Let’s Talk About

Childhood Obesity

Written by: Apprentice Dietitian Chia Hui Ying

Childhood obesity is one of the most pressing global challenges in the 21st century. In Malaysia, up to 30% of children are classified as overweight or obese. [1] According to the World Health Organization (WHO), obesity involves abnormal or excessive fat accumulation that increases health risks, including mortality. [2] Body Mass Index (BMI) is commonly used to classify weight status in children. Based on CDC growth charts, children at or above the 85th percentile are overweight, the 95th percentile obese, and the 99th percentile classified as having severe obesity. [3]

Childhood obesity can be categorized as exogenous or endogenous. Exogenous obesity results from external factors, like an imbalance between energy intake and expenditure, while endogenous obesity arises from genetic, syndromic, or endocrine causes. [4] While genetics influence body fatness, environmental factors like diet and activity levels play a larger role. Modern diets often feature energy-dense, nutrient-poor foods, alongside reduced physical activity due to urbanization and sedentary habits. [2]

Children who are overweight or obese are more likely to continue being overweight into adulthood, increasing their risk of developing non-communicable diseases like:

  • Type 2 diabetes mellitus – Children as young as 8 years old might be at risk of getting type 2 diabetes mellitus. Children with obesity might consume high calories and sugar-rich foods, thus increasing T2DM risk.
  • High blood pressure – As obesity becomes more severe, the risk of high blood pressure rises. Long-term high blood pressure puts stress on the heart.
  • Liver diseases – Fatty liver disease (nonalcoholic steatohepatitis or NASH) is common among children with obesity and this can lead to liver failure.
  • Heart diseases – Atherosclerosis (narrowing of blood vessels), is a common heart disease that people with obesity might suffer from.

Childhood obesity and related non-communicable diseases are largely preventable. Prevention is widely recognized as the most practical approach to addressing the pediatric obesity crisis, as current treatments mainly manage symptoms rather than offer long-term solutions. Achieving and maintaining energy balance throughout life is key. To prevent childhood obesity, encourage healthy eating habits, promote physical activity, reduce sedentary behaviors, and foster a supportive environment that enables children to make healthier lifestyle choices. [1]

  • Engaging in regular physical activity—at least an hour daily—helps children maintain a healthy weight, reduce obesity-related health risks, and strengthen their bones and muscles. Encourage a variety of enjoyable activities like team sports, swimming, yoga, biking, dance classes, or evening walks. A balanced fitness regimen should include stretching for flexibility and strength training for muscle growth. Outdoor activities, particularly for preschool-aged children, are highly beneficial for their physical and mental development.
  • Encourage children to eat at least five servings of fruits and vegetables daily. Create appealing, colorful meals using ingredients like tomatoes, broccoli, corn, carrots, and green peas. Replace juices with fresh whole fruits such as oranges, starfruit, or watermelon. For picky eaters, incorporate vegetables into meals by blending them into meat patties or meatballs to ensure they receive essential nutrients.
  • Reduce sedentary activities, such as watching videos, playing video games, or using the internet, to no more than two hours daily. Encourage simple habits like taking the stairs instead of elevators at malls or schools to increase physical activity levels.
  • Parents should actively support and participate in their child’s activities. Set achievable goals based on the child’s interests and abilities. Track progress using a chart and celebrate milestones with positive reinforcement. Lead by example by making exercise a family activity to encourage healthy habits.

Healthier Food Swaps

Small, easy food swaps can significantly reduce sugar, salt, and fat intake for children. Even incorporating just one or two changes daily can lead to a healthier diet. The more adjustments made, the greater the benefits for overall health.

Instead of Swap to
Milk chocolate
Dark chocolate
Cordial drinks with added sugar
Fresh fruit juices
Sweetened / Flavored yogurt
Natural yogurt with added fresh fruits
Chips
Nuts (almonds, walnuts) and seeds (sunflower seeds, pumpkin seeds)
Fat cut of poultry / meat
Lean cut of poultry / meat

Reference List

  1. Childhood Obesity [Internet]. PORTAL MyHEALTH. 2013 [cited 2023 Jan 25]. Available from: http://www.myhealth.gov.my/en/childhood-obesity/

  2. Noncommunicable diseases: Childhood overweight and obesity [Internet]. [cited 2023 Jan 25]. Available from: https://www.who.int/news-room/questions-and-answers/item/noncommunicable-diseases-childhood-overweight-and-obesity

  3. Calculate Your BMI – Standard BMI Calculator [Internet]. [cited 2023 Jan 25]. Available from: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

  4. Aggarwal B, Jain V. Obesity in Children: Definition, Etiology and Approach. Indian J Pediatr. 2018 Jun;85(6):463–71.
  5. Lee YS. Consequences of Childhood Obesity. 2009;38(1).