Childhood Obesity versus Nurture Theory - Assignment Example

Research proposal based on the literature review childhood obesity the nature versus nurture theory as its framework: Background: Today the number ofchildren suffering from obesity is alarmingly manifold than that the number a few decades ago. Child obesity has come to become one of the prime concerns that the society has to face. According to "What is Obesity", Obesity is a serious medical disease that affects over a quarter of adults in the United States, and about 14% of children and adolescents. It is the second leading cause of preventable death after smoking." According to "Obesity", Severe overweight increases the risk for high blood cholesterol, high blood pressure, and diabetes and, hence, for diseases for which these conditions are risk factors (diabetes, coronary heart disease, high blood pressure, neurological disorders, cancers, and kidney diseases). Obesity thus contributes to premature mortality. Of all obesity-related diseases, non-insulin dependent diabetes is most clearly and strongly associated with obesity. Taking into consideration, the serious nature of obesity and the fact that it is growing at alarmingly fast rates the situation calls for more research to shed more light regarding the causes and the preventive measures that are to be taken. Before any cure can be formulated the main causative reason responsible for this disease needs to be identified. To identify the cause many researchers have already conducted various investigations and have concluded that obesity in children is due many reasons like genetic factors, environmental factors, and psychological factors. Objectives: The main objective behind this research proposal is to conduct both practical and statistical investigations to verify whether the nature versus nature theory regarding childhood obesity holds good or not. The aim of this research project is to find out the extent to which the nature versus nature theory is correct and is responsible for majority of obesity cases in children. By application of statistical methods and comparison techniques to the data obtained, the extent of dependence of obesity on genetic factors can be ascertained. Conceptual framework: Many researches conducted by investigators have revealed that the role of biological factors in the regulation of body weight is important. For example the minimum energy required to maintain normal body functions-the basic metabolic rate, affects body weight and weight loss because some persons obviously use more energy to sustain indispensable body processes. The size and number of fat cells in an individual also help in establishing the amount of weight loss that is possible. Obesity is to some extent determined by a person's genetic makeup. According to Foster (2003), "One groundbreaking study published in 1986 followed children who were adopted shortly after birth. The adoptees grew up to achieve adult weights that were more similar to their biological parents than their adoptive parents, indicating the influence of a person's genetic makeup in determining body weight." This strongly shows the influence of genes in the incidence of obesity. Investigators are uncertain about the genes that affect human obesity. Studies of mice have isolated five genes that, when present in mutated form, play a role in obesity. So far, however, mutations of these genes have not been identified in obese people. Researchers believe the cause of obesity in humans is more complicated than in mice and involves the interactions of multiple genes with environmental factors such as diet and physical activity (Foster 2003). Numerous studies have already been conducted, which substantiate the role of genetic factors in incidence of obesity. According to Tanios (2000) genetics determine the predisposition to be obese such that the rough heritability estimates range from 0.40 to 0.60. This suggests that genes are responsible for almost half of the total phenotypic variation in obesity. Birch and Fisher (1997) further support this in saying, "We know that obesity runs in families, with children of obese parents at greater risk of developing obesity than children with thin parents." A study published in 1996 by Keller and Stevens entitled "Obesity: Measurement and Risk Assessment," determined that children with two obese parents had an 80% chance of becoming obese, while those with one obese parent had a 40% chance of becoming obese. This is an alarming rate compared to children with neither parents obese having only a 7% chance of becoming obese. In addition, the same study also reported that children with obese mothers were 2.5 times more likely to become more obese than children with non-obese mothers. However, most studies conducted regarding obesity undermine its heritability at particular ages by focusing mostly on the common set of genes that influence obesity, and not the impact of age specific genetic effects (Tanios, 2000). According to Birch and Fisher (1997), although research on obesity has provided significant information regarding the variance at which genetic factors determine obesity, these studies are based on cross analysis that provides little information regarding individual development. Hence, it does not significantly contribute to the design of effective preventive intervention to combat obesity because research is still needed to explain the interaction between genetics and environmental factors. Aside from the heritability of obesity, it has also been linked to familial patterns and behavioral relationships (McCarthy and Smith, 2002). As Bruch (1975) contends, "To understand the obese child, one needs to remember that he accumulated his extra weight while living in a family that, wittingly or unwittingly, encouraged overeating and inactivity." The journal article "Development of Eating Behaviors among Children and Adolescents," which discusses the factors that affect the development of a child's eating habits illustrates this relationship. According to Birch and Fisher (1997), there is extensive evidence that a child's food intake is shaped by his early experience with food and eating, indicating that parenting practices and family environment can cause obesity in children. They