Essay Example on Key Determinants of Childhood

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Key Determinants of Childhood Obesity Most proximally and simplistically excess energy calorie consumption without adequate energy expenditure over sufficient time leads to obesity Given obesity is far more complex than energy in vs energy out many additional and more descriptive key determinants have been identified These determinants primarily fall into the following categories biological individual behavioral environmental including the proximal home environment and the more distal school and community environments socioeconomic cultural and political Each category is examined in more detail below Biological Determinants Beginning in utero there are significant biological factors that predispose an individual to the development of childhood obesity This category is notable for being entirely out of the individual s control and generally dependant on parental decisions or environmental factors For example excessive maternal weight gain particularly during the first trimester has been linked with epigenetic changes which predispose children to obesity poor glycemic control appetite and lipid biosynthesis Some studies indicate that these epigenetic changes will be passed on to future generations as well Further maternal smoking during pregnancy has been shown to increase the risk of obesity in adulthood with an odds ratio of 1 50 regardless of birth weight 



Additional biological determinants that increase the risk of childhood obesity include maternal diabetes mellitus before or during pregnancy large for gestational birth weight and specific genetic syndromes such as Bardet Biedl syndrome or Prader Willi syndrome CITE Family history is a complex biological determinant with clear overlap into behavioral and environmental determinants as the parents directly impact both of these for the child Obesity of first and second degree relatives increases odds of childhood obesity with maternal obesity the strongest correlate Individual Behavioral Determinants The strongest behavioral determinant association with childhood obesity is television watching as multiple longitudinal studies demonstrate that television watching directly and proportionally correlates with childhood obesity A recent meta analysis demonstrated a linear dose response relationship between time spent watching television and childhood obesity Additionally television watching is a stronger independent risk factor for childhood obesity than total sedentary behavior Positively large scale accelerometer based longitudinal studies consistently demonstrate that moderate to vigorous physical activity time is inversely correlated with childhood overweight obesity

Among eating behaviors high consumption of sugar sweetened beverages has the most consistent evidence of association with increased childhood obesity Additional eating habits associated with childhood obesity include frequent consumption of fast food lack of family meals together and eating while watching TV Additional evidence links inadequate sleep duration and the presence of personal stress with childhood obesity It is again critical to recognize that parental behavior and modeling shapes childhood behavior Environmental Determinants In addition to the behavioral context of the home there are key home environmental determinants Simply having a television and or other screens in the child s bedroom is an independent risk factor for decreased physical activity and increased BMI Additionally the presence of family stress in the home is associated with childhood obesity Adverse childhood events such as sexual abuse have also been shown to contribute to increased risk of childhood and adult obesity While the available food choices in the home impact what children consume direct association with childhood obesity is less clear Positively since 2014 schools in Maryland have followed specific guidelines for all food sold on campus 



These guidelines outline food to be sold in the cafeteria vending machines stores and at fundraisers The school environment directly impacts childhood physical activity levels as well Opportunities including active recess PE intensity and volume and extracurricular activities vary substantially by school This is significant as the presence of a gymnasium alone has been shown to increase average student physical activity Neighborhood and community environmental determinants are significant related to both food availability and physical activity Factors including difficulty purchasing fruits and vegetables getting to a main food store and high density of fast food vendors in communities are associated with increased odds of childhood obesity Decreased availability of safe roads and sidewalks playgrounds or recreation centers has been shown to increase risk of childhood obesity by 20 60 Socioeconomic and Cultural Determinants One of the most important factors influencing obesity is individual socioeconomic status 



In fact it has been shown to be more influential than an individual s race or ethnicity Interestingly the general socioeconomic level of a neighborhood as determined by factors such as unemployment rate percent of households below the poverty level or receiving public assistance and mean income is also significantly associated with higher risk of childhood obesity In one study 42 of children surveyed at homeless shelters were overweight or obese Parents with an authoritative parenting style had the lowest rates of childhood obesity while an Authoritarian or disciplinarian style had the highest rates Political Determinants Federal State and local policies all have effects on individuals choices From laws mandating healthy food in schools to zoning regulations there is health in all policy As noted above 99 9 of Maryland schools meet current food policies and has required physical education but Maryland does not yet mandate activity time requirements for any age


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