According to the United States Centers for Disease Control and Prevention, around one in five American children is diagnosed with obesity as of March 2020. The statement would translate to approximately 14.7 million American children between the ages of 2 and 19 (Centers for Disease Control and Prevention). Childhood obesity has increased by 5.8% in just 20 years (Hales et al.). There’s no denying that childhood obesity is prominent in America; however, how did this come to be? Adekunle Sanyaolu, who has a PhD in Medical Microbiology, stated that childhood obesity is when children or adolescents have a body mass index between the 85th and 95th percentiles of the 2,000 CDC growth chart (Sanyaolu et al., 2019). The increased usage of ultra-processed foods, as stated by Joyce H. Lee, PhD in Biochemistry from Johns Hopkins University, the increased portion sizes of meals as described by the History of Portion Sizes, and the widespread availability of hyper-palatable foods in America, as stated by Saron Demeke, Kaitlyn Rohde, Lynn Chollet-Hinton, Cassandra Sutton, and Tera L. Fazzino of the University of Kansas, are a few factors causing the increase in obesity rates in America. 

Childhood obesity has increased by 5.8% in just 20 years

— (Hales et al.)

According to Joyce H. Lee, PhD in Biochemistry from Johns Hopkins University, the availability of processed and ultra-processed foods increased from less than 5% to more than 60% from 1800 to 2019. Ingredients and foods such as energy bars, sodas, and processed sugars fit ultra-processed foods (Joyce H. Lee et al.). These ultra-processed foods are high in calories, sugar, and fat; however, they have a low content of fibers, phytochemicals, and micronutrients (Temple). Ultra-processed foods make up half of the diet of Americans, including children (Grover). According to Alan Logan from the Nova Institute for Health, the requirement for high-calorie, shelf-stable foods as military rations during World War II accelerated the development of ultra-processed foods (Logan et al.). Results from military research were then transferred to commercial use. Government subsidies amplified the production of ultra-processed foods such as high-fructose corn syrup, hydrogenated oils, and modified corn starches (“Processed Foods History: 1910s to 1950s”). Ultra-processed foods have been present for a century; however, it was not deemed an area of concern until recently. In 2009, scientists at Brazil’s University of São Paulo Centre for Epidemiological Studies in Health and Nutrition introduced the term “ultra-processed foods.” Additionally, their “NOVA” classification determines how processed a food is (Temple). Currently, over 1,000 ultra-processed ingredients are found in a food item database of major American retailers (Ravandi et al.)

According to Stephan J. Guyenet, PhD, at the University of Washington, the calorie intake of Americans increased by over 20% from 1970 to 2010 (Guyenet and Schwartz). The rise in calorie intake is most likely due to the growing portion sizes of meals. The average portion of Americans’s favorite foods, drinks, and snacks has an average calorie increase of over 235% from 1996 to 2016. The same childhood favorite afterschool meal, the cheeseburger, contained 333 calories in 1996 but had a drastic calorie increase of 177%, containing 590 calories by 2016. The turkey sandwich went from 320 calories to 820 calories by 2016 (Scinta). The consumption of higher calories does not translate to higher nutrition consumption. The prevalence of total fats and saturated fats has increased substantially. As stated, these ultra-processed foods are linked to causing obesity (Huang and Huang).

According to Tera L. Fazzino, Kaitlyn Rohde, and Debra K. Sullivan of the University of Kansas, hyper-palatable foods (HPF) are food items that include high-fat, sugar, sodium, and carbohydrates. Hyperpalatable foods trigger the brain’s reward system and encourage excessive eating (Fazzino et al.). The availability of hyperpalatable foods in the United States from 1988 to 2018 increased by 20%. The most drastic changes in availability include fats and Na (Sodium), as an 18% increase in availability was observed (Fazzino et al.). Additionally, food products considered “hyperpalatable” have increased in America. The same food product from 1988 to 2001 only saw less than two times obtaining the title “hyper-palatable food.” The same food product saw less than four times the chances of obtaining the title “hyper-palatable food.” (Fazzino et al.). 

As of 2020, 8% of the world’s population from 5 to 19 years old is diagnosed with obesity, totaling up to 157 million.

—– (Iván Ochoa-Moreno et al.)

As of 2020, 8% of the world’s population from 5 to 19 years old is diagnosed with obesity, totaling up to 157 million. Researchers from the United Kingdom predict this number will rise to 19% by 2030, totaling 250 million children and adolescents (Iván Ochoa-Moreno et al.). According to David Benton and Hayley A. Young of Swansea University, tackling obesity is problematic due to flaws in treatments such as dieting plans. Dieting plans disrupt the body’s appetite-regulating hormones for at least a year (Benton and Young). Professor Joseph Proietto (MBBS, PhD, FRACP) of the University of Melbourne in the Department of Medicine, Austin Health, and an endocrinologist specializing in diabetes and obesity further support this idea. As said, “weight-loss programs have a very high long-term failure rate” (Proietto). Professor Proietto suggests providing resources to treat children who are already diagnosed with obesity. However, challenges arise with this idea. Despite federal bills, the price of obesity treatments such as insulin continues to increase (Gordon). As stated before, obesity is no doubt a problem, especially childhood obesity in America. The question should no longer remain if childhood obesity is a problem and what causes childhood obesity in America. Instead, researchers should analyze current information and ask, “What is the best way to combat childhood obesity in America and beyond?”

