Micronesian Educator Vol. 16, 2012 Potential Effects of Obesity on Heath and

Potential Effects of Obesity on Health and Learning in Children Mary Jane MiUer

Abstract Obesity is a significant problem among adults worldwide, and is an increasingly serious issue among children. Excess weight can affect children both mentally and physically and either of these circumstances can affect learning outcomes and academic performance. There have been multiple studies that link excess weight with learning problems in schools as well as to feelings of inadequacy and incompetence among our children. Both physical health and mental health issues related to obesity can be linked directly or indirectly to lowered academic achievement. This may be especially important on Guam where the incidence of obesity among children is particularly high. This paper explores some of the health related problems that obese children may face both as children and later as adults, discusses the link of obesity with learning difficulties in school, and makes recommendations to promote a healthier lifestyle for children on Guam.

Keywords: obesity, physical health, mental health, learning, causes

The Obesity Epidemic Just a few years ago, having a chubby child was seen as a good thing - an adorable cherub. Often, it was considered to be a sign of prosperity and having more than enough to eat. Today, however, this view has changed, and the single issue having the greatest impact on children's health and wellbeing worldwide, not just in the United States, is that of too much body fat. Overweight in children is considered an open door for the entry of a host of serious chronic illnesses they may trouble them both as children and later, as adults. It is a grave concern that health risks accompanying obesity are increasingly occurring at younger and younger ages {Naik, 2011).

Obesity has long been noted as a problem among adults in the United States. More than a billion people worldwide are obese (Livingston, 2003) and unhealthy weight is responsible for over 300,000 deaths each year. The financial burden on society for obesity is estimated to be nearly $100 billion (stop-childhoodobesity.com, 2011). However, the potential impact of obesity on today's children is the source of greatest alarm. Since patterns for adult behaviors and lifestyle are established in childhood, the alarming rise in obesity even among the very youngest children is very troubling.

Concern about the dramatic increase of obesity in children has become so great that in 2009 the U.S. government declared it a national epidemic (Pandita, 2011 ). Data from the International Obesity Task Force indicate that 22 million of the world 's children under 5 years of age are overweight or obese (Dietel, 2002), and about one third of the children in the United States are overweight (Harmon, 2012).

This may be of particular concern to residents of Guam which have the highest obesity rate in the United States (Leon Guerrero, Paulino, Novotny, Murphy, 2008).

A study of Diet and Obesity Among Chamorro and Filipino Adults on Guam found that in 2003 more than 48% of all adults on Guam were either oven:veight or obese (Leon Guerrero, Paulino, Novotny, Murphy, 2008). Data collected by the 2010 Behavior Risk Management Surveillance System (BRFSS) for Guam states that as of2010, more than 60% of adults on Guam are overweight or obese

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(Statehealthfacts.org, 2010). This reflects a 12% rise in rates of overweight in only seven years and is significant as it clearly highlights the rising trend of obesity rates on Guam.

There are health issues, both mental and physical, that can affect children during their school years and can linger into adulthood. Physical health problems, though serious, may be more easily identified and treated than mental ones. Psychological effects, even if the weight problem is conquered, may persist throughout the schooling years and beyond. A child's overall sense of wellbeing and socialization can be affected as well as processes such as memory and learning. The physical and psychological issues related to excess weight can have a major impact on student academic success.

Parents, educators and communities as a whole all want their children to grow up healthy, happy, successful and fully capable of shouldering the responsibilities ofthe future. A great deal of preparation for these lofty goals takes place by means of formal education. But there remain barriers to the very health, happiness and potential for success that we all seek from this educational process. One of these barriers may be the good health and wellbeing of our children in the form of excessive weight gain and the impact that carrying all this weight has, not only on the child's body, but also on the child's ability to learn effectively, retain information well, perform successfully in school, and to enjoy the educational experience.

In recent years there has been a significant increase in the number of children diagnosed with learning disabilities (Ellis, Lang, Shield, Wilkinson, Lindstone, Coulton, & Summerbell, 2006). In their study on Obesity and Disability, Ellis et al., state that the prevalence ofboth obesity and disability is on the rise worldwide. As obesity has risen, so have the number of children diagnosed with learning disabilities.

They further suggest that there is a sufficient amount of evidence from a large body of work to conclude that there is a relationship between overweight and learning disabilities. Their research outcomes suggest that childhood obesity interferes with the child's ability to learn (Brown, 2010).

In 2005, Bill No. 164 submitted to the Guam Legislature by Senator Edward J. B. Calvo was passed which states, in part, that obesity is a major health problem on Guam and that childhood obesity is a growing concern on the island (Calvo, 2005). In 2001 the U. S. Surgeon General's Office wrote a Call to Action which acknowledged that weight related behaviors begin in childhood and that early childhood obesity is a growing problem (Hodges, 2003). The Centers for Disease Control and Prevention (CDC) reports that results from its 2007-2008 National Health and Nutrition Examination Survey show that the rate of obesity among pre-school age children between the ages of 2 and 5 years doubled between 1980 and 2008 from 5% to 10.4%. (CDC, 2010). Obesity rates in young children have tripled during the past 20 years (Taras, 2005), and childhood obesity is a major health issue on Guam (Calvo, 2005).

