Understanding obesity in children and youth

New CHEO research takes a comprehensive look at the complex global health concern affecting more children and teens than ever

As parents, we often worry about whether our child or teen is going through a phase, or whether his or her current challenges may turn into longer term ones.

One of the most sensitive topics to deal with is weight. Should we be worried about body size? What does it mean for our kids’ health?

More children are overweight or obese now than ever before, and the number of children and youth who are affected has tripled in the past 20 years. Once thought to be a problem that only affected affluent countries, obesity is now widely regarded as a global health concern.

In 2004, it was estimated that one in four children was overweight or obese. Today, this number has increased to one in three. If this trend continues, up to 70 per cent of today’s children and
youth will grow up to be overweight or obese adults by 2040.

For children and teenagers, obesity is associated with an increased risk of breathing, musculoskeletal and mental health problems, including depression, body dissatisfaction, and poor self-esteem.

In addition, childhood obesity is a good predictor of adult obesity, with up to 80 per cent of obese kids and youth growing up to become obese adults. Adult obesity is associated with chronic conditions such as type 2 diabetes, hypertension, cardiovascular disease and some types of cancer.

The Healthy Active Living and Obesity Research Group at the Children’s Hospital of Eastern Ontario is examining obesity in children and youth. Dr. Gary Goldfield has studied this issue  extensively, including the psychological and social aspects.

His latest research looked at the effectiveness of aerobic training and resistance training in obese teens. The study looked at different types of exercises and how effective each was in bringing about weight loss in teenagers – something that hadn’t been studied before.

“We thought that the resistance training group might yield better results than the aerobic group because of its potential to build muscle mass and reshape the body, achieve gains in strength faster, and appeal to teens,” said Goldfield.

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Participants were divided into four groups: one did aerobic exercises, one did resistance exercises, one did a combination of both and the fourth – the control group – did not do any.

In order to determine if the exercise program was effective, Goldfield and his colleagues measured the change in body fat percentage. Other measured variables included change in waist  circumference and various biological markers.

Results showed all three forms of exercise were successful in reducing body fat percentage in teenagers, as well as decreasing waist circumference.

However, further analysis showed the most effective form of exercise involved a combination of aerobic and resistance training.

“While it is important for youth to engage in exercise or physical activities that they enjoy so they can sustain an active lifestyle, our findings highlight that combining resistance and aerobic
training may be more effective for weight management in adolescents than either type of exercise on its own,” said Goldfield.

Although diet and exercise play a crucial role, obesity is a complex issue, strongly influenced by various genetic, biological, psychosocial and environmental factors that must also be addressed.

Eating habits, as well as improper sleep habits and chronic stress, can also influence the development of obesity. Children from low-income families are at a disadvantage, likely because the parents or caregivers lack resources to prepare healthy meals and are forced to rely on unhealthy alternatives.

Obesity is a growing concern, not only in adult populations, but also among children and youth, and Goldfield’s study shows that obese teenagers who adopt an active lifestyle can reduce their body fat and improve their overall metabolic health.

He is in the process of publishing another paper, based on this study, which looks at the improvement in psychological health in these teens.

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