argue that, "The means by which parents attempt to shape children's eating towards nutritionally desirable dietary outcomes can have unintended consequences for children's eating behavior." Hence, parenting practices that are especially controlling and restrictive may have particularly negative effects on children especially if the child has a predisposition for obesity (Costanzo & Woody, 1985). The relationship between parental feeding styles and child weight has already been established by previous studies. However, while it is clear that there is a relationship between these variables, the direction at which this relationship occurs has yet to be determined. Thus, as Tanios (2000) claims, "Genetic influences determine whether an individual can become obese, but many other factors resolve if the same subject will become obese. To address this, a study was conducted by Faith et al. (2004) entitled "Parental Feeding Attitudes and Styles and Child Body Mass Index: Prospective Analysis of a Gene-Environment Interaction," which established the causal relationship between the variables by correlating parental feeding attitudes and styles with the child's body mass index (BMI). In addition, it also evaluated whether these relationships are dependent on the child's predisposition towards obesity. Based on the results, responsible feeding attitudes of parents at age 5 predicts reduced child BMI for families with low obesity risks at age 7. The results for high obesity risk families, however, indicate an increase in child BMI at age 7. With respect to parental feeding styles, monitoring predicted lower child BMI scores for low risk children; while high risk children predicted increased child BMI scores when being restricted to eat, and lower child BMI scores when being pressured to eat. Changing lifestyles occupy a key position in the increasing prevalence of obesity. It is common to find people eating at restaurants more frequently than three decades ago. Today both adults and children devote less time towards physical exercise in lieu of longer work hours at sedentary jobs, a decline in physical education programs in schools, and increased participation in sedentary recreational activities such as browsing the internet, video games, movies, and television. Besides many of the laborsaving devices of the modern lifestyle, such as personal computers, calculators, telephone extensions, intercoms and remote controls, promote a sedentary lifestyle leading to more and more incidence of obesity. Design: The research project would be based on collecting data by conducting surveys in families with members who suffer from obesity or have family history of obesity. The number of obese children in the family is to be noted by taking into consideration whether both the parents suffer from obesity or only one of them suffers from it. High incidence of obesity in children whose parents are also obese may suggest that it is a hereditary disease and can be transmitted from generation to generation. As there is a possibility that the gene responsible for obesity may be recessive in nature, it is possible that it may not be expressed in the members of the present generation and hence the members of the present generation may not be suffering from obesity. According to Fackelmann (1989), "An estimated 5 percent of the U.S. population may have inherited a tendency toward obesity, according to a new study examining family weight patterns. The research suggests obesity follows a classic model of recessive inheritance, with some individuals receiving a copy of a so-called obesity gene from each parent. People born with this genetic double whammy who fulfill their fat potential are among the heaviest in the nation and run a high risk of cardiovascular disease, the researchers say." To overcome this problem surveys would be conducted regarding the incidence of obesity in the grand parents or even in higher generations. As the disease is dependent on many other factors too it becomes necessary to include other factors into the surveying process. Some of them would the way of life i.e. sedentary or hard work, eating habits, psychological factors that are affecting the members like stress and sex of the member. As there is a possibility that the gene responsible may be sex specific i.e. gets expressed only in members of specific sex, the sex of the member is of importance and needs to be taken into account. If the data is analyzed taking into consideration these factors too then the extent of dependence of the disease on genetic factors with respect to its dependence on each of these factors can be measured and a conclusion can be formulated. Samples to be used: The research project intends to select a specific number of individuals who are suffering from obesity. The family history of these individuals would be studied for the incidence of obesity. The points that would be noted are whether one of the parents suffers from obesity or both do or neither does. In case only one of the parents does suffer from obesity the sex of the parent would be noted. In case neither parent suffers then the family history up to a few generations back would be taken into account. In the absence of family history, it would be attributed to other responsible factors. The table below gives the factors that would be taken into account for a particular individual: Name of the individual: Sex of the individual: Age: Height: Weight: BMI: Genetic factors: Family history present or not: Father: Mother: Grandfather: Grandmother: Still higher generations or distant relatives: Other factors: Eating habits: Vegetarian or non-vegetarian Food intake per day: Whether high fat content of the meals: Way of life: Sedentary, hard work or mild work No. of hours spent on physical exercise: Psychological state: Stress, etc The table below gives the details of all individuals considered together: Total number of individuals: No. of individuals only one of whose parents is obese: No. of individuals both of whose parents a are obese: No of individuals whose grandparents or distant relatives are obese: Measurements: The measurements that would be made are the age of the individual, body height and weight and the Body Mass Index (BMI). BMI is calculated metrically