Category: Children

Introduction

Malnutrition means deficiency of proper nutrition in diet due to not having enough food. It mainly involves calories, protein, vitamins and carbohydrates. It has also divided into different types of under nutrition such as stunting, wasting, underweight and no proper vitamins and minerals (Pathak & Singh., 2011).

My essay topic area is malnutrition among children of India. In India, there is highest number of children at world level suffering from malnutrition (Pathak & Singh., 2011). Poverty is the main causative factor of malnutrition. There are several programs designed to provide children proper nutrition and for their growth and development for example Integrated Child Development Scheme, Mid-Day meal program and Special Nutrition Program (Upadhyay et al., 2011).

This essay will analyze previous existing intervention that is Special Nutrition Program and the advocacy strategy for implementing malnutrition control program for development and health promotion. It is also focused to reduce hunger among poor and to make base for poverty eradication that is constant along with paying attention to sustainable development goals, social determinants of health such as poverty, theory of change and communication tactics. In my advocacy strategy, I will start with a social awareness campaign in which recruit people from grassroots. Furthermore, I will make alliance other organizations having same views towards reducing malnutrition and then set up short term and long term goals. Thus, to achieve my target there will be proper planning for putting pressure on decision making powers.

Previous intervention description

Special nutrition program was started in the year of 1970. It was launched by Social Welfare Ministry. It is operating among the people who are in serious need of it which includes urban slum area, tribal area and backward rural areas. This program was aimed at improvement of nutritional status among the targeted group (Planning Commission., 2001). During the year of 1970-71 it was limited among the age group of 0-3 years and nutritious food was supplied to 6.8 lakh (million) children. However, in 1971-72 it was extended to children age group 0-6 years and pregnant and nursing mothers also included. Furthermore, periodic check-up of children scheme was also proposed (NIHFW). Proper nutrition such as rice, lentils, vegetable or eggs, iodized salt is provided to children and also micronutrient powder having iron, folic acid and vitamin A is provided to nursing women. There are several social determinants associated with malnutrition such as low income, no sanitation, no education and lack of adequate awareness about healthy and nutritious food (Deshmukh et al., 2013).

Grass root community mobilization is present in this program. The program was initiated from grassroots only that is Anganwadi workers are playing vital role. It has proper prenatal and post natal care for mothers. New-born are provided with immunization. Children are having check-up on regular basis. Pregnant women during her last trimester is prioritized and emphasis on institutional deliveries. Lactating mothers are educated about initiation of breast feed soon after birth to focus colostrums feeding (Saxena., 2018).

Ministry of Women and child development and government of India run this program. The program was limited due to financial and lack of leadership efforts among such huge population. However, four national level organizations for example Indian Council of Child Welfare are providing grants for program implementation. There was need to monitor the program at district and block level. There should be number of outreach camps. Regular supply and monitoring of immunization material and also micronutrient powder was required. Attendance of mothers and children having nutritional services was also important for progress in management of malnutrition. Panchayats did not focus to construct Anganwadi centres. Along with these services awareness should be provided to mothers regarding child marriage, importance of education (Balarajan et al., 2016).

There was no specific theory of change was adopted in previous intervention program. The good part of this program is that services are provided in Anganwadi centres but on the other hand it is clear that some of villages are not having any Anganwadi centres and also panchayats are not focusing to construct. Then, there are some regional areas where people are lacking of services (Balarajan et al., 2016). However, it is clear in previous intervention that why change is required in malnutrition among children. Theory of change provided by Shiffman is focused on strengthen the organization (Shiffman & Smith., 2007).

The main activity of this program is to provide supplementary food to children, pregnant women and lactating mothers for 300 days throughout a year. Moreover, some initiatives were made at individual level in some states India. Program is focused to provide every child 300 calories and 8 to 15b grams of protein and for expectant and nursing mother is provided with 500 calories along with 25 grams of protein per day. Micronutrient is also given to expectant and nursing mothers such as iron, vitamin A and folic acid (Gulati et al., 2012).

Strategy plan

In my strategy plan for health advocacy implementation for issue of malnutrition among children is aimed to start with creating awareness among people regarding malnutrition. Furthermore, after involving people in malnutrition campaign, short term and long term goals should set. In short term goals home grown solutions will be there to tackle malnutrition. Long term goals will be focused to eliminate hunger and poverty. In addition to it, organizations sharing same ideas regarding reducing malnutrition will be contacted to make alliances. When several organizations will be together and aiming at same view towards malnutrition, it will be easy to target decision making powers with the help of effective communication tactics.

Link between problem and goal of advocacy to Sustainable Development Goals

Vulnerability to malnutrition among children is due inadequate knowledge about causes of malnutrition. There is no proper drinking resource which results in dehydration, lack of sanitation results in diarrhea and cholera outbreaks. There are several poverty eradication program but still have not reached to the centre of country. Mothers are illiterate which leads to several health issues due to lack of knowledge. It is commonly seen that if an illiterate mother is trying to cure diarrhea she removes solids from child diet (Gulati et al., 2012).

Reference to theory of change

In this strategy, people from the grassroots will be recruited for the development of social campaign. People from community will involve mothers, older people and community health nurses to create awareness among people regarding malnutrition and its risks to health. Community people will be taught about nutrition importance. Furthermore, educate and train community people about kitchen garden in which how to grow green vegetables and fruits rather than getting expensive and fortified food from market. Local people will be trained and then they will be sent to the isolated regions to spread information. There is continuous increase in use of artificial additives and preservatives in food that also affects health of population. Thus to limit these preservatives demonstration will be organized with the help of local community people against the companies. Community development and engagement will be helpful to address the root cause by raising awareness and also reflect on the SDGs such as no poverty and no hunger.

Alliance with other organizations

There will be continuous efforts to make alliance with other organizations. Engage with Right of Food and Nutrition Watch because it is an organization advocating for eliminating malnutrition at global level. For the development of policies this organization will play vital role in food policy to eradicate food companies’ influence. Organization is working to improve the access of food, social protection and providing people nutritionally adequate diet. In their 2015 report, the organization reveals the subtle but frightening violations of the human right to food by international corporations. The conclusion of the report indicated that the problem needs human rights-based solutions that are independent of commercial/business interests to ensure a diverse, healthy, sustainable, and culturally appropriate diet (Right to food and nutrition, 2015).

Another organization is FIAN (First Food Information and Action Network) is working to ensure that everyone should have food to feed themselves. Furthermore, this organization is present in some states of India as well (Windfuhr & Jonsén 2005). Moreover, FIAN is working on empowering starving people along with political support.

Communication tactics and building citizen power

To create awareness, it is very important to make partnership with the media. To fulfill our purpose, I will contact some reputed media partners. Furthermore, proper television programs providing information regarding malnutrition will be telecasted. In addition to it, online websites will be created with the help of organizations and NGOs working on same at world level to pressurize decision making powers. The prime minister of India Shri Narendra Modi will be aimed for my advocacy as he is leading Ministry of Agriculture & Farmers’ Welfare (MAFW). MAFW is focused to get more and more yield from farmers. Peaceful demonstrations will be organized against the MAFW and ministry of health to persuade them to limit the use of unnatural additives on food by commercial companies.

My advocacy strategy will be having following activities:

• Educate the target audience on the importance of nutrition.
• Promote the adoption of indigenous approaches to farming on the selected media outlets.
• Train target personnel who will be sent on different target regions in India to educate the affected person on how to approach indigenous farming.
• Organize peaceful demonstrations against companies promoting unnatural food as a measure against malnutrition.
• Organize a peaceful protest against the MAFW to persuade them to limit the influence of commercial companies on food policy.
• Contact representatives of ERFNW, FIAN, and other nonprofits to join the cause.
• Enquire from the Ministry of Social Justice and Empowerment of India on how far the country is towards achieving the “no poverty” goal of the SDGs.

If the progress is not impressive, hold a public exchange forum to discuss ways of engaging the target SDGs. Create an online forum for the same. Create an emergency hotline for “save a child from hunger” initiative.

References

1. Balarajan, Y., & Reich, M. R. (2016). Political economy of child nutrition policy: A qualitative study of Inadia’s Integrated Child Development Services (ICDS) scheme. Food Policy, 62, 88-98.
2. Deshmukh, P. R., Sinha, N., & Dongre, A. R. (2013). Social determinants of stunting in rural area of Wardha, Central India. medical journal armed forces india, 69(3), 213-217.
3. Gulati, A., Kumar, A. G., Shreedhar, G., & Nandakumar, T. (2012). Agriculture and malnutrition in India. Food and nutrition bulletin, 33(1), 74-86.
4. NIHFW. Special Nutrition Programme (SNP). Retrieved from http://www.nihfw.org/NationalHealthProgramme/SNP.html
5. Planning Commission. (2001). Report of the Steering Committee on Empowerment of Women and Development of Children for the Tenth Five Year Plan (2002-07).
6. Pathak, P. K., & Singh, A. (2011). Trends in malnutrition among children in India: growing inequalities across different economic groups. Social science & medicine, 7 3(4), 576-585.
7. Right to food and nutrition (2015). The Right to Food and Nutrition Watch 2015: “Peoples’ Nutrition Is Not a Business”.
8. Saxena, N. C. (2018). Hunger, under-nutrition and food security in India. In Poverty, Chronic Poverty and Poverty Dynamics (pp. 55-92). Springer, Singapore.
9. Shiffman, J., & Smith, S. (2007). Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet, 370(9595), 1370-1379. doi:10.1016/S0140-6736(07)61579-7
10. Upadhyay , R. P., & Palanivel, C. (2011). Challenges in achieving food security in India. Iranian journal of public health, 40(4), 31.
11. Windfuhr, M., & Jonsén, J. (2005). Food Sovereignty: Towards democracy in localized food systems. FIAN-International.

