The Problem of Childhood Obesity in 21st Century

The Problem of Childhood Obesity in 21st Century

Introduction

Obesity has become a global epidemic in the 21st century. In children, this health condition may have lasting implications because one may suffer from different diseases later in life. According to the available research, diabetes type II and coronary heart disease start in childhood, especially in overweight children (Sahoo et al., 2015). However, this problem can be prevented and managed through healthy living and leading active lifestyles. This paper defines obesity and highlights its epidemiology, clinical presentation, complications, and diagnosis. The Problem of Childhood Obesity in 21st Century

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The basic definition of childhood obesity is having excess body fat (BF) that presents health risks to the involved individuals. However, different definitions have emerged based on disparate contexts. Body mass index (BMI) is one of the parameters used to define this condition. According to Sahoo et al. (2015), when a child or a teenager has a BMI equal or greater than the 95th percentile, he or she is termed obese.

The Spirit of Inquiry Ignited

The prevalence of childhood obesity has been increasing consistently over the years. Agha and Agha (2017) note that from the 1980s to 2015, the number of children with obesity increased by approximately 50 percent. Currently, more than 45 million children around the world are overweight (Agha and Agha, 2017). In the United States, 12 to 19-year olds have a prevalence rate of 20.5 percent, while that of 6 to 11-year olds is at 17.5 percent. In children between 2 and 5 years, the rate stands at 8.9 percent (Agha and Agha, 2017).

Overweight children have a different clinical presentation of the condition. However, the common ones include stretchmark on the abdomen and hips, deposition of fatty tissue in different body areas, and thick and velvety skin in disparate parts, especially around the neck (Sahoo et al., 2015). Others include sleep apnea, gastroesophageal reflux, shortness of breath when active, delayed puberty in boys, early puberty in girls, and eating disorders.

Childhood obesity may have physical and socio-emotional complications. Physical complications include type II diabetes, metabolic syndrome, high cholesterol, hypertension, asthma, sleep disorders, and non-alcoholic fatty liver disease (NAFLD) (Sahoo et al., 2015). In adulthood, obese children are highly likely to suffer from different health complications. Socio-emotionally, the complications of this condition include low self-esteem, depression, and behavior and learning problems (Sahoo et al., 2015). Additionally, such children are likely to be bullied.

Obesity in childhood is diagnosed by the BMI index to determine the percentile ranking. BMI is determined by measuring one’s weight in relation to height. The score obtained is an indication of the amount of body fat that a child or a teenager has at a given time (Agha & Agha, 2017). As mentioned earlier, if the BMI index is equal to or greater than the 95 percentile, a child is considered obese. In this case, one may undergo screening to test for conditions such as diabetes, hypertension, high cholesterol, fatty liver, and menstruation in girls. The Problem of Childhood Obesity in 21st Century

The PICOT Question Formulated

PICOT Question: In school-age children (P), does 30 minutes of school-based physical activity (I), compared with no physical activity (C), decrease BMI and childhood obesity risks (O) within a one-year period (T)?

Search Strategy Conducted

CINAHL, Cochrane Library National Guidelines Clearinghouse, PubMed, and TRIP databases were used to find relevant scholarly articles. The following keywords were utilized to find the required information: childhood obesity, obese children, weight status, physical activity in obesity, et cetera. Levels I, IV, and V evidence was obtained.

