Obesity in children and adolescents: a growing global health challenge

Obesity in children and adolescents: a growing global health challenge

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The number of obese children and adolescents has risen dramatically in the past four decades, reveals a large study that was published in The Lancet in October 2017. Although more children and adolescents worldwide are moderately or severely underweight than obese at this time, the situation will reverse by 2022 if the current trend continues. The rise in obesity is of great concern, as excessive body weight in childhood and adolescence is associated with greater risk and earlier development of several health problems (e.g. type 2 diabetes, cardiovascular diseases and negative psychological consequences).

Researchers from the Imperial College London and the World Health Organization (WHO) collected data from 200 countries to see how global and national numbers on obesity, overweight, and underweight in childhood and adolescence had changed between 1975 and 2016. They looked at measurements of height and weight of 31.5 Mio. children and adolescents aged five to 19 years and calculated their Body Mass Index (BMI). The BMI is a measure that indicates whether a person’s weight is in a healthy range for their height, or too high (=overweight) or too low (=underweight).

Results show that the number of obese children and adolescents worldwide has increased more than tenfold since 1975, from 11 million to 124 million. Whereas less than 1% of all children and adolescents had been obese in 1975, almost 6% in girls and 8% in boys were obese in 2016. On a country level, the highest rates in both sexes were seen in Polynesia and Micronesia (around 25%; one in four) as well as in high-income English-speaking countries (USA, Canada, Australia, New Zealand, UK, Ireland). In Europe, boys in Greece (16.7%; almost one in five) and girls in Malta (11.3%; more than one in ten) had the highest obesity rates.

These numbers and trends are alarming and need to be urgently addressed. According to the authors, it is important that countries do not only provide a general feature of policies that target overweight and obesity in children and adolescents, but also use taxes and industry regulations to change eating and drinking behaviours. It would be a crucial step to make healthy foods such as whole grains, fresh fruit and vegetables more affordable. This would not only encourage people to rather buy them instead of unhealthy food but also tackle social inequalities in overweight and obesity. Population-based prevention of overweight and obesity is as important as the enhancement of access to healthcare interventions for weight management.

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Breastfeeding during vaccinations reduces pain

Essential, but painful: needles are used for babies’ early childhood vaccinations and medical care during childhood illnesses. They cause distress for the babies and often also for their parents and caregivers, and can result in future anxiety and fear about needles. Researchers around Harrison et al. examined if breastfeeding reduces vaccination pain in babies aged 1 to 12 months. The results were published in the Cochrane Database for Systematic Review

Painful procedure - blood samplingIn an intervention review in February 2016, the Canadian scientists searched the medical literature for studies of randomised controlled trials (RCTs) examining the effectiveness of breastfeeding babies beyond the neonatal period up to one year of life during the use of needles. They compared the effectiveness of breastfeeding in reducing pain (as scored by crying time and pain scores), to parental holding, skin- to-skin contact, babies lying flat, the giving of water or sweet solutions, placebo, other interventions, and to no intervention. For the data collection and analysis, they searched several scientific databases and identified 10 studies with a total of 1066 infants aged 28 days postnatal to 12 months. All studies examined if breastfeeding reduced pain during vaccinations. 

The results showed that breastfeeding reduced crying in young babies having vaccinations compared to no treatment, oral water, and other interventions such as cuddling, oral glucose, topical anaesthetic, massage, and vapocoolant spray (“cold spray”). On average, breastfed babies cried for 38 seconds less than babies who were not breastfed and pain scores were significantly lower. There was no evidence that breastfeeding had an effect on physiological responses, such as heart rate. No studies reported on any harm while breastfeeding healthy babies during vaccinations (based on low-quality evidence).

No studies included in this review involved populations of hospitalised infants undergoing skin-breaking procedures. Because the studies only evaluated the effects of breastfeeding during vaccination, more evidence is needed to learn if breastfeeding helps older babies in hospital during blood work or procedures such as the insertion of drips. 

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