Introduction

Chronic liver disease (CLD) occupies a major portion in pediatric gastrointestinal diseases. Around two third pediatric populations with CLD awaiting liver transplantation are malnourished.1There is a to and fro interaction between CLD and malnutrition. Majority of children with CLD are often malnutrition, and malnutrition adversely affects the course of liver disease1. Nutritional deficiencies are frequently noted in children with CLD, particularly in cholestatic liver disease and onset is in infancy period2,3. It has been demonstrated in many studies that malnutrition is an independent risk factor for poor outcome of CLD, which lead to the emergence of many severe complications in patients with cirrhosis, such as ascites, hepatic encephalopathy and various infections4. An imbalance between nutritional intake and nutrient requirement can adversely affect and lead to metabolic abnormalities, physiological changes, reduces organ and tissue function, and loss of body mass5. Protein and energy intake may be inadequate because of multiple factors such as anorexia, early satiety (caused by impingement upon viscera by enlarged liver, spleen or ascites) recurrent infections. Malabsorption of dietary fat due to impaired bile flow is also observed in many children with CLD6,7. In addition, alteration in amino acid metabolism8, 9 and increased energy requirements due to disease process and many other factors10 may contribute to suboptimal energy and nitrogen balance. These nutritional imbalances are thought to be secondary to the interaction between factors such as reduced energy intake, lipid and fat-soluble vitamins malabsorption, increased energy expenditure, altered intermediate metabolism, hormonal dysregulation and chronic anemia related to hypersplenism and portal hypertension.11,12,13,14

Regarding laboratory parameters, which are markers of nutritional status, such albumin and prealbumin could be low because of low levels of synthesis, rather than because of poor nutritional status. So, their levels may not reflect true nutritional status.

Weight for height more useful as it assesses weight in relation to current stature. It might be more accurate as it can assess weather wasting, stunting or both have occurred and it is also age independent parameter to assess nutritional status in children. Other important parameter is body mass index (BMI), a very important index of nutritional status, may also be overvalued in patients with edema and ascites because fluid in form of ascites and edema will reflect as falsely extra body weight. Intelligent and analytical interpretation of nutritional data using these techniques in the presence of these complications is therefore required. Generally accepted methods for assessment of the clinical status and severity of disease in cirrhotic patients are the Child-Pugh-Turcotte classification15. The uses of anthropometric parameters that are not affected by the presence of ascites or peripheral edema are mid-arm muscle circumference (MAMC), mid-arm circumference (MAC), and triceps skin fold thickness (TSF). Subcutaneous fat is approximately (50%) of body fat stores, therefore measuring subcutaneous fat would reflect total body fat (TBF)16. Diagnosis of malnutrition is established by values of MAMC and/or TST17. By measuring TSF and MAC it enables arm muscle area (AMA) and arm fat area (AFA) to be calculated. AMA reflects calorie intake and muscle mass and is sensitive to changes in nutritional status18. Skinfold thickness is not useful in infants less than three months because of variations in fluid compartments.

Dual-energy X-ray absorptiometry (DEXA) is an indirect, low radiation exposure of bone mineral content or bone mineral density. It uses the same assumptions as the body compartment approach of assessment, that is, Soft tissue = bodyweight − skeletal mass and soft tissue = fat + water equivalent tissue.

It also assumes soft tissue-overlying bone cannot be sampled and its composition has to be extrapolated from the composition of adjacent tissue. Bone mass, FFM and fat body mass (FBM) can be determined with a 2–3% precision in adults (5% in newborns). The comfort of use, very less radiation exposure and ability to obtain bone mineral content makes this method very useful19.The availability of report of DEXA is instant so no time spent in getting report.

Detailed nutritional status assessment should be done at the time of diagnosis of CLD by a trained dietician/nutritionist and subsequently while on nutritional rehabilitation20. Serial measurement of nutritional status can guide and confirm the effects of successful nutritional therapy. Till date there are scarcity of literature on nutritional assessment of children with CLD. We have prospectively evaluated the usefulness of various nutritional assessment techniques to find out magnitude and type of malnutrition present in children with CLD.We also correlated the anthropometric, biochemical and whole body DEXA scan parameters.

Discussion

We found that nearly half of the patients had chronic malnutrition, and in many of them it was compounded by superadded acute malnutrition. Under nutrition and stunting is explainable on the basis of primary disease process and reduced oral intake leading to inadequate calories. More than two third of children had low caloric intake, which may be due to various factors, i.e. chronic disease process leading to anorexia, easy satiety due to extrinsic compression of stomach by organomegaly and ascites. Muscle wasting was more prominent in younger age group (1-5 years) children indicating that this subset children is more vulnerable to morbidity and complications. As expected, children with ascites have more protein depleting parameters. This also indicates that there is more severe catabolic state in ascetic form of CLD patients. Both low serum albumin and total proteins values reflect poor synthetic functions of the liver in the majority of disease process is advanced.

The whole body DEXA scan reveals that total body fat was less affected as compared to muscle mass, because CLD patients have higher catabolic state that leads to protein utilization as energy source leading to protein depletion and sparing of fat. Only few children have low bone mineral density content might suggesting that Vitamin D3 metabolism is least affected in children with chronic liver disease.

Conclusion

Majority of children with CLD were malnourished. Children below 5 years were more affected compared to older children. Bone metabolism was less affected in children with CLD.Early detection of malnutrition and early specific and therapeutic nutritional intervention is the key point in the nutritional management of CLD.

Abstract

An increasing number of people are developing diabetes across the nation. The affect on children has become overwhelmingly high. Schools need to educate teachers on the signs and symptoms of the disease to insure the health of students. If school officials and teachers are aware of how diabetes affects children and the signs to look for proper treatment can be achieved without causing severe health complications. Familiarity with hypoglycemia, hyperglycemia, and the different types of diabetes enables a teacher to respond accurately in the case of an emergency. The paper is used to describe what types of diabetes there are, what symptoms to look for, treatments that are used, and information that is necessary to manage the disease in the classroom.

Pediatric Diabetes

Diabetes is a disease that affects women, men, and children of all ages. The disease causes the body to ineffectively use glucose, which is a sugar our bodies need for energy. There are two different types of diabetes, type 1 and type 2. Type 1 is not preventable and has no true evidence as to why or who will become susceptible. Type 1 diabetes isn’t contagious, so you can’t catch it from another person or pass it along to your friends (Dowshen, 2018). If a person is diagnosed with type 1 diabetes, their immune system goes havoc on the pancreas. The pancreas is what our bodies use to make insulin. Insulin helps get glucose into the cells of the body to form fuel and when the pancreas is being attacked by the immune system, the cells that make insulin are destroyed. Without enough energy the body cannot work properly, and organs will begin to shut down. Type 2 diabetes on the other hand can be prevented and tends to become an issue for obese children and adults. A person that becomes diabetic with type 2 have problems getting insulin to work correctly in the body thus, causing an abnormal amount of sugar to get into the blood. To much sugar in the blood can make a person very sick and even cause death. As a teacher, one must be aware of the signs, symptoms and management of such diseases to insure the health and safety of the students in which they teach.

Signs and Symptoms

Approximately 1 out of every 400 children is diagnosed with diabetes, particularly type 2. It is important that teachers be familiar with the signs, symptoms, and treatment of diabetes because of the number of children with diabetes continues to increase (Marotz, 2015, pp. 96). The symptoms of type 1 and type 2 are very similar. Type 1 tends to begin with the onset of a viral infection and rapidly takes over from there. Type 2 develops at a slower rate and can happen over a greater period of time. Regardless of the time it takes the disease to infect the body, early signs are helpful in determining treatment. Children that have been identified as diabetics reported having frequent urination, excessive thirst, and fatigue in the early stages. Teachers should make note of any student complaining of blurred vision, dry, itchy skin, and/or dehydration as these can be warnings that the child’s body is not working properly. Hair loss, rapid weight loss, and irritability are a few other common symptoms of the disease. By monitoring students and regulating children with diabetes serious complications can be avoided and may even save a life.

Teachers and caregivers should be educated on both types of diabetes. Not only the types of diabetes, but the symptoms of hyperglycemia and hypoglycemia are very important to learn for those caring for diabetic children and teens. When a person is familiar with the warning signs of hyperglycemia and hypoglycemia a child can be treated promptly. Hyperglycemia is a state in which blood glucose levels become too high. Frequent urination is a symptom of those that become hyperglycemic. The kidneys respond to high levels of glucose in the bloodstream by flushing out the extra glucose in the urine. A child with diabetes who has hyperglycemia may need to pee more often (Carakushansky, 2016). When a child urinates frequently, they can be pushing out more fluids than they are taking in which causes extreme thirst and/or dehydration. Many children begin to lose weight even though their appetite may rise. Due to the body not having enough insulin, muscle and stored fat begin to break down in an attempt to feed cells with energy. If a child’s body isn’t using glucose correctly, it can cause extreme fatigue.

