The World Health Organization’s (WHO) Commission on Ending Childhood Obesity (ECHO) has presented its final report to the WHO director-general, culminating a two-year process to address the high global levels of children who are obese and overweight. The ECHO report proposes a range of recommendations for governments aimed at reversing the rising trend of children under the age of five becoming overweight and obese. At least 41 million children in this age group are obese or overweight, with the greatest rise in the number of children being obese or overweight coming from low- and middle-income countries.
According to the report, many children are growing up in environments encouraging weight gain and obesity. Driven by globalization and urbanization, exposure to unhealthy environments is increasing in high-, middle-, and low-income countries and across all socioeconomic groups. The marketing of unhealthy foods and non-alcoholic beverages was identified as a major factor in the increase in numbers of children being overweight and obese, particularly in the developing world.
Overweight prevalence among children under the age of five has risen between 1990 and 2014, from 4.8% to 6.1%, with numbers of affected children rising from 31 million to 41 million during that time. The number of overweight children in lower middle-income countries has more than doubled during that period, from 7.5 million to 15.5 million.
In 2014, almost half (48%) of all overweight and obese children under the age of five lived in Asia and one-quarter (25%) in Africa. The number of overweight children under the age of five in Africa has nearly doubled since 1990 (5.4 million to 10.3 million).
The ECHO Report has six main recommendations for governments:
- Promote intake of healthy foods: Implement comprehensive programs that promote the intake of healthy foods and reduce the intake of unhealthy foods and sugar-sweetened beverages by children and adolescents (through, for example, effective taxation on sugar-sweetened beverages and curbing the marketing of unhealthy foods).
- Promote physical activity: Implement comprehensive programs that promote physical activity and reduce sedentary behaviors in children and adolescents.
- Preconception and pregnancy care: Integrate and strengthen guidance for the prevention of noncommunicable diseases (NCDs) with current guidance on preconception and antenatal care.
- Early childhood diet and physical activity: Provide guidance on, and support for, healthy diet, sleep, and physical activity in early childhood and promote healthy habits and ensure children grow appropriately and develop healthy habits (limiting consumption of foods high in fat, sugar, and salt; ensuring availability of healthy foods and physical activity in the early child care settings).
- Health, nutrition, and physical activity for school-age children: Implement comprehensive programs that promote healthy school environments, health and nutrition literacy, and physical activity among school-age children and adolescents (by establishing standards for school meals; eliminating the sale of unhealthy foods and drinks; and including health and nutrition and quality physical education in the core curriculum).
- Weight management: Provide family-based, multi-component, lifestyle weight management services for children and young people who are obese.
The report calls for nongovernmental organizations to raise the profile of childhood obesity and advocate for improvements in the environment, and for the private sector to support the production and improved access to foods and beverages that contribute to a healthy diet.
WHO ECHO report (pdf)