as weight divided by height (kg/m2). People with a BMI of 25.0 to 29.9 are considered overweight and people with a BMI of 30 or above are considered obese. Ethical considerations: According to "National Statement on Ethical Conduct in Research Involving Humans", Ethics and ethical principles extend to all spheres of human activity. They apply to our dealings with each other, with animals and the environment. They should govern our interactions not only in conducting research but also in commerce, employment and politics. Ethics serve to identify good, desirable or acceptable conduct and provide reasons for those conclusions. The guidelines for ethical conduct during research involving humans as subjects have been laid down by the Belmont report. It is based on the three principles of respect for persons, beneficence and justice. According to the report, "Respect for persons incorporates at least two ethical convictions: first, that individuals should be treated as autonomous agents, and second, that persons with diminished autonomy are entitled to protection. The principle of respect for persons thus divides into two separate moral requirements: the requirement to acknowledge autonomy and the requirement to protect those with diminished autonomy." In conformation with these the following measures would be taken. Informed consent would be obtained from participants prior to the onset of data collection. This would involve the use of signed informed consent forms which specify the dimensions of informed consent. Informed consent requires that the researcher insure that participants are aware of: the purpose of the research; the name of the researcher(s) and collaborating parties; potential benefits; tasks to be performed by participants; any anticipated inconveniences to participants; rights of participants including: the right to refuse or withdraw at any time; the right to confidentiality of personal information; potential harms involved; time period over which consent applies; how to rescind consent. Consent would be completely voluntary. Informed consent would be obtained from those persons who are legally responsible or appointed to give informed consent i.e. parents on behalf of children who are under legal age and who are not able to provide informed consent. Data collection would be restricted only to information which is germane to the purpose regarding obesity. The data obtained would be handled in such a way as to ensure its security. This would include adequate plans for destroying or safeguarding records. The participants would be informed regarding the measures that will be taken to protect confidentiality. The measures that would be taken in this regard are 1) Surveying only those individuals who come forward voluntarily. 2) Personally identifiable information would not be collected. Even if it is collected it would not be disclosed. Data analysis methods: On the basis of parental history the individuals would be grouped into categories. The number of individuals falling into each category would be counted and their numbers compared. Use of graphs would be made to depict these differences. The results would then be compared to approach an answer. Direct comparison would also be done to come to a particular conclusion. Findings and inferences: The results that would be obtained can be summed up as: 1) Obesity found in individuals whose both parents have obesity: Inference: Both parents carry gene responsible for obesity. This gene has been inherited by the individual. If this gene could be identified, a cure can be affected in early phases of growth itself. 2) Obesity found in individuals one of whose parents is obese: Inference: The obese parent carries the gene responsible for obesity. This gene is inherited by the individual. 3) Obesity found in individual whose grand parents or distant relatives have obesity: Inference: The gene responsible in this case is recessive and has been suppressed in earlier generations but expressed in the particular individual. Budget: Around $500 to $1000. Appendix: BMI stands for Body Mass Index. It is a number that shows body weight adjusted for height. BMI can be calculated with simple math using inches and pounds, or meters and kilograms. For adults aged 20 years or older, BMI falls into one of these categories: underweight, normal, overweight, or obese. BMI=weight/height. Units:Kg/m2. References: Birch, L.L. & Jennifer O. Fisher. (1997): Development of Eating Behaviors Among Children and Adolescents. Pediatrics 101: 539-549. Bruch H. (1975). Emotional aspects of obesity in children. Pediatr Ann. 4: 91-99 Costanzo P.R., & Woody E.Z. (1985). Domain-specific parenting styles And their impact on the child's development of particular deviance: The Example of obesity proneness. J Soc Clin Psychol. 3:425-445. Fackelmann K. A. (1989): Family ties point to recessive obesity gene. Retrieved July 23, 2005 from htttp://www.highbeam.com/library/doc0.asp docid=1G1:8150195&refid=ink_tptd_mag&skeyword=&teaser= Faith, M.S., Robert I. Berkowitz, Virginia A. Stallings, Julia Kerns, Megan Storey, and Albert J.Stunkard. (2004). Parental Feeding Attitudes and Styles and Child Body Mass Index: Prospective Analysis of a Gene-Environment Interaction. Pediatrics 114: e429-e436. Foster G. D. (2003): Obesity. Retrieved July 20, 2005 from Microsoft Encarta 2003. Keller, C. & Stevens, K. (1996): Childhood obesity: measurement and risk assessment. Pediatric Nursing. 22:6, 494-498. McCarthy, J.R., Mary Ann Burg, Kristen Smith & Cathy Burns: (2002). Pediatric Obesity In the Clinical Setting: Epidemiology of Childhood Obesity. Primary Care Interventions, and Needs Assessment for Future Prevention. Priory Lodge Education Ltd. Univ. of Florida, FL. Obesity: (n. d). Retrieved July 23, 2005 from http://www.geocities.com /nutriflip/Diseases/Obesity.html What is obesity (n. d): Retrieved July 20, from http://www.HateWeight.com National Statement on Ethical Conduct in Research Involving Humans: Retrieved July 23, 2005 from http://www7.health.gov.au/nhmrc /publications/humans/preamble.htm The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research (1979). Retrieved July 23, 2005 from http://www.brown.edu/Administration/ Research_Administration/belmont/belmont.html Read More