Kaung Khant Htet Naing
ASB, Thailand

---

Citations

Benton, David, and Hayley A. Young. “Reducing Calorie Intake May Not Help You Lose Body Weight.” Perspectives on Psychological Science : A Journal of the Association for Psychological Science, vol. 12, no. 5, SAGE Publications, 2017, pp. 703–14, https://doi.org/10.1177/1745691617690878. Accessed 26 Sep. 2024.

Centers for Disease Control and Prevention. “Childhood Obesity Facts.” Obesity, 2 Apr. 2024, http://www.cdc.gov/obesity/php/data-research/childhood-obesity-facts.html. Accessed 14 Sep. 2024.

Demeke, Saron, et al. “Change in Hyper-Palatable Food Availability in the US Food System over 30 Years: 1988–2018.” Public Health Nutrition, May 2022, pp. 1–8, https://doi.org/10.1017/s1368980022001227.

Fazzino, Tera L., et al. “Hyper-Palatable Foods: Development of a Quantitative Definition and Application to the US Food System Database.” Wiley Online Library, Wiley Online Library, 5 Nov. 2019, doi.org/10.1002/oby.22639. Accessed 26 Sep. 2024.

Gordon, Bianca. “Insulin Prices in ESI Nearly Doubled from 2012-2021, with Effects of Emerging Biosimilars Evident in Recent Years.” Health Care Cost Institute, 4 Apr. 2023, healthcostinstitute.org/hcci-originals-dropdown/all-hcci-reports/https-healthcostinstitute-org-hcci-research-insulin-prices-in-esi-nearly-doubled-from-2012-2021-with-effects-of-emerging-biosimilars-evident-in-recent-years. Accessed 16 Sep. 2024.

Grover, Emily. “The Overconsumption of Ultra-Processed Foods in the United States.” Ballard Brief, 2024, ballardbrief.byu.edu/issue-briefs/the-overconsumption-of-ultra-processed-foods-in-the-united-states#:~:text=The%20 consumption%20of%20 ultra%2d Processed. Accessed 24 Sep. 2024.

Guyenet, Stephan J., and Michael W. Schwartz. “Regulation of Food Intake, Energy Balance, and Body Fat Mass: Implications for the Pathogenesis and Treatment of Obesity.” The Journal of Clinical Endocrinology & Metabolism, vol. 97, no. 3, Mar. 2012, pp. 745–55, https://doi.org/10.1210/jc.2011-2525. Accessed 24 Sep. 2024.

Hales, Craig M., et al. “Prevalence of Obesity among Adults and Youth : United States, 2015–2016.” Cdc.gov, Oct. 2017, stacks.cdc.gov/view/cdc/49223. Accessed 21 Sep. 2024.

Huang, Kuo S., and Sophia Wu Huang. “Changes in the Nutrient Content of American Diets.” Health Economics Review, vol. 1, no. 1, Dec. 2011, https://doi.org/10.1186/2191-1991-1-19.

Iván Ochoa-Moreno, et al. “Projected Health and Economic Effects of the Increase in Childhood Obesity during the COVID-19 Pandemic in England: The Potential Cost of Inaction.” PLOS ONE, vol. 19, no. 1, Public Library of Science, Jan. 2024, pp. e0296013–13, https://doi.org/10.1371/journal.pone.0296013.

Lee, Joyce H., et al. “United States Dietary Trends since 1800: Lack of Association between Saturated Fatty Acid Consumption and Non-Communicable Diseases.” Frontiers in Nutrition, vol. 8, Jan. 2022, https://doi.org/10.3389/fnut.2021.748847. Accessed 29 July 2022.

Logan, Alan C., et al. “‘Food Faddists and Pseudoscientists!’: Reflections on the History of Resistance to Ultra-Processed Foods.” EXPLORE, vol. 20, no. 4, Dec. 2023, https://doi.org/10.1016/j.explore.2023.12.014. Accessed 26 Sep. 2024.

“Processed Foods History: 1910s to 1950s.” Modern Pioneer Mom, Modern Pioneer Mom, 5 July 2012, modernpioneermom.com/2012/07/05/processed-foods-history-1910s-to-1950s/.

Proietto, Joseph. “Why Is Treating Obesity so Difficult? Justification for the Role of Bariatric Surgery.” Medical Journal of Australia, vol. 195, no. 3, Aug. 2011, pp. 144–46, https://doi.org/10.5694/j.1326-5377.2011.tb03242.x. Accessed 26 Sep. 2024.

Ravandi, Babak, et al. “GroceryDB: Prevalence of Processed Food in Grocery Stores.” MedRxiv, Apr. 2022, https://doi.org/10.1101/2022.04.23.22274217.

Sanyaolu, Adekunle, et al. “Childhood and Adolescent Obesity in the United States: A Public Health Concern.” Global Pediatric Health, vol. 6, no. 6, Dec. 2019, https://doi.org/10.1177/2333794×19891305.

Scinta, Wendy. “How Portion Sizes Have Changed throughout History.” Your Weight Matters, 29 Apr. 2016, http://www.yourweightmatters.org/portion-sizes-changed-time/. Accessed 22 Sep. 2024.

Temple, Norman J. “The Origins of the Obesity Epidemic in the USA–Lessons for Today.” Nutrients, vol. 14, no. 20, Oct. 2022, p. 4253, https://doi.org/10.3390/nu14204253. National Library of Medicine. Accessed 24 Sep. 2024.