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.