Hypoglycemia on the other hand is the opposite of hyperglycemia. Blood glucose levels drop too low and cause symptoms to arise. Extreme hunger, cold sweats, headaches, and even seizures can be symptoms that appear when a child is hypoglycemic. Low blood glucose levels usually happen when meals are skipped, the intake of too much insulin, exercises more than usual, and during sleep, also known as nocturnal hypoglycemia. Kids who have nocturnal hypoglycemia may have bouts of crying, nightmares, or night sweats (with damp sheets and/or pajamas) and might wake up groggy or with a headache (Carakushansky, 2016).

Treatment

Each person that is affected by diabetes has an individualized treatment plan. The treatment plan needs to be readily understood by teachers, nurses and school personnel to insure students stay healthy while not in their parent’s care. Just as there are different types of diabetes, there are different treatments for each type. Kids with type 1 diabetes will need to take insulin throughout the day by either injection or pump. It is well advised for the teacher to learn how to administer the injection to a student in the case of an emergency. Parents of children with diabetes will relay special dietary plans and restrictions to follow while in school. Following the dietary plan is very important for the health of the student and should be taken into consideration when planning field trips and class parties. Checking blood sugar levels is mandatory in order to keep glucose levels in a healthy range before a meal and at the onset of a child not feeling well. Those with type 2 diabetes can be treated by making lifestyle changes and in severe cases oral medication. A health care provider has a number of different oral medications that can help either make, release, reduce, improve, or absorb insulin depending on the patient’s needs.

Management

Regardless of what type of diabetes a child has, there must be lifestyle changes that occur. These changes come from eating a healthy diet and becoming more active. Teachers should help to educate students on healthy eating habits and encourage physical activity whenever possible. Children and students may find it hard to follow such restrictions and limitations while at school among their classmates. The condition poses a significant challenge to children and adolescents as they find it difficult to follow the necessary discipline and change their lifestyles to control their diabetes. The disease is associated with numerous duties; those affected must regularly conduct blood glucose tests, follow a diet, and apply insulin therapy. All of these challenging aspects of diabetes may adversely affect relations with peers, lead to difficulties at school, impair the quality of sleep, cause mood swings, and disturb daily functioning (Czenczek-Lewandowska, et al., 2019). With that being said, teachers have to make sure they are encouraging positive behavior among students and keeping all children equally involved in school activities. Being mindful of meal schedules, length of outdoor play, and any extra activity that may cause the child to need more insulin can help a student from feeling restricted or excluded from other classmates. Teachers can be instrumental in helping children understand and learn about diabetes so that those diagnosed do not feel ashamed or embarrassed about their condition.

Summary

In conclusion, there are 29 million Americans living with diabetes. A recent study found that rates of new cases of diabetes in children and teens rose during 2002 to 2012. The researchers reported increases in the rates of both type 1 and type 2 diabetes (‘Diabetes Increases in Children and Teens’, 2017). With the rise in numbers of those affected by diabetes all schools should provide informative details and facts for their employees to better assist those living with the condition. There is no doubt one of the students in a classroom during a teacher’s career will have diabetes. A teacher should be educated on pediatric diabetes and learn how to best care for such students. Remember, communication between parents and caregivers is priority in regard to a child’s health and what is best for their medical needs. The importance of knowing the signs, symptoms, treatment, and management of the disease can save a student from having serious complications.

References

1. Carakushansky, M. (Ed.). (2016, October). Hyperglycemia and Diabetic Ketoacidosis (for Parents). Retrieved October 7, 2019, from https://kidshealth.org/en/parents/hyperglycemia.html.
2. Carakushansky, M. (Ed.). (2016, October). Hypoglycemia (for Parents). Retrieved October 7, 2019, from https://kidshealth.org/en/parents/hypoglycemia.html.
3. Czenczek-Lewandowska, E., Leszczak, J., Weres, A., Baran, J., Wyszyńska, J., Grzegorczyk, J., … Mazur, A. (2019). Sedentary behaviors in children and adolescents with type 1 diabetes, depending on the insulin therapy used. Medicine, 98(19). doi: 10.1097/md.0000000000015625
4. Diabetes Increases in Children and Teens. (2017, September 8). Retrieved October 7, 2019, from https://newsinhealth.nih.gov/2017/06/diabetes-increases-children-teens.
5. Dowshen, S. (Ed.). (2018, February). Can Diabetes Be Prevented? (for Teens). Retrieved October 7, 2019, from https://kidshealth.org/en/teens/prevention.html?WT.ac=t-ra
6. Marotz, L. R. (2015). Health, safety, and nutrition for the young child (9th ed.). Australia: Cengage Learning.

Business owners are constantly placing unhealthy, cheap snacks on the way out of stores to promote customers to spend a few extra dollars. Consequently, children are provoked by food cues, the sight of an item that initiates hunger (Keesman, Aarts, Vermeent, Häfner, Papies, 2016), which increases the amount of ‘junk-food’ they are consuming. Not only are Canadian parents spending more money, but the extra chocolate and candy negatively affects the overall health of their children by initiating weight gain and the onset of obesity (Kakoschke, Kemps, Tiggemann, 2015). The consumption of innutritious foods, one of the key factors of obesity, has various negative mental and physical health effects, especially relating to the heart. Subsequently, impulsivity plays a key role when purchasing ‘junk-food’ as it initiates a sudden desire for sweet or salty treats (CITE?), hence why businesses should promote healthy snacks that have several positive effects on the body instead of contributing to rising obesity rates. Business owners should be conscientious to the fact that obesity is a growing health concern in Canada, and they should choose to promote healthy snacks instead of feeding into the impulsivity of ‘junk food’ cravings. Canadian business owners should be prohibited from promoting unhealthy food at checkouts as it has negative health aspects and leads to childhood obesity.

Negative effects of unhealthy food

Firstly, eating unhealthy foods causes health problems, both mental and physical, for children. Although kids may not be purchasing ‘junk food’ directly, promoting unhealthy foods near the checkout of grocery stores can influence parents to purchase them for their children. Consumption of snacks that are high in sugar and fat can immediately affect the mood of an individual (Finch, Cummings, Tomiyama, 2019) and contribute to long-term health issues (Kelsey, Zaepfel, Bjornstad, Nadeau, 2014). Therefore, constant small doses of negative emotions, results in an overall negative lifestyle. A recent study highlighted that unhealthy comfort foods, which are thought to help with stress, in fact make it worse and have no psychophysiological stress reduction benefits (Finch, et al., 2019). Aside from the limited enjoyment at the moment of ingestion, unhealthy foods have no mental benefits and instead hinder the mental state of the individual. While some may view ‘junk-food’ as a mood booster, food should ultimately be considered to please hunger. Often when using food to alter emotion, the wrong dietary choices are made, and mental state is compromised. In addition, overconsumption often also occurs because an individual’s food consumption does not provide their body with adequate nutrition. Thus, overconsumption, especially of saturated foods that lack nutritional value, places children at a high risk for obesity. Lesser, Arroyo-Ramirez, Mi, Robinson (2016) conducted a recent study suggesting that overconsumption of unhealthy foods at a very young age can impede brain development, leading to irreversible changes. Proper child development is crucial for academic success and is not worth destroying for short-term satisfaction such as unhealthy foods. Parents should be aware of the frequency and amount of unhealthy food their children are ingesting because most kids are unaware of the health defects saturated foods have. It is the parent’s responsibility to provide a healthy lifestyle for their children so they can fully grow and develop without any unnecessary negative effects that will carry on and inhibit their future. Additionally, if parents are constantly persuaded to purchasing ‘junk-food’ for their children, consuming unhealthy food becomes a norm for their kids. Unhealthy habits should be avoided at all costs, especially for children, so it is important for parents to work on developing good habits on behalf of their children for future health and happiness. Despite any health concerns like diabetes and cardiovascular disease, it is crucial to implement healthier choices at a younger age because obesity may also affect quality of life, education and contribute to premature death (O’Neill, Kornas, Rosella, 2019). The last-minute promotion of saturated snacks in stores should be avoided so children can live happier and healthier lives without harming brain development and increasing the risk of obesity.

Negative effects of obesity – heart disease/CV

Furthermore, as Lesser, et al. (2016) stated, many unhealthy foods lack crucial nutrients that young children require to develop normally and are instead full of saturated fats and sugars. Excessive consumption of innutritious food can often lead to weight gain and obesity (Kakoschke, et al., 2015) which are precursors to type two diabetes, increased cancer risk, and cardiovascular disease (CV disease) (Kelsey, et al., 2014). Although it is not definite that all obese individuals will suffer from one of these health conditions, it does increase their risk significantly. Without the visual food cues of candy or chocolate at checkouts, any extra ‘junk-food’ that parents were not intending to purchase will not be bought as it will not be in view to grab or desire. Therefore, children will mostly be consuming what is available to them at home after their parents leave the store. Although some parents may still be purchasing other saturated food items that are promoted throughout the store, they will be avoiding one extra item that contributes to the health of their children. One unhealthy food item is not going to cause cardiovascular disease, however; once impulsively buying ‘junk-food’ becomes a habit, the accumulation of constant consumption impacts one’s health and increases the risk of CV. As stated by Ayer, Charakida, Deanfield and Celermajer (2015), obesity, which may derive from an innutritious diet, negatively effects the heart, one of the key organs in the body, leading to a “higher heart rate, greater resting and reactive hyperaemic blood flow, and larger brachial artery diameter”. These are all health indicators of CV disease and obesity in children that can be avoided with nutritious food choices. The heart effects of obesity are life threatening as they increase the risk of heart failure and stroke due to the altered cardiac structure through increased left ventricular mass and left atrial size (Ayer, et al., 2015). These heart defects can be developed during childhood as a consequence of a poor diet. It is important to avoid preventable bad habits in youth that could be detrimental in the future. As the heart is one of the body’s vital muscular organs, protecting and allowing it to perform its natural function at ease is an essential part of living a healthy life. Without the possibility of any inevitable health conditions, avoiding frequent consumption of unhealthy foods to prevent obesity ensures that the heart will remain in lifelong good health to provide the body with proper blood flow. Therefore, it is unjust for business owners to promote unhealthy foods at checkouts as it instigates poor dietary choices in children that can cause future detrimental health problems to their heart.

