The World Health Organization recognizes that the increasing prevalence of childhood obesity is mainly due to social changes. This problem is mainly associated with a bad diet and little physical activity, but it is not only related to the child’s behavior, but also to social and economic development and policies in agriculture, transport, urban planning, the environment, education and food processing, distribution and marketing.
The problem is social and, therefore, requires a population-based, multisectoral, multidisciplinary approach, adapted to cultural circumstances.
Unlike most adults, children and adolescents cannot choose the environment in which they live or the food they eatThus, they have a limited ability to understand the long-term consequences of their behavior. So, need special attention in the fight against the obesity epidemic.
For an individual to increase their body fat, it is essential that they have, or have had, a positive caloric balance. The mechanisms to have this condition are the increase in dietary (energy) intake or the decrease in caloric expenditure, and the most common is that both mechanisms concur. Both the increase in intake and the decrease in expenditure are influenced by generic, environmental and associated pathology factors.
The truth is that the etiopathogenesis of obesity is complex and probably heterogeneous. There are some cases in which a primary cause that contributes to its development is identifiable, as in the case of certain genetic diseases, endocrine pathologies … However, in most cases it is not possible to identify a single cause, although the physiology of the weight change is clear and does not give rise to doubts: weight is gained when the energy intake exceeds the caloric expenditure.
The two most commonly accepted reasons for the increased prevalence of childhood obesity are some poor dietary practices and widespread reduction in physical activity. The question is: Are they the only culprits?
When the robustness of the evidence for the two major causes is questioned as the main contributors, the importance of energy intake and energy expenditure is not questioned, but the fact of not neglect the possible contributions of other factors in the balance between intake and energy expenditure.
The current nutritional recommendations, with an important basis of the diet in carbohydrates, should be more rationalized and more insistent on the intake of slow absorbing carbohydrates, as well as cereals, pasta and brown rice.
So, the balance of protein consumption should increase And, for this, there are new recommendations on a balanced dish, where bet on whole grains, a significant increase in fruits and vegetables and an increase in the percentage of protein in the diet. Also, requirements on certain highly refined carbohydrates have been reduced.
On the other hand, the recommendations on physical activity are insufficient in terms of intensity, and the necessary levels of physical activity must achieve changes in hormonal adaptations to exercise and physical condition in order to achieve the effect of increasing energy expenditure. If not, there is a risk of causing the opposite effect: increase appetite and reduce basal metabolism.
Also, having one (or both) parent with obesity also increases the risk of being an obese child, but this factor, in isolation, does not predict individual weight characteristics, reflecting the combined effects of various genetics, the family environment and factors external to the family. The truth is that, as important as genes are, the etiological interest in obesity focuses on changes in the energy balance. Maintaining a stable weight requires a delicate balance between intake and energy expenditure. Young children are able to adjust their intake to their spending, but this capacity is lost as they grow older