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There is no single cause of childhood obesity and the energy imbalance occurs due to a complex interaction of several (risk) factors, including lifestyle and behaviour, genes, environment, and medication which are discussed below.
Pregnancy and early life nutrition Women who are affected by obesity or overweight have a higher risk to conceive a large-for-gestational-age (LGA) baby, which is a risk factor for the child to develop obesity or overweight.
Maternal obesity during pregnancy exposes the foetus to an increased amount of nutrients and altered hormone levels, which determine the growth and body composition of the foetus, and potentially affect the programming of appetite of the child.
Undernutrition may not only affect the foetus’ growth, it could also affect its metabolism leading to a more increased storing of energy, thereby increasing the risk of the baby having obesity in childhood.
Lifestyle and behaviour Lifestyle and behaviour factors play a key role in the development of childhood obesity, particularly diet, eating behaviours, physical activity, sedentary behaviour, and psychosocial factors.
Obesity is a multifactorial condition linked to an energy imbalance.
To keep weight stable, energy intake and energy expenditure must be in balance.Any excess energy taken in is stored as fat, which over time can lead to overweight or obesity.For a simple explanation of the concept of energy balance, and the complexity of it, please watch EUFIC’s Energy Balance video.Overweight and obesity are often assessed by body mass index (BMI).This is weight (in kilograms) divided by height (in metres) squared (kg/m For children, the BMI cut-offs for overweight and obesity vary depending on age and gender.National and international reference standards differ from each other, because they may be based on different populations and time periods.Figure 1: The World Health Organisation (WHO) BMI chart for boys (above) and girls (below) aged 5 to 19 years old.Therefore, BMI charts (Figure 1) - instead of set BMI values - are used as a reference standard for children and adolescents.These charts show the age-related population distribution of BMI values per gender.Figure 2: Geographical distribution of the prevalence of overweight (including obesity) in children aged 6–9 years (sexes combined) of Childhood Obesity Surveillance Initiative Round 2 (2009/2010), based on WHO definitions.Monitoring the prevalence of childhood obesity is important to assess the effectiveness and success rate of intervention schemes and prevention programmes.