Critical Appraisal of the Evidence Performed

Citation Design Sample size: Adequate? Major Variables:
Independent Dependent
Study findings: Strengths and weaknesses Level of evidence Evidence Synthesis
Agha, M., & Agha, R. (2017). The rising prevalence of obesity: Part A: Impact on public health. International Journal of Surgery, 2(7), 1-6. Literature review. Taxonomy 53 authoritative sources are used. Adequate sample size IV: age, gender, ethnicity
DV: obesity
S: Allows comparing different populations regarding the prevalence of obesity. Discusses its influences on life expectancy, employment, quality of life, associated diseases, and economic costs.
W: Does not include any original research study.
Level V In the UK, the number of obese population increases grammatically, which increases the number of people who have health issues (blindness, cancer, kidney issues, etc.). Childhood obesity leads to increased mortality in this population.
Avis, J., Cave, A., Donaldson, S., Ellen, C., Holt, N., Jelinski, S.,…, Ball, G. (2015). Working with parents to prevent childhood obesity: Protocol for a primary care-based e-health study. JMIR Research Protocols, 4(1), e35. Randomized control trial. Multi-method study. Managed in 3 phases: development, refinement, testing. 200 parents of children of both genders (5-17 years old)
30 healthcare professionals
Adequate sample size
IV: parents of children
DV: obesity rate
S: The study focuses on existing health system gaps and provides parents with valuable information.
W: Research can be modified. Feasibility parameters and the effectiveness of the intervention will be revealed further.
Level I (when accomplished) Online education of parents that lasts for less than an hour can show them how to encourage their children to maintain healthy lifestyles.
Hsieh, P.-L., Chen, M.-L., Huang, C.-M., Chen, W.-C., Li, C.-H., & Chang, L.-C. (2014). Physical activity, body mass index, and cardiorespiratory fitness among schoolchildren in Taiwan: A cross-sectional study. International Journal of Environmental Research and Public Health, 11(7), 7275-7285. Cross-sectional study 1230 male and 1189 female children. Adequate size IV: Age, gender, fitness, weight.
DV: obesity
S: Reveals the connection between physical activity in students, cardiorespiratory fitness, and obesity.
W: Self-reported data. Appropriate only to similar populations.
Level IV Children with obesity have poor cardiorespiratory fitness and are rarely involved in physical activities.
Muthuri, S. K., Wachira, L. J. M., Onywera, V. O., & Tremblay, M. S. (2014). Correlates of objectively measured overweight/obesity and physical activity in Kenyan schoolchildren: results from ISCOLE-Kenya. BMC Public Health, 14(1), 436-448. Cross-sectional study 563 children (adequate sample size) IV: age, physical activity, neighborhood environment, transportation
DV: body composition
S: Reveals causes and risk factors of obesity in children
W: No direct measures of physical activity
Level IV The intensity of physical activity in children is often not enough. Parental education and socioeconomic status also matter.
Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary Care, 4(2), 187–192. doi.10.4103/2249-4863.154628. Literature review 46 articles that focus on obese children IV: factors that cause obesity: activity, environmental, socio-cultural, family, psychological.
DV: number of obese children
S: The study reveals various factors that increase children’s risks of becoming obese. In addition to that, medical, socio-emotional, and academic consequences are identified. The provided information can be used to develop a guideline that should be used to prevent childhood obesity.
W: Even though epidemiological data is discussed, no primary research is developed.
Level V Childhood obesity is affected by the environment, lifestyle, and culture. It has adverse influences on kids’ health and well-being.

Evidence Integrated with Clinical Expertise and Patient Preferences to Implement the Best Practice

Purpose

In order to successfully translate the gathered evidence, it is essential to plan the intervention. The purpose of the proposed 30-minute school-based physical activity is to assist obese children in reducing their weight and also help healthy students to prevent similar health concerns. The consideration of the identified intervention is critical in terms of schools as students spend much time there, while they tend to be physically passive. Therefore, the creation of engaging physical activity tasks by school nurses seems to be a relevant option to address obesity. One more important purpose of this evidence-based project proposal is the evaluation of the intervention outcomes in the long-term period of one year. Ultimately, the PICOT question stated earlier in this paper should be answered as a result of the study. The Problem of Childhood Obesity in 21st Century

Clinical Question

For the given project proposal, the following clinical question may be posed: if a 30- minute school-based physical activity effective in reducing body mass index (BMI) and preventing obesity compared to no exercises in children?

Time

In the mentioned PICOT question, a one-year period is mentioned as the timeframe for measuring the intervention. Based on the reviewed research studies, one may claim that the mentioned period is suitable for assessing the level of BMI reduction in children. Since weight is a factor that cannot be decreased rapidly, it is essential to maintain change within a one-year period and encourage school students to participate in physical activities.

Stakeholders

Nurses and patients compose the key groups of stakeholders in the proposed evidence-based project. The role of the former is to introduce change, support it, and measure the outcomes. As for the latter, it is expected that school students will also be active in changing their activity patterns and becoming more willing to exercise. In other words, mutual understanding and efforts should be implemented. Among non-direct stakeholders, it is possible to mention init administrators and nursing managers who would coordinate the project. The Problem of Childhood Obesity in 21st Century

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