Positive effects of healthy food

Moreover, business owners should promote healthy foods instead of innutritious ones because of the benefits of a healthy diet. By enticing consumers with healthier food options, it shows that business owners care about the wellbeing of their customers and wish for them to live wholesome and happy lives. Recent research has proven that daily healthy eating can promote long term happiness (Wahl, Villinger, König, Ziesemer, Schupp, Renner, 2017), so when at the grocery store, customers should be reaching for healthier options opposed to innutritious ones. If business owners were to replace the sweet and salty saturated snacks with nutritious options like fruit at checkouts, customers would be more likely to reach for the healthier choice because it is now the item of convenience. Due to the new lack of unhealthy food promotion, individuals will also not experience any food cues that would suddenly make them crave an unhealthy snack. Aside from the improvement in diet when making healthy food choices, consumption of fruits and vegetables also reduces stress levels, especially when one feels that a desired saturated snack will positively reflect their mood (Finch, et al., 2019). Although many may believe that nutritious foods only have physical effects on the body like preventing weight gain and obesity, healthy choices also have mental effects. As Wahl (2017) highlighted, consuming fruits and vegetables results in greater overall happiness, so when one is in a state of stress and is turning to food for comfort, healthier options will have a much better impact on their mood. Business owners should consider the health of their customers when choosing which products to promote at checkouts. Choosing to replace chocolate and candy with fruits and vegetables would offer consumers greater happiness and a healthier lifestyle while still maintaining the convenience of purchasing an inexpensive snack. Additionally, successive consumption of healthy foods contributes to a longer lifespan by decreasing mortality rates by about 5% in women for “each additional daily serving of fruits and vegetables” (Finch, et al., 2019). Introducing a healthy lifestyle during childhood can contribute to lower mortality rates as an adult. As chocolate and candy are one of the last items customers view on their way out of a grocery store, this alters their mindset to crave a saturated snack and purchase one as well. Modifying product placement in supermarkets to having fruits or vegetables near exits initiates the thought of healthy food consumption. Therefore, gravitating customers towards more nutritious options and guiding them in the right direction of healthy eating during childhood can decrease future mortality risks. Furthermore, generally a parent would not discourage their child away from wanting to make more nutritious choices. By businesses placing healthy snacks at checkouts, children would become accustomed to seeing fruits or vegetables on their way out of the store; thus, they will be more inclined to ask their parents to purchase a healthier snack for them which would develop good dietary habits early. Store owners should rethink the commercialization of ‘junk-food’ and aim to promote healthier food options at checkouts such as fruits or vegetables.

Impulsivity

Furthermore, impulsivity plays a key role when purchasing “junk food” at checkouts because customers are generally not intending to buy an extra item until it is promoted at the last minute. Customers who are hungry will often unintentionally give in to the subtle promotion of unhealthy snacks because there is an indirect crave for high-caloric foods when in the state of hunger (Cheval, Audrin, Sarrazin, Pelletier, 2017). Despite all of their food already being purchased, customers will often still reach for the sudden impulsive option due to convenience. If businesses were to replace the chocolate and candy at checkouts will healthier ones, perhaps customers would reach for the more nutritious one instead, which would have positive health benefits. Constantly submitting to unhealthy desires in supermarkets accumulates and adds up financially as well as increasing the risk of obesity and other linked health effects. Additionally, those who purchase unhealthy food options are often already overeaters with high “indulgence” (Cheval, 2017). Thus, business owners are using their captive audience to increase their revenue through food cues which results in an increased consumption of highly saturated snacks. Children especially have a ‘sweet tooth’ and naturally gravitate towards unhealthy food (CITE) However, the more often parents purchase innutritious foods for their children, the higher possibility of overconsumption which can lead to weight gain and obesity. Continuously submitting to a child’s desires of saturated snacks results in a higher craving next time they are in the same position because their indulgence would increase as well. Business owners should eliminate the promotion of chocolate and candy at checkouts as it increases impulsivity and the risk of obesity. Subsequently, a study revealed that consuming food for comfort while in a state of stress actually has less stress releasing benefits than when out of the state of stress (Finch, et al., 2019). While some may think purchasing a chocolate will decrease stress or bring comfort to a screaming child at a grocery store, Finch, et al., (2019) stated otherwise. Purchasing food, the instant it is craved during a state of distress, has less of a positive impact on mood than if one were to wait. Even if one were to cave to their impulsive saturated food craving, the food choice should be rethought, and a fruit or vegetable should be considered instead. Children would be more likely to impulsively gravitate towards fruits or vegetables if businesses were prohibited from contributing to childhood obesity by promoting unhealthy saturated foods.

How businesses contribute to rising obesity rates

Lastly, promoting unhealthy foods in stores contributes to the rising rates of childhood obesity. A recent study indicates that adult obesity rates have almost doubled in the past forty years resulting in 25% of Canadian adults to be obese (Nardocci, Leclerc, Louzada, Monteiro, Batal, Moubarac, 2018). Thus, child obesity rates are also increasing because the children today are the adults of the future. If poor nutritional habits begin in a person’s youth, it is starting the next generations on the wrong path of an unhealthy diet that could continue throughout adulthood. By making positive food choices at a young age, both the mind and body will be healthy and the mindset of living a healthy lifestyle will also develop. Kakoschke et al. (2015) mentioned that society has created an ‘obesogenic’ environment where ‘junk-food’ is easily available, a result of businesses selling and promoting saturated foods. The rising rate of childhood obesity should alarm businesses to consider the layout of products. Placing unhealthy ‘junk food’ on low shelves near the store’s cash registers, is easily visible for children and triggers them to convince their parents to purchase. Although, banning ‘junk-food’ production would be quite extreme and drive many companies out of business, controlling product placement in stores would help limit saturated food consumption. By prohibiting companies from promoting unhealthy items at checkouts, sudden unintended purchases that contribute to weight gain would be avoided. Despite product placement, businesses also contribute to the portion size of packages. Aerts and Smits (2017) discuss the relation between larger package sizes and overeating. Often when consuming a chocolate for example, it is being eaten out of desire opposed to hunger. Therefore, one will continue to eat even when they are satisfied, especially when there are still contents left in the package. Companies will often promote a larger item at a better deal than the smaller size to encourage customers to spend a bit more money and receive more product. Although consumers may believe this is a better offer, the larger package size is unnecessary and will in fact negatively affect their health. The harmful effects of the saturated snack are not worth the short-lasting satisfaction during consumption. Canadian business owners are fueling bad dietary habits in young children by indirectly fueling child obesity rates through the promotion of unhealthy chocolates and candies at checkouts.

Unhealthy eating can be detrimental to a child’s growth and development which can inhibit their future health (Lesser, 2017). Consequently, Canada has made the prevention of obesity one of their top health concerns to decrease morbidity and mortality rates (Janssen, 2013). Therefore, companies should promote healthier dietary options so families can prepare nutritious food for their children at home.