With such stark fmdings on the increasing incidence of obesity among children in our population on Guam, it is important to further explore the ramifications this has on children's health and the relationship of weight gain to learning.

Obesity Defined

The most straightforward definition of obesity is simply that it is an excessive accumulation of body fat (Summerfield, 1990). Health professionals often use Body Mass Index (BMI) as a means of assessing whether a child is overweight (Calvo, 2005). BMI is a number derived from a formula that uses a comparison of height to weight. The easiest way to describe obesity may be to say that children are generally considered obese when 25 percent or more of the total body weight in boys is fat or when more than 32 percent of total bodyweight in girls is fat (Williams, 1992). About one in three children in the United States is overweight or obese (Harmon, 2012).

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Causes of Obesity To say that weight gain or loss is merely the result of a numerical formula may be superficially true, but it does not address the complexity of underlying causes. It is true that if one consumes more calories than he expends, then weight gain will occur. If more calories are expended than are consumed then weight loss will take place. It is not a surprise that the basic cause of overweight today is too much unhealthy food and not enough physical activity (Harmon, 2012) . Clearly, many of our youth today are consuming more calories than they are expending and this has not been the case throughout most of history .

Lifestyle is a major factor in the upward trend in excess weight. Financial responsibility in our current economic environment often requires that both parents work outside the home. Consequently, reliance on fast foods, pre-prepared foods and high-calorie snack foods seems to be an indispensable part of coping with overfilled schedules and the demands of daily living.

Children ride in automobiles and use elevators and escalators rather than walking or climbing stairs. The amount oftime that children spend playing outside is less than it was even ten years ago and physical education programs seem to be the first to be reduced and eliminated when school budgets suffer cuts (Livingston, 2003). Playing computer games and watching television have replaced outdoor activities for many children and have become favorite pass time activities. Add this more sedentary lifestyle among children to the tendency for higher calorie snacks and meals and the result can be serious weight gain (Naik, 2011).

While the primary reason for the current dramatic rise in obesity rates is rooted in our modem-day lifestyle, genetic factors may play a role for some people (Naik, 2011). There is an elevated risk of becoming obese among children who have two parents who are obese (Dietz, 1983 CB Eric). This could be due either to strong genetic factors or to the effects of parental modeling in both eating and in exercise habits. At least half of parents of elementary school children never exercise vigorously (Ross, 1987).

Obesity and Learning In today' s demanding world of technology and academic rigor there is a huge amount of content that a successful student needs to learn at every grade level. If students are not present in school, their ability to learn, apply, and retain appropriate content knowledge is impaired. One reason why there is concern about the relationship that obesity may have on learning is that there are numerous potential health problems associated with children whose weight is excessive . These factors can be problems with physical health or psychological health, and any one or combination of factors can affect school attendance and overall success in school.

Obesity, Physical Health and Learning Even during their youth and adolescence, overweight children are at greater risk for serious health problems . They are more likely to have risk factors associated with cardiovascular disease and diabetes than are other children (Stop childhood obesity.com, 2011). Overweight is the leading cause of pediatric hypertension and is a significant risk factor for asthma, kidney failure and other serious illnesses (Miller, 2004). More than 70% of obese youth are at higher risk of heart disease (Pandita, 2011). Sixty percent of obese children six years of age and older have at least one factor for heart disease, and one child in four also has impaired glucose tolerance potentially leading to diabetes (Miller, 2004) .

A study based on results from data collected on more than 12,500 third grade students showed there was a positive relationship between students' Body Mass Index (BMI), physical activity, and their academic achievement levels. Students who maintained a higher level of physical activity and who were a normal weight maintained higher grades and learned at a faster rate than those students who were less physically active. A negative relationship was observed between obesity, as rated by the BMI, and academic

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It is during these important childhood years that a person's self-image, self-confidence and self-esteem begin to form. Excessive weight during childhood is associated with lower self-confidence, a tendency to withdraw from others, increased loneliness, sadness, and nervousness, and greater use of alcohol and tobacco (Summerfield, 1990). Some children also suffer from a fear of being disliked by their parents and friends or fear of being bullied by other children (Naik, 2011). Obesity can heighten children's levels of sadness, and interfere with the quality of their relationships with peers (Schwimmer, 2003). Researchers have observed a link that connects obesity in children with emotional and psychological problems like depression, anxiety and the tendency to develop obsessive-compulsive disorder. The problem of weight gain becomes especially difficult as children enter school and face the normal pressures of peer acceptance (Riley, 2010).

