Overweight and obesity in children are global public health and social issues. Since 2007, the Ministry of Health has promoted and financed the development of the Okkio alla Salute surveillance system, coordinated by the National Center for Epidemiology, Surveillance and Health Promotion of the Istituto Superiore di Sanità (ISS) and conducted in collaboration with the Regions and the Ministry of Education, University and Research to understand the dimension of childhood obesity and associated behaviors. To offer an initial picture of the evolution of the problem in our country, we compared the data released this year with those of 2008 and 2012, discovering that the phenomenon is in slight but constant decline, although it still remains worrying and widespread, with higher percentages in the regions of central and southern Italy.
These are certainly comforting data, which moreover bode well for the future. However, it seems they are not enough to advance Italy in the European ranking of the worst countries for childhood obesity, as denounced by the Childhood Obesity Surveillance Initiative (COSI) of the European Region of the World Health Organization (WHO).
«Obesity has become one of the major public health problems in Italy – reads the website of the Ministry of Health, in the words of Walter Ricciardi, president of the ISS – The decrease in the obesity rate in children is a sign that the policies health measures put in place are beginning to give the first results However much remains to be done, above all in promoting awareness of correct lifestyles. Parents must do their part : in fact, these data tell us that around 40% of mothers of overweight or obese children believe that their child's weight is within the norm". The latest surveys released by Okkio alla Salute were carried out in 2016 on a sample of 48,946 children aged 8-9 (and 48,464 parents). Children who are already 'grown up', therefore, but be careful: numerous studies have shown that, basically, obesity already takes root during very early childhood, especially in the first two years of life : it is in fact precisely in this period that prevention takes place more importantly, through the adoption of correct eating habits and lifestyles.
CAUSES AND CONSEQUENCES
Overweight and obesity are the result of the interaction of various causes: incorrect or excessive nutrition, reduced physical activity , but also genetic and family factors. Obesity linked to hormonal alterations is observed only in rare cases . As for the long-term consequences, overweight and obesity can favor the onset of chronic-degenerative diseases deriving from organic complications (hypercholesterolemia, hypertriglyceridemia, arterial hypertension, steatosis/steatohepatitis.
ANTI-OBESITY TIPS
Breastfeeding. Feeding the baby exclusively at the breast for at least the first 6 months of life (even better the first 12) removes the risk of excessive weight accumulation in the years to come. Furthermore, the substances contained in mother's milk protect the baby from the danger of contracting diabetes and other diseases.
Weaning. The guidelines of the Ministry of Health recommend starting weaning no earlier than 6 months. Weaning too early (but also too late) can increase the risk of developing dietary problems in the future. 
Proteins in the first baby food. It is advisable to limit the introduction of proteins into the child's diet: formulated milk must have a low protein content, cow's milk should not be offered before 12 months and, in the first baby food, only a spoonful of Parmesan and no more than 30 grams of cooked ham or meat per day.
Portions. For a child with a sweet tooth, excessively abundant dishes are a temptation: adjust the doses according to his nutritional needs, without exaggerating. In general, parents tend to worry a lot when their child doesn't eat enough, while overeating problems are often underestimated or diagnosed late, when the state of overweight or obesity is now full-blown.
Sugary sodas and juices. Avoid consumption as much as possible, perhaps limiting it to moments when you are away from home, so that it is not a habit but an exception.
Stroller. Except in rare cases, after the age of 3 it is good to get the child used to walking: a short walk a day is enough to offer a fundamental contribution to his present and future health.
TVs and computers. Before the age of 2, children shouldn't spend time in front of a screen. Obviously, an occasional cartoon doesn't hurt, but their primary activity should always remain the actual game. Even after that, access to all kinds of devices should be limited, up to a maximum of 8 total hours per week.
Sports and movement games. Children should be directed towards sport from the first years of life, through dynamic activities that amuse and involve them.
THE DIAGNOSIS
There are several tools for diagnosing overweight and obesity in children; the important thing is to provide before the age of 6, or when there is still plenty of time to change course.
Growth curve or percentile. It is a graph (different for boys and girls) showing the child's weight, height and age. Based on the data, underweight, normal weight, overweight and obesity can be diagnosed. The percentile must be compiled and interpreted by the pediatrician according to the parameters considered valid by the scientific community.
Body Mass Index (BMI) . By dividing the body weight by the height squared, a value correlated to the subject's fat mass is obtained: the higher it is, the greater the lipid deposits. Also called Bmi (Body mass index), the International Obesity Task Force adopts this method considering it the best.
Waist circumference/height ratio. Indicates the presence of abdominal fat and represents an additional cardiometabolic risk assessment tool. In children, this value should not exceed the limit of 0.5.
By Duccio Scarpelli | Article taken from "Nascere Mamma" ed. Winter