References

1. Aerts, G., & Smits, T. (2017). The package size effect: How package size affects young children’s consumption of snacks differing in sweetness. Food Quality and Preference, 60, 72–80. doi: 10.1016/j.foodqual.2017.03.015
2. Ayer, J., et al. “Lifetime Risk: Childhood Obesity and Cardiovascular Risk.” European Heart Journal, vol. 36, no. 22, 2015, pp. 1371–1376., doi:10.1093/eurheartj/ehv089.
3. Cheval, B., Audrin, C., Sarrazin, P., & Pelletier, L. (2017). When hunger does (or doesn’t) increase unhealthy and healthy food consumption through food wanting: The distinctive role of impulsive approach tendencies toward healthy food. Appetite, 116, 99–107. doi: 10.1016/j.appet.2017.04.028
4. Finch, L. E., Cummings, J. R., & Tomiyama, A. J. (2019). Cookie or clementine? Psychophysiological stress reactivity and recovery after eating healthy and unhealthy comfort foods. Psychoneuroendocrinology, 107, 26–36. doi: 10.1016/j.psyneuen.2019.04.022
5. Janssen, I. (2013). The Public Health Burden of Obesity in Canada. Canadian Journal of Diabetes, 37(2), 90–96. doi: 10.1016/j.jcjd.2013.02.059
6. Kakoschke, N., Kemps, E., & Tiggemann, M. (2015). External eating mediates the relationship between impulsivity and unhealthy food intake. Physiology & Behavior, 147, 117–121. doi: 10.1016/j.physbeh.2015.04.030
7. Keesman, Mike, et al. “Consumption Simulations Induce Salivation to Food Cues.” Plos One, vol. 11, no. 11, July 2016, doi:10.1371/journal.pone.0165449.
8. Kelsey, Megan M., et al. “Age-Related Consequences of Childhood Obesity.” Gerontology, vol. 60, no. 3, 2014, pp. 222–228., doi:10.1159/000356023.
9. Lesser, E. N., Arroyo-Ramirez, A., Mi, S. J., & Robinson, M. J. F. (2017). The impact of a junk-food diet during development on ‘wanting’ and ‘liking.’ Behavioural Brain Research, 317, 163–178. doi: 10.1016/j.bbr.2016.09.041
10. Nardocci, M., Leclerc, B.-S., Louzada, M.-L., Monteiro, C. A., Batal, M., & Moubarac, J.-C. (2018). Consumption of ultra-processed foods and obesity in Canada. Canadian Journal of Public Health, 110(1), 15–16. doi: 10.17269/s41997-018-0142-6
11. O’Neill, M., Kornas, K., & Rosella, L. (2019). The future burden of obesity in Canada: a modelling study. Canadian Journal of Public Health. doi: 10.17269/s41997-019-00251-y
12. Wahl, D. R., Villinger, K., König, L. M., Ziesemer, K., Schupp, H. T., & Renner, B. (2017). Healthy food choices are happy food choices: Evidence from a real life sample using smartphone based assessments. Scientific Reports, 7(1). doi: 10.1038/s41598-017-17262-9

Teen suicide is a major epidemic of teenagers today. It is the third leading cause of death in all teens ages, 15-19, and the second leading cause of death in ages 19-24. Everyone feels overwhelmed by difficult situations sometimes. Many people put their problems in perspective and find a way to go with their life, but many are too depressed so they take their life. Despite age, gender, or race, teens go through so much and trying to maintain a high school reputation doubles the stress.

According to the Washington Post, “When a teenager or child talks to a parent about mental health concerns or thoughts about suicide, the best thing to do is to listen.” No one knows what a teenager is going through unless you are listening to what they have to say. Teens may be dealing with physical abuse, poor relationship with their parents, feelings of agitation, and sexual identity in an unsupportive family. Most of the time, teens do not want to talk with anyone because of the embarrassment that they feel. Many parents are scared and worried about suicide, and it is hard for parents not to let their own feelings take over when their child informs them that they are suicidal. So, what parents can do is ask clarifying questions, such as; “ How often do you feel this way ?” or “ What do you mean when you say suicide ?”. One could also figure out a communication system that works for them. A treatment plan or a family doctor may help with problems that a teen may be facing. Thoughts about suicide should always be taken seriously.

Bullying has been around for a long time, but the negative influence that it has on society is becoming overwhelming. Bullying can occur anywhere, from work to the store, but its main place is at school. Bullying in school is a major concern. Some of the negative influences of bullying are depression and anxiety in students, which is causing them to be drug addicts. Also, bullying is one of the major causes of suicide among teens in the United States. It’s always the quiet ones that get bullied. Many teens are being bullied because of their intelligence, and their social and economic status. Teens should never have to be bullied because of their status in society. Most bullies bully because they would like to keep their status in High School. The bully may have been through a lot growing up and feels as if it’s only right so they can keep their status. If a teen is being bullied, the school administrators and teachers should ask the student if they are being bullied or if they need to talk if they are being bullied.

Although bullying is the first leading cause of teen suicide, one may also be physically abused at home. A teen may feel as if they’re not special or feel unwanted because people at home have been abusing them. They feel as if they have no one to talk to because of the feeling of being judged. One day, they will get tired of being hit, slapped, and talked about so their next step will be suicide. No one understands how something like this can affect a person this way, but everyone doesn’t have the same mentality as someone who does get bullied or physically abused. The feeling of leaving the house every day will be a relief to the teen. This has been proven to be true because when you get out of a negative environment, you tend to feel better about yourself.

Research has shown that teens who hide their sexuality have a higher suicide risk. This is relevant to today’s society because there are a lot of teens who are dealing with gender and sexual identity issues. As a parent, it is a good thing that you let your child know that it is alright for them to talk to you about identity confusion. No matter if their gay, straight, or bi they are still your child and should be accepted the way that they are. Identity confusion can bother someone who is suffering because they are confused and don’t have anyone to vent to. One can also be bullied at school because of their preference. They get called names, such as; “Faggot”, “Punk”, or “Sissy”. These are hurtful words that can trigger someone to want to harm themselves, especially if they are being bullied. If someone is being bullied because of their sexual preference, they should talk to a school counselor because this type of bullying can be stressful. Bullycide is real and shouldn’t be left alone.

Some kids might also be insecure about their weight and feel as if they’re not skinny enough or they’re too skinny. Some may suffer from anorexia, which is an eating disorder that makes you obsessive about your weight. Teens may try to starve themself since they are insecure about their weight, and that can cause stress and low self-esteem. Suicide is something that can be prevented if teens are comfortable enough to vent and talk to adults who can help guide them in a challenging situation.

Studies have proven that suicide can run in the family. Just as depression, a major cause of suicide, can be passed down from one generation to the next. If one has close family members that deal with depression, it is a natural progression from the thought to action. This makes sense when you consider that when in depression, one has lost all sense of hope of a positive future. An individual may feel stuck, exhausted, and completely disconnected from everyone around them. When those thoughts occur, their next thought is suicide.

After the teen has killed their self it is the police’s job to investigate and look into what provoked it. In many cases, everyone is a suspect. It’s never one person who may provoke someone to want to commit suicide. It all ties with bullying in the schoolhouse, and what may happen outside of school. Some police officers report to the school or the home to find evidence or any such to find what may have caused the teen to be suicidal. Sometimes the lack of parenting and agitation can also bring about the reason for suicide. Some may feel as if they are a burden on their parents and that their parents aren’t around as much. Having to work, pay bills, and raise children can be hard for some parents and if parents are always at work; the child may feel like they are alone or raising themself. This has become a problem in today’s society and this is why a lot of kids are turning to suicide.

As a teenager, some kids get caught up in believing that the person that they meet in high school is who they are going to spend the rest of their lives with. Some people may kill themselves because they feel like if they can’t have the person that they want then they feel as if it’s no purpose in living anymore. It may seem crazy, but some people rather have a companion than be alone their whole life. Heartbreak and love can kill a person.

Suicide is real and it can bring heartbreak to many families and friends. Teen suicide is one of the leading causes of death in teens and adults. As parents, teachers, and friends, we should come together to talk to teens nowadays because no ones knows what someone can be dealing with unless we are there to comfort and support their decisions. There are plenty of suicide lines and prevention programs that can help in a crisis.

Since 2000, obesity in America has increased by 40 percent (Brown,2003) More than 45 percent of American children are currently either obese or morbidly obese. This does increase in obesity among children has been caused by A, B and C. and into today’s world obesity is among children, adolescents have emerged the worldwide prevalence of childhood obesity has increased strikingly over the 3 decades. (1) obesity is a multi-factorial condition and has been described as a phenotype of numerous pathological. the diagnosis for diabetes is very serious matter to watch out for. studies have shown that overweight and obesity in the pediatric group and highlights. I think that diabetes is something that should be taking as very serious disease without any major issue with people’s in society where food comes from in such abundance, people are overeating and compared to the 21st century. Only 5% of the population. Which is only about five percent that diabetes. Today that number has nearly double and continue to do so. In order see a different change in obesity for children because the increase in childhood obesity has been caused by a dependence on fast foods, a decrease in physical activity, and hormones in our food system. One cause of increase in obesity among children is a growing dependence on fast food in the US.

diabetes can destroy a child’s health by not getting the necessary antibodies that’s needed for the body to get stronger each and every day. diabetes can be contained with the right diet, exercising and with right meals everything will alright from this point moving forward. Obesity is a complex, multifactorial condition affected by genetic and non-genetic factors. Figure 1 outlines the determinants of pediatric obesity. In children and adolescents, the overweight state is generally caused by a lack of physical activity, unhealthy eating patterns resulting in excess energy intake, or a combination of the two resulting in energy excess. Pediatric obesity is also a multifactorial condition which is a resultant of genetic and non-genetic factors and the complex interactions among these. Genetics and social factors socio-economic status, race ethnicity, media and marketing and the physical environment also influence energy consumption and expenditure. Obesity seems to be the result of a complex interplay between the environment and the body’s predisposition to obesity based on genetics and epigenetic programming. To date, research has been unable to isolate the effects of a single factor due to the co-linearity of the variables as well as research constraints.

