In the United States, childhood obesity is a problem that has continued to increase in prevalence over the past thirty years. Obesity contributes to a long list of health concerns and diseases, including hypertension, dyslipidemia, chronic inflammation, asthma, endothelial dsyfunction, hyperinsulinemia, diabetes, cardiovascular disease, certain cancers,w and premature death. While there has been an increase in the amount of fast food consumed, and growing trends toward eating away from home, two-thirds of the foods children consume are in the home. Childhood obesity is a problem that stems for several sources, and in order to deal with the problem, several areas need to be examined for what can be done to create a better lifestyle for children. The authors of this article propose a model that divides the home food environment into three different domains, each one with macro and micro level implications. Micro refers to areas closer to the child's home life, whereas macro refers to existing in the greater community. The three domains include political and economic environments, socio-cultural environments, and built and natural environments.
Political and economic environments are composed of financial resources, policies, and laws. The macro level includes food prices, which determine the likelihood of what kinds of foods families will purchase, and government and business policies. Businesses will make use of inexpensive commodities by processing and adding value to create and market profitable, palatable, energy rich food. The availability of federal and community food programs such as food stamps for the poor and the WIC ( women, infants, and children) program are designed to improve the eating habits of the disadvantaged or vulnerable. The last macro influence is the link between economic conditions and healthy eating. The less money people have, the less willing they will be to spending more money to eat healthier foods. On the micro level, lower family socio-economic status has a wide variety of effects on families, including: eating fewer family meals, having parents with less authoritative feeding practices, eat less fruits and vegetables, are more likely to skip breakfast, watch more television, are more likely to be overweight, and are more likely to eat fast food, just to name a few. Another micro level effect is family food insecurity, which is defined as the limited or uncertain availability of nutritionally adequate foods, and has strong links to poverty and financial insecurity. In the United States, more than fourteen million children under the age of 18 live in a home where they sometimes do not get enough to eat. Therefore these children are less likely to eat fruits and vegetables and more likely to eat energy dense foods when they are available. The third and final micro level structure is the lack of use of federal assistance programs by those who qualify for them. The reasons that less than seventy-five percent of those eligible sign up for a food program includes the fear of stigma for being poor, the lack of funds to afford the food, or being ignorant of what programs are available.
In terms of socio-cultural environments, there are several macro and micro influences on eating behaviors. On the macro level, race, ethnicity, and cultural identity all have an influence on children becoming obese. Children from ethnically diverse groups are at an increased risk of obesity. In a study of adolescent meal patterns, blacks were four times as likely as whites to eat less that two meals a day, skip meals, or snack frequently. Similarly, Mexican American children may be help to culturally specific standards where there parents expect them to have hearty appetites. Advertisers will also target their ads toward specific ethnic groups. Another macro level change is in the consumption trends changing to favor greater consumption of soda and snacks. In the micro level, it has been shown that cultural inheritance accounted for thirty to forty percent of the dietary intake variance for children. Also, changes in family structure have led to less meals eaten together as a family, which has the risk of having children live on convenience diets, which are not healthy. Other influences include family eating habits, parental eating habits, and educational and nutritional knowledge of the parents.
Lastly, the built and natural environments have an impact on children's eating habits. On the macro level, the food landscape, which refers to the production of food and its availability and accessibility. Studies show that lower income neighborhoods are less likely to have grocery stores, whereas wealthier areas are more likely to have more supermarkets. Television has a major impact on eating habits, especially in permissive environments. It leads to sedentary behavior, which leads to low energy expenditure, which leads to obesity. People are also more likely to eat while watching the television, which leads to mindless eating, a high energy intake, and then obesity. Children see adversing through the television, which leads to either the child or the parent making food purchases that are not nutritionally beneficial. In conclusion, all three of these domains need to be examined in order to find a way to reduce the levels of childhood obesity in this country.
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