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Childhood Obesity in Developing Countries: Facets of Abnormal Growth

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Handbook of Growth and Growth Monitoring in Health and Disease

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Abstract

Increased availability of indigenous and “westernized” energy-dense fast foods, aggressive advertising practices, relatively low cost, and improved purchasing power have led children and adolescents in developing countries to increasingly consume saturated-fat snacks, refined carbohydrates, and sweetened carbonated beverages. Such rapidly changing dietary practices accompanied by an increasingly sedentary lifestyle predispose to nutrition-related non-communicable diseases, including childhood obesity. Over the last 5 years, reports from several developing countries indicate prevalence rates of obesity (inclusive of overweight) > 15% in children and adolescents aged 5–19 years: Mexico 41.8%, Brazil 22.1%, India 22.0%, and Argentina 19.3%. Moreover, secular trends also indicate an alarming increase in obesity in developing countries: in Brazil from 4.1 to 13.9% between 1974 and 1997; in Thailand from 12.2 to 15.6% between 1991 and 1993; in China from 6.4 to 7.7% between 1991 and 1997; and in India from 4.9 to 6.6% between 2003–2004 and 2005–2006. Other contributory factors to childhood obesity include high socio-economic status, residence in metropolitan cities, and female gender. Over-protection and forced feeding by parents may also account for the growing prevalence rates. Mothers in developing countries often have false traditional beliefs such as “feeding oils, ghee (clarified butter), and butter to children would benefit their growth” and “a chubby child is healthy child.” Childhood obesity tracks into adulthood, thus increasing the risk for conditions and diseases linked to obesity in childhood and later in life too (the metabolic syndrome, type 2 diabetes mellitus (T2DM), sub-clinical inflammation, polycystic ovarian syndrome, hypertension, dyslipidemia, and coronary artery disease). Interestingly, prevalence of the metabolic syndrome was 35.2% among overweight Chinese adolescents. Presence of central obesity (high waist-to-hip circumference ratio) along with hypertriglyceridemia and family history of T2DM increases the odds of T2DM by 112.1 in young Asian Indians (< 40 years). Further, overweight children tend to have a poor body image and low self-esteem, which could interfere with their learning and may result in depression. Therapeutic lifestyle changes and maintenance of high levels of physical activity are most important strategies for preventing childhood obesity. Parental initiative and social support are necessary to bring about changes. Governmental control of “calorie-dense junk foods” and audiovisual advertisements of such junk foods through legal and policy initiatives are urgently required in many developing countries. Effective health awareness educational programs for children should be immediately initiated in developing countries following the successful model program in India (project “MARG”).

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Abbreviations

BMI:

Body mass index

CAD:

Coronary artery diseases

CDC:

Centers for Disease Control and Prevention

HDL-c:

High-density lipoprotein cholesterol

hs-CRP:

high-sensitivity C-reactive protein

IDF:

International Diabetes Federation

IOTF:

International Obesity Task Force

NAFLD:

Non-alcoholic fatty liver disease

NCEP, ATP III:

National Cholesterol Education Program, Adult Treatment Panel III

NFHS:

National Family Health Surveys

NMC:

Non-metropolitan cities

NNMB:

National Nutrition Monitoring Bureau

NR-NCDs:

Nutrition-related non-communicable diseases

Ob:

Obesity

OW:

Overweight

PCOS:

Polycystic ovarian syndrome

PUFAs:

Polyunsaturated fatty acids

RDA:

Recommended dietary allowance

RHD:

Rheumatic heart disease

SCAT:

Subcutaneous adipose tissue

SES:

Socio-economic status

T2DM:

Type 2 diabetes mellitus

WC:

Waist circumference

WHO:

World Health Organization

W–HR:

Waist-to-hip circumference ratio

Yr:

Years

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Acknowledgments

We acknowledge the support and cooperation of National Diabetes, Obesity, and Cholesterol Disorders Foundation (N-DOC), New Delhi, Diabetes Foundation (India), and World Diabetes Foundation, Denmark, in various research initiatives in childhood obesity undertaken by our group. We thank Dr Priyali Shah, Ph.D. (Public Health Nutrition) for her helpful comments and reviewing the manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Children’s Hospital of Michigan, Detroit, Detroit, MI, 48017, USA

    Nidhi Gupta

  2. Endocrine Research Unit, Mayo Clinic College of Medicine, Rochester, Detroit, MI, 48017, USA

    Nidhi Gupta

  3. Department of Internal Medicine, Wayne State University, Detroit, Detroit, MI, 48017, USA

    Kashish Goel

  4. Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Detroit, MI, 48017, USA

    Kashish Goel

  5. Fortis-C-DOC (Centre of Excellence for Diabetes, Obesity, Metabolic Diseases and Endocrinology), Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi, 110070, India

    Anoop Misra

  6. Centre of Internal Medicine (CIM), Fortis Hospital, Vasant Kunj, New Delhi, 110070, India

    Anoop Misra

  7. National Diabetes, Obesity and Cholesterol Foundation (N-DOC), Vasant Kunj, New Delhi, 110070, India

    Anoop Misra

  8. Diabetes and Metabolic Diseases, Diabetes Foundation, Vasant Kunj, New Delhi, 110070, India

    Anoop Misra

Authors
  1. Nidhi Gupta
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  2. Kashish Goel
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  3. Anoop Misra
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Corresponding author

Correspondence to Anoop Misra .

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Editors and Affiliations

  1. Dept. Nutrition & Dietetics, King's College, Stamford St. 150, London, SE1 9NH, United Kingdom

    Victor R. Preedy

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Gupta, N., Goel, K., Misra, A. (2012). Childhood Obesity in Developing Countries: Facets of Abnormal Growth. In: Preedy, V. (eds) Handbook of Growth and Growth Monitoring in Health and Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1795-9_89

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