Obesity in Special Populations: Causes and Responsibilities of Childhood Obesity

Obesity in special populations

Among the masses, not everyone has an equal chance of becoming obese; and not every period of life is conducive to weight gain.

Obesity particularly favors certain specific groups of people and often occurs at certain specific stages. This chapter will provide a brief introduction to obesity in some of these specific groups.

I. Childhood Obesity

Children are the flowers of the motherland and the hope of mankind. Young parents all hope that their children will be healthy, lively, intelligent and wise. They care a lot about their children's growth and invest a lot of energy and money in their children's nutrition.

From before pregnancy to pregnancy, infancy, early childhood, childhood, and even adolescence, parents try every means to get their children to eat or to feed them.

However, some parents, either due to a lack of nutritional knowledge or a lack of understanding of the developmental characteristics of children at different growth stages, insist on feeding their children, feeding them more, and feeding them the best food. This has led to the emergence of one "little fat boy" after another, which has brought serious consequences to children, families, and society.

The prevalence of childhood obesity in the United States is 5% to 25%; in China, it has been increasing year by year, with some scholars reporting that it has now reached 5% to 10%.

The author conducted a survey of primary school students aged 8-12 in urban and rural areas. The obesity rate was 13.9% for boys and 12.9% for girls in urban areas; and 3.3% for boys and 3.4% for girls in rural areas.

The survey results indicate that the incidence of obesity among urban children and adolescents is high, and this situation can no longer be ignored.

(I) Fat Development and Obesity

Childhood obesity is closely related to age, specifically to the development of adipose tissue.

There are three key periods in the development of adipose tissue. When the fetus is 5 months old, the largest fat deposit in humans-subcutaneous adipose tissue-begins to develop. By full term, the subcutaneous fat layer is already quite significant; this is the first stage of adipose development. After birth, especially from 6 months to 3 years old, the subcutaneous fat layer continues to grow; this is the second stage. From 3 to 8 years old, the growth of the subcutaneous fat layer temporarily stops, and the body fat content decreases. It only begins to gradually increase again after 8 years old. During this period, girls' fat content increases much faster and at a greater rate than boys', and their weight increases rapidly, with fat content reaching 10% of body weight. In the following 3 to 4 years, menarche occurs, and weight gain becomes even more rapid; this is the third stage of adipose development.

Corresponding to the development of adipose tissue, epidemiological data confirms that obesity mostly occurs during infancy, school age, and adolescence, when adipose tissue development is vigorous.

Obesity is balanced between boys and girls during infancy, but more girls than boys are obese during school age, and significantly more girls than boys are obese during puberty.

The development of adipose tissue is an objective law that cannot be controlled by human factors. However, during the period of vigorous development of adipose tissue, coupled with poor dietary habits, obesity is very likely to occur.

Excessive nutrition during pregnancy, excessive artificial feeding, premature introduction of solid foods, forcing children to eat, and indulging children's picky eating and overeating are all artificial factors that contribute to obesity.

What we can do is eliminate these man-made factors that cause obesity in a timely and appropriate manner.

(II) Pregnancy Nutrition and Fetal Obesity

After a woman becomes pregnant, her diet receives extraordinary attention.

Many people have the one-sided view that "a fat mother means a strong son".

Therefore, many people force themselves to eat, causing them to gain weight.

Some people believe that pregnant women are eating for two people, and therefore eat excessively.

With reduced physical activity and less energy expenditure, weight gain can occur quickly.

However, while the mother gained weight and the child grew bigger and heavier, he did not become stronger.

Excessive calorie intake by the mother during pregnancy leads to accelerated division of the fetus's fat cells, resulting in a significantly larger number of fat cells than in a normally developing fetus. This accelerated fat conversion can turn a normal fetus into an obese macrosomic fetus, making it a new member of the congenital obesity group and posing a serious threat to the child's health.

Well-meaning parents shouldn't feel wronged; the correct approach is to ensure they consume an adequate, nutritious, and balanced diet.

(III) Feeding methods and infant obesity

In developed countries such as Europe and America, the development of breastfeeding has followed a saddle-shaped pattern.

At the beginning of this century, the breastfeeding rate was very high. It dropped to its lowest point in the early 1960s. Since then, with the continuous deepening of research on breast milk, the breastfeeding rate has rebounded significantly, reaching 60% to 70% in some countries.

In my country, breastfeeding has been declining since the 1960s. Although breastfeeding was promoted after the 1980s, breastfeeding in urban areas continued to decline.

In cities like Beijing and Shanghai, the breastfeeding rate is only around 10%.

The United Nations World Health Organization advocates and promotes breastfeeding globally.

The Chinese government and relevant departments have responded positively to this and vigorously promoted the positive effects of breastfeeding on infants.

Baby-Friendly Hospitals have been widely established in large and medium-sized cities.

However, mothers do not yet have sufficient understanding of breastfeeding, and the breastfeeding rate has not increased significantly.

Breast milk is the best source of nutrition for infants under 4 months old.

Recent studies have shown that obesity, like malnutrition, is more common in infants who cannot be breastfed.

Some researchers observed and compared the weight changes of breastfed and formula-fed infants. Of 210 breastfed 6-month-old infants, only 40 (19%) were overweight, while of 238 formula-fed infants, 143 (60%) were overweight.