Specific causes for the increase in prevalence of childhood obesity are not clear and establishing causality is difficult since longitudinal research in this area is limited. The heritability of body weight is high and genetic variation plays a major role in determining the interindividual differences in susceptibility or resistance to the obesogenic environment Appetite regulation and energy homeostasis depend on a large number of hormones many of which are secreted by the gastrointestinal tract (9). Ghrelin is currently the only known appetite-stimulating orexigenic gut hormone, secreted by the oxyntic glands of the stomach. Ghrelin levels rise shortly before mealtimes. The other gut hormones identified to date are anorexigenic (decrease appetite and food intake). These include: peptide tyrosine pancreatic polypeptide, oxyntomodulin, amylin, glucagon, glucagon-like peptide and. For example, PYY acts as a satiety signal. The levels of PYY rise within 15 minutes after food intake, resulting in reduced food intake

The gastrointestinal tract is the body’s largest endocrine organ producing hormones that have important sensing and signaling roles in the regulation of energy homeostasis There are several determinants or risk factors for development of pediatric overweight or obesity. These can be categorized.

I think that child obesity would be a lot different if the children were provided with healthy meals each and every day because eating un healthy can cause a lot of health problems to the body altogether. it’s up to the parent to do the right thing here a lot of kids suffer through obesity throughout the United States and that’s why kids deal with obesity on a regular basis because they don’t get the right medication that’s needed for them take whatever time is doable. Because diabetes is a disease that cause flair ups and won’t even know it. I think it’s better to make a chart to try to manage the children’s diabetes I think it will make all the difference in the world. Diabetes among children can be manageable with a meal plans for each day of the week. Dietitians would recommend some kind of meal plan to be setup for children so that parents can decide on how to work with this throughout the whole year.

There are various strategies that can be used towards the management and control of diabetes among children and adolescents in the United States. One of the most realistic strategies for the reduction of the condition is subjecting children to constant screening tests to ascertain the severity of the medical condition. This can be undertaken by taking them through blood sugar tests. Children that are highly predisposed should be subjected to these tests to reduce the risk of attack by the condition that is likely to reduce the quality of life. It is also important that proactive measures are undertaken towards the control of the condition. This can include a complete change of lifestyle toe embrace a healthy living. The weight of children should be managed by ensuring that they undergo exercises. This can reduce the prevalence of obesity that is likely to lead to the diabetes condition among children. Embracing a healthy eating is also an essential step that can promote the health of children. This can be through promoting good nutritional habits among children and adolescents. NDEP, (2014).

References

1. PCRM. Nutrition for kids, a Dietary Approach to Lifelong Health. The Physicians Committee for Responsible Medicine.
2. NDEP, (2014). Overview of Diabetes in Children and Adolescents. National Diabetes Education Program.

In the article titled, “Developing Sustainability” a website called Feed My Starving Children (FMSC) focuses on considering at working together to provide FMSC Mannapack meals it is creating food security to help communities and families that can’t be able to afford food; in fact, individuals will recover their steadiness to supply for themselves continually. The webpage addresses it is troublesome to ensure future generations do not go hungry; although, (FMSC) created various sustainability programs to work toward poverty alleviation.

Furthermore, the article presents (FMSC) distribution partner with the Project-Based Food Assistance (PBFA) its mission is to decrease hunger-related illness and financial burden on individuals within a specific region come together to help their community. Overall, (FMSC) website discloses they trust that food support and community growth work collectively to climb out of the state of living poor and self-sustaining. As a result, (FMSC) closes off with hope starts with providing nutritious (FMSC) meals to children and families who don’t have a sustainable food source.

When evaluating this source, I considered its currency, reliability, authority, and purpose. The article is quite recently it has been published in 2019, so it is new and suited to current writing ideas. (FMSC) uses data and statistics to include in the article. The writer maintains credit to “World Health Organization’s for Body Mass Index” to assess data which describes that 35% of children were malnourished; to illustrate, midway through the resourcefulness, the percentage decreased to 24%. As with (FMSC)’s interest, through (FMSC)’s Project-Based Food Assistance want to make it possible to completely change lives, to rise out of poverty and have people to become self-reliant.

The source is an influencer persuading to make a change, work together to alleviate poverty, support sustainability, and move the communities they serve toward self-sufficiency until all are fed. Importantly, the Project-Based Food Assistance organization is an implementer who seeks opportunities to enhance their relief and development activities while others are ”solution providers,” who are subsistence agriculture, education, and spiritual development.

Feed My Starving Children (FMSC) contributes and supports the point that I am to establish in my essay: that (FMSC) makes great efforts to serve each community according to its needs and resources, with the goal of helping people to grow on their own. Unlike crisis-drive relief agencies, (FMSC) and its other organizations never leave behind its communities for the long haul, helping them move from relief to rehabilitation to development. It is extremely difficult to grow an individual living and community sustainability while struggling with malnutrition; while many families fall short on food sources. FMSC Mannupack acts as a direction with increasing local food protection to secure later coming generations do not go starving. Food Aid is necessary for families and populations to move out of hunger and starvation into better quality conditions.

Is obesity a threatening or non threatening disease? This issue has been a problem not just for the United States but around the world. The dictionary definition of obesity is “condition of being grossly fat or overweight.” Symptoms can include pain in the back or joints, binge eating constantly, fatigue, pot belly, and snoring. The simple treatments for obesity are pretty clear physical exercise and changing your diet. Obesity has been linked to many tragedies such as: obesity effects 1 in 6 children in the United States, Obesity is linked to more than 60 chronic diseases, and obesity causes more deaths than being underweight. I believe that obesity is a threatening disease, and will become more lethal if we don’t take action now. While obesity is a very serious matter, there are some who will argue that obesity isn’t a serious matter and that it shouldn’t be taken seriously. In this paper I will explain and tell you why obesity is a very serious matter.

Obesity has recently been linked to having effects on the brain. There was a article I found which discussed the effects of obesity on the brain. The article talks about how food specifically junk food has a big impact on obesity around the world, the article also talked about how the brains circuits react around different food scenarios (Shell and Ruppel, 2019, p.38-45). Kevin Hall, who works at the National Institute of Diabetes and Digestive and Kidney Diseases, has done some experiments where it shows that the food that we eat, pulling it apart and making these sweet snacks is the reason that obesity rates have risen (Shell and Ruppel, 2019,p.38-45). Hall conducted two experiments where he studied if carbohydrates do play a role in weight gain (Shell and Ruppel, 2019,p.38-45). He had participants stay in the hospital for a few weeks controlling what they ate. At the end of his first experiment the conclusion was that reducing carbohydrates didn’t help in weight or fat loss (Shell and Ruppel, 2019, p.38-45). His second study which showed a new reason for weight gaining was due to the fact that people ate more of ultraproccessed foods then unprocessed when they should’ve been eating as much or little.

Participants who ate the ultraproccessed foods gained two pounds in two weeks.(Shell and Ruppel,2019, p.38-45). Barry M. Popkin who is a professor at the university of North Carolina described Halls experiments “ seminal, really as good as a clinical trial as you can get”(Shell and Ruppel, 2019,p.38- 45). Dana Small who is a neuroscientist at Yale University, has researched why people tend to use substitute foods instead of real foods. She studies the impact of food environments on the brains circuits (Shell and Ruppel, 2019, p.38-45). Small says “If the brain doesn’t get the proper metabolic from the gut, the brain doesn’t know what food is in there” (Shell and Ruppel, 2019,p.38-45). Small did a neuroimaging studies on the brain that showed the sensory cues (smells, color, and texture) that entail with high calorie foods which activate the striatum a decision making part in the brain (Shell and Ruppel, 2019, p.38-45). Small says “This is the where ultraproccessed foods become a problem” (Shell and Ruppel, 2019, p.38-45). As you can see in the article, the brain plays a big role in what we decide goes into our stomachs and that Hall’s experiments actually helped us understand why people tend to gain double their body weight.

Everyone doesn’t want their kid to be overweight let alone obese, obesity is starting to affect young children starting at the age of 2. This article focuses on the increasing rate of obesity of children, while leading them to be bullied and discriminated (Mithers and Lynn, 2001, p.108). It starts off by first explaining how obesity rates in 1960 children ages 6-11 were only four percent obese, in 1980 it spiked to seven percent, and by the early 1990’s it was at thirteen percent (Mithers and Lynn, 2001, p.108). According to Gerald Berenson M.D.” a 10 year old whose fifteen pounds over their weight limit will have high blood pressure and cholesterol levels and low levels of HDL (good cholesterol)” (Mithers and Lynn, 2001,p.108). “Even with kids ages 2-5, being overweight is linked to elevated blood pressure” says Dr. Williams (Mithers and Lynn, 2001,p.108). The health problems overweight children aren’t just physical but verbal and mental (Mithers and Lynn, 2001, p.108). William Dietz M.D. director of Nutrition at the CDC, explains that overweight kids “become early targets of systematic discrimination while also being associated with laziness and sloppiness” (Mithers and Lynn, 2001, p.108). I found this article to be very interesting, I had no idea that obesity could effect children s young.

Over the years obesity has grown to become the number one public health hazard in the United States. The article focuses on obesity in the US with accusations towards the government having exaggerated the obesity epidemic (Gibbs and Wayt, 2006, p.76-83). The National institute of Health said that “ excess body weight during midlife including overweight is associated with death” (Gibbs and Wayt, 2006, p.76-83). In 2005 journalist Jay Olshansky and David B. Allison explained that due to the obesity epidemic “ the steady rise in life expectancy during the past two centuries may come to a end soon” (Gibbs and Wayt, 2006, p.76-83). The article also talks about how scholars who are overweight blame public health officials and the media for exaggerating obesity (Gibbs and Wayt, 2006, p.76-83). Campos who is a professor of law at University of Colorado Boulder says “ health professionals are giving advice to maintain a BMI (body mass index) in the ‘healthy weight’ range that is impossible for individuals to maintain” (Gibbs and Wayt, 2006, p.76-83). Oliver who is a political scientist at the University of Chicago explains that “ small groups of doctors and scientist who are all funded by either the government or the weight loss industry, have created a very unrealistic definition of obesity” (Gibbs and Wayt, 2006, p.76- 83). He goes on to explain “ They have inflated claims and distorted statistics and they have ignored the complicated health realties associated with being fat” (Gibbs and Wayt,2006,p.76-83). The article shows how obesity has affected many lives and explains why the government and health officials aren’t taking the matter seriously.

