Childhood obesity: an ecological perspective

Sarni, Roseli Oselka Saccardo; Kochi, Cristiane; Suano-Souza, Fabiola Isabel

doi:10.1016/j.jped.2021.10.002

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Sumário

REVIEW ARTICLE • J. Pediatr. (Rio J.) 98 (suppl 1) • Mar-Apr 2022 • https://doi.org/10.1016/j.jped.2021.10.002 copy

Childhood obesity: an ecological perspective

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To describe the participation of the environment in the childhood obesity epidemic, since childhood obesity currently represents a great challenge, with high prevalence worldwide, including in Brazil.

Data source:

Survey of articles published in the last 10 years in PubMed, evaluating the interface between the environment and childhood obesity.

Data synthesis:

Recent studies show that the environment is very important in the etiopathogenesis of obesity and its comorbidities. Therefore, factors such as air pollution, exposure to chemical substances that interfere with the metabolism, excessive consumption of ultra-processed foods, changes in the intestinal microbiota, and sedentary lifestyle are associated with increased obesity, insulin resistance, type 2 diabetes, and changes in lipid metabolism. These factors have a greater impact on some stages of life, such as the first thousand days, as they affect the expression of genes that control the adipogenesis, energy expenditure, and the mechanisms for hunger/satiety control.

Conclusions:

Environmental aspects must be taken into account in the prevention and treatment of childhood obesity, both from the individual and the population point of view, with adequate and comprehensive public health policies.

KEYWORDS
Childhood obesity; Ultra-processed food; Epigenetics; Sedentary lifestyle; Endocrine disruptors; Microbiota

Age	Time	Examples
Less than one year	At least 30 min a day on their stomach, which can be distributed throughout the day	Plays and games involving activities that place the child on their stomach or sitting, moving arms and legs and stimulating the child to reach, hold, pull, push, crawl, crawl, roll, balance with or without support, sit and stand, among others.
1 to 2 years	At least 3 h a day of physical activities of any intensity, which can be distributed throughout the day.	Plays and games involving activities such as the balance on two feet, balance on one foot, turning, crawling, walking, running, hopping, climbing, jumping, throwing, tossing, bouncing, and holding, among others;
3 to 5 years	At least 3 h a day of physical activities of any intensity, with at least 1 h of moderate-to-vigorous intensity activity that can be accumulated throughout the day.	Play and games involving activities such as walking, running, spinning, kicking, throwing, jumping, and crossing or climbing objects, among others. At this age, physical activity can also be performed during the school physical education class, swimming, gymnastics, wrestling, dancing, and sports. Also, through active commuting, such as on foot or by bicycle, always accompanied by parents or guardians.
6 to 17 years	At least 60 min or more of moderate-to-intense physical activity during the day (child or adolescent can speak with some difficulty while moving and cannot sing). This time can be divided into small blocks or all at once. As part of these 60 min or more a day, including at least 3 days a week of muscle and bone-strengthening activities (jumping, jumping rope, pulling, and pushing).	Choose and alternate activities that the child or adolescent likes the most (walking, running, flying a kite, dancing, swimming, cycling, surfing, playing soccer, volleyball, basketball, bocce ball, tennis, shuttlecock or frescobol, doing gymnastics or martial arts, or participating in games and plays such as hide-and-seek, tag, jump rope, elastic jump, dodgeball, play tacobol, among others. Include activities of daily living such as commuting to school, recess, physical education, and household chores shared with the family.

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[1] * Corresponding author. E-mail: suano.souza@unifesp.br (F.I. Suano-Souza).