices that must be amended in the child’s and his or her family’s lifestyle. For young children with obesity, the whole family should be involved in treatment. According to Croker et al. (2011), comprehensive family-based programmes provide the best outcomes in treating childhood obesity. Not only will the child concerned be helped in his or her treatment of obesity but the whole family will benefit in learning how to prevent it for themselves as well. The World Health Organization launched the Five A Day strategy urging people to eat five servings of fruit and vegetables per day in recognition of the fact that a minimum of 400g of fruits and vegetables is recommended per day to prevent chronic diseases such as heart disease, cancer, diabetes and obesity as well as for the prevention and alleviation of several micronutrient deficiencies (WHO, 2011). In the UK, the government initiative of School Fruit and Vegetable Scheme adopts the Five A Day programme in schools entitling all four to six year old children in LEA maintained infant, primary and special schools to a free piece of fruit or vegetable each school day (Department of Health, 2010). This is to increase the children’s consumption of healthy fruits and vegetables. The teachers and staff found that this programme was effective in improving the children’s health and as a supplement to their diet. Due to positive outcomes of this health promotion programme, the schools regarded it as a useful support in teaching and learning about healthy eating. It is a good practice for children in the early years to be accustomed to eating healthy food such as fruits and vegetables on a daily basis. Although some people with limited funds may argue that the increase in the price of food makes this initiative difficult to achieve, those who are serious about being healthy should find alternative solutions such as planting their own vegetable garden. One of the other health promotion initiatives which may help to address a child’s environment outside of school is Sure Start. They follow a child Health promotion programme as part of their child and family health services which aims to promote a healthy lifestyle at home. This takes an educational approach through offering workshops and cooking classes. As a sub brand of Change4Life government anti-obesity campaign, Start4Life is intended for infants and young children in the early years. Working with young families and children’s centres, this health promotion stresses the importance of diet during breastfeeding and weaning as well as provision of a toolkit on healthy eating and active play for children in the early years. Apart from these are programmes such as Let’s Get cooking that offers training and support to children and adults. The programme helps them gain skills and confidence to cook healthy food and develop a positive attitude towards cooking (House of Commons, 2010) With regards to physical activity, the Centres for Disease Control and Prevention (CDC) provide data that suggest that the number of children attending daily physical education classes declined from 18.3% in 1995 to 12% in 2001. At the same time, children are more sedentary due to increased television or computer activity. Reducing these behaviours and encouraging routine activity is an important strategy in reducing childhood obesity (Sallies & Glanz, 2006). The programme called Change4Life, which was mentioned earlier, has been recruiting families to participate in regular physical activity (Change4Life, 2011). Increasing physical activity and engaging in exercise helps to maintain a healthy weight. Some people may complain of not having enough time to follow the routines promoted by Change4Life, but they still need to include exercise within their day, even in simple ways such as walking or cycling to school. Young children in the early years may be trained to do simple and physically active chores in a game-like manner such as picking up trash and “shooting” it in the wastebasket. However, some criticisms on Change4Life have been circulating about its involvement with corporate partnerships. Sponsorship for this programme has been funded from big companies peddling unhealthy drinks and food to children (Watts, 2008). These products have been known to be fatty and sugary, which are the very characteristics of junk food that children need to avoid. Unless Change4Life can get on top of the situation and use its noble purpose to combat obesity and even advocate their corporate sponsors to make their products more healthy for consumption, then it may just be used as a façade to market the products of its corporate sponsors, which defeats the whole idea of the health promotion campaign. The many programmes initiated by government of organizations should be interesting enough for people to really take notice and eventually become a part of. One takeaway that individuals should have from these health promotion programmes is proper education on good health habits such as eating healthy and regular exercise to maintain one’s health and fitness and prevent the likelihood of illnesses. Otherwise, going through with the programme will only be routinary and once they stop, there is no appreciation for the benefits that the programme has provided. So far most of the programmes discussed have been known to be effective in making people healthier especially the children in the early years, hence, they are consistently endorsed by people. Government just needs to be wary of collaborating with industries in their health promotion and choose those who rightfully support its advocacy for better health and prevention of obesity. It is always hoped that interventions and prevention strategies of health promotion programmes become successful in both the local and national levels. If not, the upward trend of cardiovascular and other diseases will continue to rise when the current population of children grow up to be adults themselves (Snorof et al, 2004). However, the best solution is still modeling. Adults should practice what they preach and show young children through eating right themselves and having enough exercise and rest. If children see that their role-models take care of themselves this way, then they are more likely to follow suit. Conclusion Knowledge of what healthy foods to feed young children is now becoming a must for adults caring for them to keep them healthy and maintain a safe weight. Reducing the consumption of junk food and increasing the amount of fruits, vegetables and nutrient-filled foods in their diet will greatly help counteract the risks of being overweight or obese which leads to dangerous consequences for children. This is currently being actively addressed in school through the Healthy school programme and at home through Sure Start. Engaging in sports, dance and other exercise programmes on a regular basis will definitely be advantageous for young children to balance the sedentary, academic activities they have in school. It builds their muscular strength and endurance and provides a cardiovascular workout. It also helps children build character as they learn to persist in a skill and to deal with competition and cooperation with others. It helps children to be more rounded individuals who may be equipped with the necessary skills to survive in a tough world. Parents should be well-educated on the advantages of physical exercise in their children and should be more vigilant in encouraging them to take part regularly in exercise. Caring for young children’s health is a big responsibility for adults and society in general. Parents should be vigilant in looking into all their health needs such as nutritious food, regular physical exercise, enough rest and recreation, proper grooming and hygiene and regular medical check-ups. Prevention of health risks such as being overweight or obese should be taken more seriously. Since these young children will grow up to give hope for a brighter future, the effort will all be worth it. References Barnes, J. (2011) Childhood Obesity: Statistics and Trends. Accessed on 08/11/11 http://www.stop-childhood-obesity.com/childhood-obesity-statistics.html [i.p.] Bronfenbrenner, U. (1979) The Ecology of Human Development.Harvard University Press. Cambridge. 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