Obesity and overweight in Children below 5 years of age: Environmental, Behavioural and Social Factors and Their Active Use in Prevention and Management

Abstract

Introduction: Early childhood is a critical time for obesity prevention. Children are developing taste preferences, learning to walk and play. They eagerly mimick both the healthy and unhealthy behavior of their parents, siblings and caregivers. Obesity during early childhood is a major health concern of the developed world and is steadily affecting many low- and middle-income countries, particularly in urban settings. Unfortunately, overweight, and obese children often stay obese into adulthood and more likely to develop many non-communicable diseases at a younger age. Important environmental and socioeconomic factors play a significant role in the initiation and progression of early childhood obesity. In this minireview, we try to shed light on the published data exploring various relevant issues, including possible etiologic factors in this target population at risk (children below 5 years) that may enable the initiation of early and effective policy and tactics for the prevention and management of this problem, particularly in high-risk communities.
 Methods: We examined the English language literature (Pubmed, Google scholar, and Cochrane library ) on the environmental and socioeconomic factors that appeared to be important in the pathogenesis of early obesity in children for the past 20 years. Inclusion criteria were obesity and overweight in young children below 5 years of age. 
 Results: Education, income, and urbanization, food environments and increased energy intake through consumption of fatty foods and a high sugar diet as well as parental effects through conveying their behaviors, attitudes, and feeding styles to their children appear to be among the most important factors that contribute to the initiation and progression of obesity in young children. Overfeeding preterms and small for gestational age infants, using artificial milk formula, and early addition of solid foods play a considerable share in inducing early obesity. In addition, lack of health education to parents and children, poor health care, and scarcity of access to physical activity are important risk factors in poor populations.
 Conclusions: Many important social and environmental factors can actively contribute to the production and progression of early childhood obesity. These factors differ considerably among different populations. Understanding these factors is essential for appropriate and early prevention as well as management of early childhood obesity, especially in high risk communities.

The burden attributable to risk factors in Mexico, 1990-2021. Summary of the findings from the Global Burden of Disease 2021 study

“…Metabolic risk factors are key to understand the dual burden of disease 26,27 present in adulthood, while a wide array of factors, from urbanization patterns to parental influences on sedentary behaviors, shape the transition from childhood malnutrition to adulthood obesity and related cardiovascular risks. [28][29][30][31] Addressing this complex matrix calls for exhaustive and integrated interventions. This transition is further driven by population aging, rapid acculturation, and improved access to unhealthy foods in deprived areas.…”

Carga atribuible a factores de riesgo en México, 1990-2021. Resumen de los hallazgos del estudio <i>Global Burden of Disease</i> 2021

“…Los factores de riesgo metabólicos son clave para comprender la doble carga de enfermedad 26,27 presente en la edad adulta, mientras que una amplia gama de factores, desde los patrones de urbanización y las influencias de los padres sobre las conductas sedentarias, configuran la transición de la desnutrición infantil a la obesidad en la edad adulta y los riesgos cardiovasculares relacionados. [28][29][30][31] Para abordar esta matriz compleja, se requieren intervenciones exhaustivas e integradas. Esta transición se ve impulsada, además, por el envejecimiento de la población, la rápida aculturación y un mejor acceso a alimentos no saludables en zonas desfavorecidas.…”