Children whose schooling experiences include ostracism, teasing and negative feedback about their physical appearance and overall acceptability will generally be less happy in school, less satisfied with their level of achievement, less willing to attend school daily, and may be less able to focus on the academic agendas of their classrooms. Being overweight may lower children's feelings of self-worth, making it more difficult for them to concentrate in class and to have positive learning experiences. As a result, these children may learn less than their classmates (Kellow, 2009).

Mental health problems, which tend to be more common among overweight children, often cause them to be less happy at school and less satisfied with their achievement. This may affect their participation in classroom studies as well as their willingness to attend school regularly. These and other factors affect overall school success (Kellow, 2009).

Although it may be that many overweight school children are too young to experience the numerous health problems resulting from obesity, the emotional issues can keep them home from school and can have far reaching and long-lasting effects. The link between obesity and learning difficulties may be due to physiological factors, or it could result from a connection between self-esteem and learning, but the fact remains that both obesity and the number of children identified with learning disabilities are dramatically increasing at the same time (Ellis, et al., 2006).

Social stigma due to obesity may be less prevalent on Guam than in some other communities, but even here children are aware at a young age that obesity is not a particularly desirable condition and may experience the resultant bullying that often adds to the burden of excess weight (Riley, 2010).

Taken as a whole, mental and physical health, absenteeism and attendance, and satisfaction and happiness with the school experience all play a large role in children ' s academic achievement and overall success in school.

Weight Gain Versus Pre-existing Overweight A recent study monitored the weights of almost 7000 American school children from the time they first entered kindergarten at around age 5 until the end of their third grade year when most students were about 8 years old. The researchers assessed how well each child did at school by measuring their mathematic and reading ability as well as their social skills. They also recorded any behavioral problems and absences from school (Kellow, 2009).

The researchers discovered that girls who started school at a normal weight but then gained so much body fat that they were seriously overweight by the end of the third grade performed less well on reading and math tests and had lower ratings for social skills. However, boys who became overweight had more absences from school than boys of normal weight (Kellow, 2009). Interestingly, there was little difference in the final tested ability among those children who were already overly heavy when they began their

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Traditional foods on Guam can only be described as delicious. Many are full of vitamins and other essential nutrients but some are deep fried or otherwise contain more fat than is desirable. Without changing traditions or significantly altering the good taste, it is often possible to prepare more low-fat versions of the same foods.

It is encouraging to know that in the face of potentially severe consequences for our children, the obesity epidemic can be reversed. Overweight can be prevented, cured, and eliminated. And it is responsible adults, the ones who care the most - parents, families, teachers, school and community leaders - who are in the right position to do so.

The families of Guam are among the closest and strongest anywhere. If there is to be a resolution to the obesity epidemic on Guam it will ultimately happen within the families with support from schools, educators, and government leaders. When parents, children and the community work together to make informed choices about wholesome foods and healthy lifestyle we can expect to see a change in the obesity epidemic.

References Brown, J. (2010). Confronting childhood obesity: Educational needs of children, adolescents, and parents. Retrieved from MedScape Public Health Website: http://www .medscape.com/viewarticle/732541 Byrd, J. (2007, March 30). The Impact of Physical Activity and Obesity on Academic Achievement Among ElementaJy Students. Retrieved from the Connexions Web site: http://cnx.org/content/m14420/1.11 Calvo, E. Guam Legislature, First Regular Session. (2005). Certification of passage of an act to I Maga' lahen Guahan. (Bill No. 164). Hagatna, Guam.

Centers for Disease Control. (2010, March 31). Childhood overweight and obesity. Retrieved from http://www.medscape.com/viewarticle/449670 Centers for Disease Control. (2011, November 15). Nutrition, physical activity and obesity: school health guidelines to promote healthy eating and physical activity . Retrieved from http://www.cdc.gov/healthyyouth/npao/strategies.htrn Childhood obesity statistics and trends. (2011, March 30). Retrieved from http://www.stop-childhoodobesity.com/child-obesity-statistics Deitel, M. (2002). The International obesity task force and "obesity." Obesity Surgery, 12:613-614.

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Scientific American, Retrieved from http:/lblogs.scientificamerican.com/observations/2012/04/10/new-technology-maps-the-surprisingsubtleties-of-childhood-and-teen-obesity Henderson, T. (2010, August 4). Does obesity and diabetes equal1earning disabilitiey? Parent Dish, Retrieved from http :1/WW\v.parentdish.com/20 10/08/04/does-obesity-plus-diabetes-equal-learningdisability/ Hodges, E. (2003). A primer on early childhood obesity and parental influence. Pediatric Nursing, 29(1).

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Leon Guerrero, R., Paulino, Y., Novotny, R., Murphy, S. (2008). Diet and obesity among Chamorro and Filipino adults on Guam . Asia Pacific Journal of Clinical Nutrition, 17(2), 216-222. Retrieved from http://apjcn.nhri.org. tw/server/AP JCNNolume 17/vol17 .2/Finished/5_ 1070 .pdf McConnaughey, J. (2003, June 16). CDC diabetes warning for children. Associated Press.

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