Childhood Obesity: A Literature Review

Childhood Obesity: A Literature Review

Grand Canyon University

HLT 314V

Childhood Obesity: A Literature Review

The 21st Century presents many challenges that have an alarming effect on humanity in significant ways that include public health issues. One serious issue that has become an epidemic in the United States and globally is childhood obesity. A definition of obesity is excess body fat that can be measured by way of the body mass index (BMI) percentile. A BMI screening that is equal to or exceeds the 95th percentile in children is considered obese. According to the Centers for Disease Control and Prevention (CDC), data that was collected from 2015-2016 in the United States, indicates that 1 out of 5 school age children/adolescents between the ages of 6 to 19 years old are obese (Centers for Disease Control and Prevention, 2018). Research indicates the main causes of childhood obesity are genetic, environmental, insufficient exercise and an unhealthy diet (Mayo Clinic, 2019). The health risks associated with overweigh children include increased cardiovascular disease, type 2 diabetes, asthma, sleep apnea and physiological disorders. The American Heart Association states that obese children have an 80 percent chance of remaining obese through-out their entire life (The American Heart Association, 2019). The purpose of this paper is to provide evidence-based research on the rapidly growing epidemic, the effect of quantitative interventions in synthesis data and the quality of interventions in the prevention of childhood obesity.

Explanation of Literature Review Research

The review for this literature was compiled from research that included statistical and analysis data, outcome measures in disease prevention, qualitative intervention sources and peer reviewed journal articles. Journals included Grand Canyon University Library and BMC Public Health. Internet websites included The Centers for Disease Control, The Department of Health and Human Services and Medical research institutions included the American Heart Association, The American Journal of Public Health and The Institute of Medicine. Additionally, the Mayo Clinic was the one independent website included. Search terms utilized were childhood obesity, statistics, physical education in school, social difficulty and socioeconomic. The PICO Model format (P) patients, populations or problems, (I) intervention, prognostic factor or exposure, (C) comparison or intervention and (O) outcome was utilized. Analysis of Covariance (ANCOVA) for control measures.

A Discussion of the Ethical Considerations for Data Collection

Ethics is critical in conducting research that provides knowledge, integrity, truth and the avoidance of an error. “Because ethical considerations are so important in research, many professional associations and agencies have adopted codes and policies that outline ethical behavior and guide researchers” (Grand Canyon University, 2019). Research ethics promotes moral values and holds researchers accountable to adhere to ethical standards.

An Explanation of What Data Reveals in Terms of Statistical Analysis

A study used a hospital-based sample in an out-patient clinic for patients between the ages of 2 to 18 years of age and a school-based sample for children between the ages of 9 to 14 study over a 9-month period. Common correlations such as demographics and variables that include median family income and calculations of BMI-Z with age and gender was conducted through analysis of data to determine if a hospital-based sample could be used in the estimation of regional obesity levels (Gilliland, Clark, Kobrzynski, & Filler, 2015). “Samples of children visiting hospital clinics could provide representative local population estimates of childhood obesity using data from 2007 to 2013” (Gilliland et al., 2015). The results indicated that the hospital BMI-Z was greater than that of the school group. Interventions for childhood obesity is critical in early risk prevention and treatments. To monitor childhood obesity population, certified electronic health record technology (CEHRT) has been implemented to monitor the child’s weight status. “CEHRT presents new opportunities to monitor childhood obesity in areas where overweight and obesity are most prevalent” (Davidson et al., 2014). Collaboration of Accountable care organizations (ACO) communities, organizations that are non-profit, public health agencies and health care providers benefit by monitoring and evaluating data interventions (Davidson et al., 2014). Not only does the CEHRT interventions provide cost effective benefits in early risk prevention it has longitudinal analyses that provides local or population-specific trends in weight status for children (Davidson et al., 2014). Multi-level and community interventions are components for a healthy environment. According to the Healthy Food in Schools as an intervention through the Obama administration, healthier food choices were made available and in the “2004-05 school year, although most school meals were consistent with meal pattern requirements and provided most key nutrients, 93-94% of meals failed to meet all nutritional standards, primarily due to not meeting standards for fat, saturated fat, or calories” (The Institute of Medicine, 2014). Since that time the dietary guidelines have been updated for nutritional standards (, 2015). Affordable healthy food in grocery stores, fast food and restaurants has become more available due to the obesity epidemic. Physical activity in the classroom environment, not including the physical education class has been proven effective in obesity prevention. In a non-randomized controlled trial, a 12-week multi-component physical activity study that included 921 children between the ages of 7 to 15 years of age. The children had a mean age of 10.4 years, mean body mass index (BMI) of 19.59 kg/m2, and 36.8 % of them were overweight or obese at baseline survey. The change in duration was significant with an adjusted mean difference of −0.43 kg/m2 that decreased the BMI (Li et al., 2014).


The literature review demonstrates that a hospital-based sample in the general population for estimating obesity levels is more effective than the school-based sample. Further studies between the two characteristics of the school-based sample and the hospital-based sample should include other correlations such as built environments, income and social components. Collaboration between health care providers and other organizations that provide patient information and interventions through CEHRT. Data analysis, evidence-based research and patient monitoring improve the patient’s overall health. Physical activity in schools that focus on more activities through-out the day with movement at a higher level prove to be essential in maintaining a healthy BMI. Healthy food options that is provided by schools, less expensive healthy food in supermarkets, healthy food choices in fast-food and restaurants aid in obesity prevention.


The review indicated limitations to the study requiring investigations on a larger scale that provides the components needed to determine childhood obesity prevention. Other studies that included interventions such as physical education and healthy eating prove to be beneficial in lowering a BMI and or controlling a healthy BMI. However, family-based interventions, physical activity at a higher level of intensity and healthy nutrition interventions should also be practiced in the home environment to be conducive in obesity prevention. Further research that follows children in a controlled environment and in a home, environment needs to take place to determine the results.

A higher quality study from monitoring systems such as the certified electronic health record technology suggest a stronger outcome in that collaboration between health care providers and other organization that provides the ability to monitor childhood obesity in all areas.

Childhood obesity continues to be a national epidemic, however interventions that identify and provide resolution will benefit overweight children and their health. Further studies that provide quality data and analysis, support from community and multi-level based, local, state and government will aid in the child obesity public health crisis.


Centers for Disease Control and Prevention. (2018). Childhood Obesity Facts. Retrieved from

Davidson, A. J., McCormick, E. V., Dickinson, M., Haemer, M., Knierim, S., & Hambidge, S. (2014, June 14). Population-Level Obesity Surveillance: Monitoring Childhood Body Mass Index z-Score in a Safety-NetSystem. Academic Pediatrics, 14, 632-638. Retrieved from

Gilliland, J., Clark, A., Kobrzynski, M., & Filler, G. (2015). Sampling of Children Presenting to Hospital-Based Clinics to Estimate Childhood Obesity Levels in Local Surroundings. American Journal of Public Health, 105, 1332-1335. Retrieved from

Grand Canyon University. (2019). Ethical Considerations. Retrieved from (2015). Key Recommendations: Components of Healthy Eating Patterns. Retrieved from

Li, X., Lin, S., Guo, H., Huang, Y., Wu, L., Zhang, Z., … Wang, H. (2014, December 16). Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial. BMC Public Health, 14, 1282.

Mayo Clinic. (2019). Childhood Obesity. Retrieved from

The American Heart Association. (2019). BMI in Children. Retrieved from

The Institute of Medicine. (2014). III. Healthy Food in Schools. Retrieved from