Milk is a common milk substitute in some regions. However, it is not surprising that if milk is used before 6 to 8 months of age, it can cause children to grow too fast. This is because milk is the food for calves, and calves need to double their weight within two months of birth, while infants need four months.

A child growing too fast is not a good thing. Even with the increasing availability and better quality of formula (closer to breast milk), breastfeeding still has many benefits that formula feeding cannot match.

Some mothers often attribute their baby's crying to hunger and feed the baby concentrated milk products as soon as the baby cries. However, research shows that some babies cry not because they are hungry, but because they lack their mother's affection.

Breastfed babies, when in contact with their mothers, derive a sense of security and belonging from the mother's body heat, a feeling that is stronger than the act of breastfeeding itself.

Breastfeeding can enhance the bond between mother and child. The mother's care, touching, and contact with the mother's chest, breasts, and arms all provide positive stimulation for the baby, giving the baby a sense of satisfaction and security, which is crucial for the baby's psychological and intellectual development.

Artificially fed infants lack this kind of affection and are often replaced by highly concentrated milk, resulting in excessive energy intake and obesity.

Children often experience these psychological feelings into adulthood. When they feel a lack of love or are unhappy, they often eat certain foods, with snacks being the most common.

This phenomenon is particularly common among women, who use food to gain psychological comfort and to satisfy a lack of love, thus laying the foundation for adult obesity.

Breastfeeding not only reduces the incidence of infant obesity, but also promotes the recovery of the mother's figure and prevents postpartum obesity in women.

This is because the excess fat accumulated in the body during pregnancy is consumed through breastfeeding. In addition, breastfeeding can stimulate the secretion of oxytocin, causing the uterus to contract and accelerating the return of the mother's abdomen to its original shape.

A study by Sun Yat-sen University of Medical Sciences found that breastfed infants had a significantly lower prevalence of anemia than infants who were mixed-fed or formula-fed; and in terms of intellectual development, breastfed infants were significantly better than those who were mixed-fed or formula-fed.

The result of breastfeeding is a mother with a well-proportioned figure and a healthy baby.

(iv) Complementary food introduction and obesity

At the beginning of this century, pediatricians advocated that infants under one year old should not be given any food other than milk products.

By the 1960s, the situation had reversed, with most doctors strongly advocating that solid foods should be introduced at two or three weeks of age and that three meals a day should be provided.

Their reasons are twofold: first, introducing solid foods earlier allows children to get used to different flavors as soon as possible, timely supplementing insufficient breast milk feeding and providing enough calories to meet the baby's growth needs; second, solid foods can prolong children's sleep time, allowing them to sleep soundly through the night.

This also pleased the lazy and sleepy couple, who, in order to avoid getting up in the middle of the night to feed the baby, fed the baby a lot of solid food before going to bed at night, so that the baby would sleep until dawn.

After gaining these successful "experiences," some people even proudly share this secret with those around them, and many people imitate them.

In my opinion, this is unacceptable. Whenever I encounter this situation, I will do my best to dissuade the perpetrator. One should not prioritize one's own comfort over the physiological characteristics of one's child, as this will inevitably cause endless harm.

The ability to chew and digest solid food depends on the physiological development of an infant. Newborns cannot secrete enzymes to digest starches. If too much starchy food is added too early, it will induce the production of large amounts of amylase. Starch is digested into monosaccharides, which are absorbed in the body and transported to various tissues for metabolism via the liver and blood circulation. If the amount exceeds the body's metabolic capacity, the excess sugar will be stored as fat. In this case, the muscles are not firm, there is excess fat tissue, and the body is fat but not plump.

Regarding the latter point, we must consider that even if a young baby can sleep through the night, there are inevitably two possibilities: either the total amount of food consumed is reduced, or the baby eats more at each feeding time.

Some scholars believe that this habit of overeating formed in early childhood is likely to persist throughout life and become a factor in adolescent obesity.

This type of obesity is the most difficult to reverse.

When introducing complementary foods, attention should also be paid to their quality.

Refined sugar should be avoided as much as possible in children's diets, as it can lead to a vicious cycle where children develop a preference for sweets.

As long as babies get nutritious food, they won't crave sweets.

As for adding salt and MSG, nutritionists believe it is unnecessary. The purpose of adding them is actually to satisfy the mother's taste, not for the child's benefit.

Infants' kidneys are not yet fully developed and cannot excrete large amounts of electrolytes, inevitably resulting in weight gain, which may become a potential factor in high blood pressure and obesity. This must be taken very seriously.

The relationship between salt intake and hypertension and obesity and hypertension is extremely close. Excessive salt intake can easily lead to hypertension, and the incidence of hypertension in obese people is much higher than that in the general population. This is an academic viewpoint that has been affirmed by relevant experts and scholars around the world.

I have also discovered this pattern in my actual work.

This scientific knowledge is not well known to the general public in my country, so their salt intake is far beyond the recommended level. In particular, excessive salt intake by infants and young children increases the burden on their immature kidneys, causing electrolyte and water retention and leading to premature high blood pressure and obesity. On the other hand, children adapt to the taste of salt at an early age and gradually form dietary habits that are difficult to change. Excessive salt intake will continue into adulthood and even throughout their lives.

Therefore, the hidden dangers caused by the parents' bad eating habits and unnoticed behavior will affect the child's entire life.