You would think everyone wants to keep their weight in control and not become overweight or obese, I did say there were some people who do not see obesity as a serious matter. This article talks about how society attempts to scold “fat and unhealthy” people are only relevant if they engage in some sort of physical activity (Bogart). Laura Bogart explains that being fat doesn’t result from moral values, that it can be a reflection of someone’s individual character (Bogart). Bogart explains that due to her catastrophic injury, budget, and work that she is overweight and should not need any sort of defense (Bogart). Virgie Tovar says that “ There is incredible cultural impetus to be ‘healthy’ and ‘health’ is framed by a personal/individual responsibility” (Bogart). Bogart talks about when she broke her ankle, she spent two months in bed and when she started her physical therapy that she had to use a cane because of the weight she gained (Bogart). She explains how she wasn’t the “good fatty” no more, due to the fact she was eating all junk food while sitting on the sofa, then se realized something (Bogart). She realized that she became more in touch with herself as her walks became shorter and after coming home from working eight hours she managed to finish the first draft of her book (Bogart). One day when she went to a neighborhood picnic one of her neighbors said “ Honey I used to see you walk all the time ” (Bogart). Bogart simply replied with “ I don’t care” (Bogart). As you can see Bogart doesn’t seem to care about her weight anymore because she thinks that doesn’t define a individual, she thinks that everyone’s appearance shouldn’t be based upon their waist size or bra size.

Obesity is already the number one health hazard in the United States, while some may brush it off and say “ I don’t care”, they very much should care. If we don’t take action now this could just be as bad as the HIV epidemic back in the 1980’s. Parents and children should all educate themselves on diet and some sort of exercise. The government should be advocating to the schools and weight loss industry to push these ideas first. If you have seen the Disney movie Wall-e, that is how our future generations will end up looking like. I myself used to be obese after high school due to sports injuries, I turned to fast food and in 2 years I gained almost 100 pounds. Since then I have gotten back into a moderate diet where I still treat myself every now and then while also hitting the gym 5 times a week maximum. It is possible to be done and everyone just has to commit both mentally and physically

Obesity is a worldwide epidemic that effects many people all across the globe. Obesity is a slow onset of gaining weight, that is defined as having a body mass index (BMI) of 30 and above that happens from improper nutrition and inadequate exercise. It can be prevented by many different ways such as teaching on what a proper diet entails, promoting and practicing a proper diet, being surrounded by positive influences, and maintaining a healthy lifestyle with exercise. Obesity comes with many different types of health problems from chronic to acute such as: diabetes, high blood pressure, coronary artery disease, coronary vascular disease, heart attack, stroke, and even cancer. Not only does obesity affect you, it affects all the people you surround yourself with. It can be a major influence on friends and family by promoting a non-healthy lifestyle. With parents, this issue is very important, because children are highly susceptible to this influence. Children are very impressionable, and the people whom they surround themselves with have a major impact on their personality, preferences, hobbies, and more importantly, lifestyle choices. For children, who spend most of their time with their parents and usually rely on their parents for providing for them and guidance, this issue can life changing impacts on them. So, the PICOT question to be researched is: Does obesity in parents have effects on their children?

To try to answer this PICOT question Gogia, Begum (2018), researchers who are specialized in pediatrics and an assistant professor at respected universities, conducted a quantitative pre and post experimental convenient sampling study design to study the effectiveness of occupational therapy in homes with children that are overweight and obese and its impact on their quality of life. The study was conducted by taking a group of 30 obese and overweight children and “Each individual was then evaluated for B.M.I and Weight. Each individual responded to PEDS QL and ROSENBERG SELF ESTEEM SCALE. Each subject was provided 45 min of 5 days a week of occupational therapy intervention and an Occupational Therapy based Self-instructional Module. The subjects were reevaluated using PEDS QL and Rosenberg self-esteem scale. Post assessment was done after 4-week intervention programme, conducted 20sessions” (Gogia, Begum, 2018, p. 167). The independent variable of this study was occupational therapy intervention and the dependent variable was obesity and self esteem. The researchers did not list any limitations but some limitations I could see would be that there could be some inconsistency with the type of occupational therapy interventions. This could lead to false results of the research because some interventions might be more influential than others. The results showed that not only does occupational therapy improve overall quality of life, but it promotes a better lifestyle for both the parents and the child. The parents learned a lot by this study by how to prevent and treat obesity of their children, since they have the most impact on their lives. Gogia, Begum (2018) state “It is concluded that occupational therapy addresses the prevention and concerns of obesity through a holistic and client centered approach to lifestyle through participation in activities that promote health” (p. 169). It is believed that this research was done to show both parents and children the proper lifestyle and actions to take to prevent and treat childhood obesity.

The second study presented by Li et al. (2018), is a qualitative study conducted by a variety of doctors, professors, and researchers. The phenomenon of interest Li et al. (2018) is trying to investigate is “the parental and child contributions of 83 adult body mass index (BMI)-associated single-nucleotide polymorphisms (SNPs) to obesity-related traits in children from birth to 5 years old” (p. 133). In simpler terms, the researchers were trying to find a correlation between genetics of parents and its influence on the child and their risk or contributions to obesity. This question of its influence or not was tested by “A total of 1402 individuals were genotyped for 83 SNPs. An unweighted genetic risk score (GRS) was generated. . . Repeated weight and length/height were measured at birth, 1, 2, 3 and 5 years of age, and age-specific and sex-specific weight and BMI Z-scores were computed” (Li et al., 2018, p. 133). The researchers listed that there were no limitations to their study but if I were to expect any limitations I could see calculations being a limitation. After reading this study, it is shown that this genetic and BMI testing requires a lot of calculations, which in turn can be at risk for miscalculations and errors. The key findings and results in summary showed that the genes tested that were contributing to parent’s obesity influence their children at birth and in early childhood (Li et al., 2018, p. 133). Results of this study show that only does the lifestyle and diet of a parent have effect their child in the household, but so does the genes they carry. This study can be an opportunity for parents to see that their obesity can have an effect on their child even before they are born.

The final study to investigate into the PICOT question is one done Vaughn, Martin, Ward (2018) and investigates the model parents need to be for their kids to promote a better lifestyle. These researchers both had the titles of professors or faculty at respected universities and conducted a quantitative study. The study “. . . examined the influence of parents modeling of healthy eating (“parent role modeling”) and parents’ actual food intake (“parent dietary intake”) on child diet quality, and explored whether these practices work together to influence children’s diets” (Vaughn, Martin, Ward, 2018, p. 102). The sample groups were chosen by having the criteria of having at least one overweight or obese parent in the household of a pre-school age child that from being chosen from a baseline of another larger previous study. Vaughn, Martin, Ward (2018) tested this influence from parents to kids by using “The Comprehensive Feeding Practices Questionnaire” (p. 102) to observe the parent’s practicing healthy eating patterns and exam their food logs. After three days of observation “Associations between parent healthy modeling and parent Healthy Eating Index (HEI) score on child HEI score were examined. . .” (Vaughn, Martin, Ward, 2018, p. 102). The variables of this study included the independent variable being the parents’ healthy modeling and HEI score and the dependent variable being the children’s HEI score. Vaughn, Martin, Ward (2018) listed the limitations as “. . . the cross-sectional nature of the data, the reliance on parent report, and characteristics of the study sample” (p. 106). The scale used for this type of model of study was believed to be to small or narrow of a focus and that is why it is listed as a limitation. The results and conclusion gathered by Vaughn, Martin, Ward (2018) showed that “Children whose parents had high parent healthy modeling scores had higher HEI scores. . .” (p. 102). This study proves that the parent’s model of healthy lifestyle and diet played an important role in influencing the child.

References

1. Gogia, R., & Begum, R. (2018). To study the effectiveness of occupational therapy in children with overweight/obesity and its impact upon quality of life. Indian Journal of Physiotherapy and Occupational Therapy – An International Journal, 12(4), 166-170.
2. Li, A., Robiou-Du-Pont, S., Anand, S. S., Morrison, K. M., Mcdonald, S. D., Atkinson, S. A., . . Meyre, D. (2016). Parental and child genetic contributions to obesity traits in early life based on 83 loci validated in adults: The FAMILY study. Pediatric Obesity, 13(3), 133-140.
3. Vaughn, A. E., Martin, C. L., & Ward, D. S. (2018). What matters most – what parents model or what parents eat? Appetite, 126, 102-107.

