Upcoming Series: Potential Contributors to the Pediatric Obesity Epidemic

Last November I completed my comprehensive exams at the University of Ottawa, which involved writing 2 comprehensive reviews on areas related to my research.  One of those topics was “Potential Contributors to the Canadian Pediatric Obesity Epidemic”, and I was fortunate to have my article on the topic accepted for publication in the journal ISRN Pediatrics earlier this month.  While the article is nominally focused on Canada, the conclusions apply equally to other developed nations.

I find this area to be a really fascinating topic, so I thought it would be fun to turn it into a week-long series of posts.  Next Monday-Thursday, I will examine 2-3 potential contributors to the childhood obesity epidemic each day.  On Friday, I thought it might be fun to discuss other potential contributors that I omitted from the paper for one reason or another.

Here are the topics that I covered in my review:

  • Reduced sleep
  • Reduced physical activity
  • Increased total energy intake
  • Increased fat intake
  • Increased sedentary time
  • Exposure to endocrine-disrupting chemicals
  • Increased consumption of sugar-sweetened beverages
  • Inadequate calcium intake
  • Increased maternal age
  • Reduced breastfeeding
  • Increased adult obesity rates

If anyone has suggestions for topics that they think I might have overlooked, feel free to post it in the comments section below.  Keep in mind that the focus is on factors that could increase obesity rates at the population level, not just factors that can predispose an individual to weight gain. This issue has been dealt with previously in a paper focused on adults, and I have followed their definition for how to determine whether something is a potential contributor to the pediatric obesity epidemic:

…we offer the conclusion that a factor (e.g., X) that has contributed to the epidemic will logically follow acceptance of two propositions: (1) X has a causal influence on human adiposity and (2) during the past several decades, the frequency distribution of X has changed such that the relative frequency of values of X leading to higher adiposity levels has increased. In the absence of countervailing forces, if both propositions are true, obesity levels will increase.

So feel free to add your suggestions in the comments, or to get a jump start by reading the paper itself, which is available here.

Have a great weekend!

Travis

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9 Responses to Upcoming Series: Potential Contributors to the Pediatric Obesity Epidemic

  1. WRG says:

    Sorry if this is a bit off topic, but I’d like to know whether you’ve reflected on your use of the term “epidemic” as in “obesity epidemic”. Do you feel it is warranted? Have you thought about the potential misuse of the term and the kinds of erroneous concepts it may lead to?
    Inquiring minds want to know!

    Thanks.

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    • Travis says:

      I know that some people take exception to the term, and I am guessing that you probably know a bit more about the debate around it than I do, so please feel free to add your thoughts below.

      I tend to use the term obesity epidemic for 2 reason. Obesity rates have increased substantially in the past 50 years, and while I know that may or may not meet the classic definition of “epidemic”, I think it captures it more succinctly than any other single term. The second issue is that when you say “obesity epidemic”, people know exactly what you are referring to, and it’s a bit simpler than saying “Potential causes of increased obesity rates in the pediatric population”.

      The other reason is that the comprehensive exam question that led to this paper specifically asked me to give a comprehensive explanation to the pediatric obesity epidemic, and so it made sense in that context to include the term in the title of the paper.

      I realize that these aren’t the strongest arguments, and they basically amount to “I did it because that’s what people do”. I’m open to using another term if there is a reason why “obesity epidemic” is especially problematic (I’m less interested in dropping the term simply because of a semantic argument about the traditional meaning of the word epidemic).

      I’m interested to hear what you think!

      Travis

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  2. blu-k says:

    This is just a thought – but as a mum of a toddler I’m seeing more baby food that comes in tubes/packs to be sucked down, rather than jars to be spooned out. I’ve read that people consume more calories when they drink something rather than eat it, so I do wonder if kids sucking down these tubes are consuming more calories than if they had to chew.

    (No judgment of people that use them here though, the main reason seems to be that they are clean as well as convenient.)

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  3. How about the explosion of availability of palatable food- not just higher fat, but higher sugar- which is directly marketed to children? Foods that are resistant to sensory specific satiety, and foods that exploit endogenous opioids?

    Children can’t really stop themselves from liking and wanting these foods. Food companies, in their need to achieve financial targets, exploit this natural predilection. Bewildered parents stand very little chance to controlling food intake of children, 100% of the time, and these preferences are twigged almost immediately.

    I really look forward to reading the article!

    margaret

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  4. How about Fructose?

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  5. Travis says:

    Thanks for the excellent suggestions. They are all touched on, at least tangentially, and I will try to get into a bit more detail in the wrap-up post. Keep them coming!

    Travis

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  6. Lack of sleep I found I little puzzling because in my experience, I have found that obesity increases sleep levels but it is just disparate.

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  7. WRG says:

    Excuse me for throwing out the following thoughts in a rather pele-mele manner, but as I see it, here are some of the assumptions behind the term “obesity epidemic”. :

    The word epidemic conjures up images of “catching” a disease, of a disease that is spreading like wildfire throughout the population, of something horrible that we must all avoid like…the plague (or AIDS, for instance). A lot of people don’t want to even be seen around fat people. Remember that study that said we get fatter just if we have fat friends or a fat spouse?

    When we talk about the obesity epidemic, we equate overweight with an automatic state of ill health. But is that really true?

    What makes us sick? Is it being sedentary? Eating poor quality foods? Working in an unhealthy environment? Stress? Stigma? All of the above? Permutations of the above? Or is it simply, as the term “obesity epidemic” implies, because we are fat.

    When we use the expression “obesity epidemic”, we imply that all people who are overweight are necessarily in poor health. We totally negate the fact that people, like dogs and trees and rocks and insects, come in all shapes and sizes. We pathologize anyone who doesn’t look a certain way. We assume that people whose BMI is over 24.9 are by definition unhealthy (and let’s not forget that the BMI overweight cutoff was arbitrarily changed in the late 1990s; not to mention the fact that the BMI was not even originally designed to be a proxy for health–it was just a way to establish a bell curve for average weight).

    The more we insist on an obesity epidemic, the less we try to find ways to help people become healthier because the assumption is that only people of “normal” or low weight are healthy. We assume that only through losing weight, can we be at all healthy. Yet the success rate for dieting is barely 5%. Does that mean that fat people should give up, stop walking, biking, swimming, never go to the gym, not eat healthy foods because the only losing weight will truly improve their health? As long as weight is the sole arbiter of health, we will be doomed to live in an increasingly unhealthy world.

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  8. Pingback: Contributors to the Pediatric Obesity Epidemic Part 5: Risk Factors I Missed | Obesity Panacea