Introduction

This report will be discussing eczema in children, specifically causes and treatment of eczema. According to James McIntosh (2017) eczema is defined as a condition where the skin becomes inflamed, flaky and red causing the child to be itchy and can sometimes result in bleeding. The main aim of this report is to determine whether eczema can affect a child’s life in terms of sleeping patterns, sleep quality and sleep deprivation, and the effects these will have on the child daily. This report will also discuss factors that could affect the severity of eczema e.g., gender, age and ethnic background. To fully understand eczema, this report uses articles, journals and medical definitions in order to fully explain what eczema is. Eczema can interfere with a child’s life so its important for others to understand this for people to become knowledgeable and more understanding.

Background

According to Thomsen (2014) there are different types of eczema, atopic eczema being the most common, although not easily manageable there are many ways of treatment. This condition affects one fifth of individuals in their entire lifespan. Between 1950-2000 eczema had become an epidemic which was labelled the “allergic epidemic” due to pollution from industrialisation, causing allergies. In developing countries there are higher chances of developing the disease due to poor sanitation and pollution from factories. The effects of eczema in children up to the age of 11 years is from 5%-20%. Research suggests that this causes severe disruption to the child and their families, which leads to stress and anxiety. According to Tennesy et al (2019) this also has an impact on the health care system. Research suggests that a study conducted by Ninan and Russel, showed a high rate of atopic eczema over the past 30 years, therefore from 1964-1989 there was an increase to 12% from 5.3%. In a Danish study, research suggests there was a 3% risk of developing eczema between the ages of 0-7 between 1960-1964 birth cohort compared to 1970-1974 which was 10%. However younger children may be affected by food allergens which contribute to their atopic eczema. Teenagers are affected by allergens caused from grass, pollen, birch and dust. 7.4% of teenagers are triggered by cow’s milk and eggs from hens Ricci et al (2011). Eczema in adulthood is less common than in childhood, this is due to the disease not being cured in childhood and progressing into adulthood. In adults, eczema can also be caused by smoking Lee C H et al (2011) this suggests that passive smoking in childhood leads to onset of adulthood eczema. Research suggests that eczema is a genetic disorder passed down to families via genetics. A questionnaire was conducted by professional networks who were recruited by collaborators, to do research in different countries where a selection of children aged 7 years completed the questionnaire describing their symptoms and 13-14-year-old children completed their questionnaires in their classrooms. In result of the questionnaires, researchers found that in a particular population; the number of cases of atopic eczema were higher in countries like Urban Africa, Australasia, The Baltics, Northern and Western Europe (above 15%) and the lowest was found in Eastern Europe, China and Central Asia (under 5%) (William H et al 1999).

Given that the main cause of eczema is currently unknown, researchers and scientists have found a link between genes that are passed on from parents and asthma. So, families that have 1 parent with eczema or asthma are more likely to inherit eczema National Health Service (2019). Eczema makes it so that the person cannot keep enough moisture in their skin making it dry and flaky causing irritation and the child itches as a result. Other causes could be a problem with the immune system and even the environment can cause eczema Stephanie Watson (2017). This is relevant to sleep deprivation as the itching can be very irritating and can persist for hours, leaving the child itching more than they sleep, which can have numerous impacts on their day; for example, being too tired to be able to take part in school activities, having to leave constantly to moisturise, pain and bruising on bad days. Research shows that children with eczema are more likely to suffer from depression and bullying along with social withdrawal, changes in eating patterns and irritability National Eczema Association (2020).

As eczema effects between 15-20% of children in the UK (Hoare C 2000), there are many types of treatment as eczema affects so many, some of the treatments are simple, for instance: moisturising many times throughout the day, or avoiding trigger foods or limiting how much skin irritants you use e.g. fabric softener. However, for people who do not show improvement with simpler treatment, need stronger medication called “corticosteroids” this help reduce inflammation of the skin and comes in different dosage levels from over the counter to prescribed by a professional. However, some people with eczema do not show any response to these types of medicines and must undergo more serious measures, for example phototherapy, which uses UV light. UV light can help stop the skin from overreacting but too much exposure can age the skin which increases likelihood of skin cancer in the patient, so professionals minimise the exposure to reduce the risk of causing cancer. But there is another type of treatment called PUVA treatment that uses psoralen, a medicine that must be prescribed making the skin more sensitive to the UV rays in an attempt to heal the eczema however this also increases sensitivity to UV light in the environment also meaning that you are more at risk from getting skin cancer (Gardner 2020).

Methodology

To collect information, doctors reports, journals and experiments were taken into account, these were chosen as doctors reports are overseen, reviewed and corrected by other doctors that have first-hand knowledge on eczema, as far as reliable goes they had the highest reliability in the matter. Then articles were taken into consideration after doctors reports as sometimes articles can be altered by the public which is not reliable as the information might not always be correct. In addition, some of the articles were written over 20 years ago, therefore it is hard to ensure that all the information in the articles match up today (in terms of quantitative data/statistics) due to advancements in medicine. Most of the data collected is qualitative as eczema is a subject where pain can alter from person to person, meaning questionnaires can only give a rough measure, therefore quantitative data was required to set a standard and use qualitative along side other pieces of data.

Case study

This case study will be focussing on eczema in boys compared to girls, covering topics such as which gender develops eczema faster, who is more effected by eczema and if ethnic background of the child has any link with eczema. However, to fully understand eczema, its necessary to understand that there are many types but for this report, atopic eczema will be considered the main type, any other form of eczema for this report will be addressed as non-atopic eczema. A German study, investigated whether sex of the child had any effect on the type of eczema on children aged 5-7,the process consisted of a full dermatological exam along with a questionnaire that the children filled out, the tests used skin samples and used the 5 most common triggers that can cause a flare up (Morenschlanger et al 2000). Out of the 2693 girls examined 8.7% of them had exhibited signs of irritation on the first day of experimentation; regarding the boys (2783) 6.1% of them had portrayed signs of irritation on the first day. Therefore, regarding who is more likely to get irritated first from the most common irritants, the scientists were able to conclude that in their sample it would be the girls. The scientists were also able to link this with early onset eczema, suggesting that girls who already had eczema who were under the age of 2 had a strong link to atopy in children aged 5-7, but girls who developed eczema after the age of 2 didn’t have a link to atopy. In simple terms, girls who had eczema from age 0-2 are more likely to develop atopic eczema, but girls who developed eczema after the age of 2 are less likely to have atopic eczema later in life. The study also showed that there were more boys who had developed atopic eczema, with a ratio of 28.3%:20.6%. Assuming if both genders had a similar lifestyle, boys are more at risk of developing atopic eczema but did not have a link to early onset eczema like the females in the sample. The investigation was able to reveal that atopic and non-atopic eczema develops in girls and boys differently, whereas boys are more likely to exhibit atopic eczema, girls predominantly are impacted more by eczema that is not related to atopy. The report was also able to determine that different lifestyles also have an impact on eczema as the girls in the sample predominantly played inside which is more related with eczema (Noiesen et al 2008).

Although atopic eczema can affect anyone, studies have found that it is most common in people with African descent, with 19.3% African American 16.1% Caucasian and 7.8% Asian (Kaufman, 2020). However, another study showed that African Americans are 1.7 times more likely to develop more serious cases of atopic eczema as shown below.

The figure shows prevalence of more serious cases of eczema, the darker shades show geographically where the worst cases are in the world and the darker shades are situated around Africa with some also in South america and the UK (Brunner, 2018). Certain races and ethnic backgrounds are more susceptible to atopic eczema if their lifestyle and family history is associated with atopic diseases. As genetic mutations occur,this can effect skin cells and if the person is able to survive it means they are able to reproduce making the genes with atopic eczema more easy to pass onto their children, which is the theory of evolution, as proven by Charles Darwin (1859). Mutations occur randomly but can happen in certain ethnic backgrounds more often which can aid in the explanation of the differences in eczema of different races.

Conclusion

After much research, doctors and other trained professionals have concluded that eczema can be very serious both physically and mentally. As there is a direct link between depression, and children who have eczema resulting from bullying, social withdrawal or lack of sufficient sleep. Eczema also varies from child to child, each child requires a different type of treatment whether that be conventional methods like moisturising or limiting exposure to irritants and a controlled diet steering clear of trigger foods; or more serious ways of treatment, like phototherapy or using steroid medication as explained in the background. Each of these factors contribute to the fact that having eczema can have a traumatic experience on a child. Even getting treatment such as phototherapy can have a traumatic effect on a child, as they may be frightened of the equipment or even the staff especially in younger children. Aswell as varying from person to person, eczema varies from gender to gender and race, as some races are more susceptible to inheriting eczema through family memebers and other atopic diseases (e.g. asthma). This was proven on a scientific level aswell as an explorative method through research and through scientific principles like natural selection and the hardy-weinberg principle. These scientific laws explain that if there are certain genes that people possess over time they will become more apparent in more people in the world. This explains why eczema has risen up to 40% in the last four years (Devlin 2020). Also in terms of gender neither gender has it easier as males are more at risk of eczema linked to atopy after a certain age, meaning that there will be more children in the future who will be more depressed than the average child (assuming that there will be no big changes that will affect the field of medicine). However on the other hand, females are more at risk of carrying eczema from birth into childhood and through to adulthood. Given that there is no cure for eczema at the moment, and no certain way to prevent eczema it is quite apparent that eczema will increase in the future and may continue to do so, especially in places where medicine is not a luxury eg less economically developed countries. By providing information on eczema and making people understand the severity that comes with eczema will lead to a positive change.