“The term used in the definition of childhood obesity applied by the Institute of Medicine is: A body mass index (BMI) at or above the 95th percentile of a fixed reference group of children of the same age and sex”[1]. The concerning factors for childhood obesity include racial makeup, ethnic background, income and education levels, employment patterns, family composition, housing and access to supermarkets. Children with the age between 6-17 years are estimated to have an above average risk for childhood obesity. Forty percent of children living in poor households have the chances of developing childhood obesity. Reversing the childhood obesity is a major challenge in the modern day society. Childhood obesity has in fact tripled since 1980 in the United States. Early onset obesity has been seen to be of major concern of the younger generation as well. It is improved health care and the quality of life with proper education that can help the health care system work more efficiently concerning the management. Demographic data show that body mass index (BMI) is of particular importance in measuring childhood obesity[3].The concern at present is that the obesity epidemic can exacerbate the economic crisis[4]. The main domain where childhood obesity can be controlled is the school. The assessments as well as the nutritional educational values developed in school are a major source of setting standards for childhood obesity[5]. Screening for childhood obesity includes exclusion of diseases like Type 2 Diabetes Mellitus and physical inactivity[6]. At present the adult obesity rate is ranging between 20- 25 percent in the different geographic areas across the world. Public health data concerning demographics, household structure, education, income, supermarkets spending with regards to per capita income, and other relevant data are of major concern in the progression of childhood obesity to adult obesity. As obesity is becoming a pressing problem the main concern is the associated poverty rate, unemployment rate, increase in uninsured population,and some underlying community problems, like crime, overcrowding, lack of community participation to mention a few. Reports show that around 9.1% of the medical spending is attributable to Obesity and overweight [4,7].

Statistical reporting of childhood obesity

Data trends from 2000 to 2016 indicate that, in the absence of interventions, the prevalence and total number of overweight or obese young people (ages 5-19) worldwide is predicted to rise from approximately 430 million, or 22% of the world's youth, to 770 million, or 39%, by 2035[1,8].

Table1:The number of young people worldwide who are overweight (BMI >1sd – 2sd)* and obese (BMI >2sd)* is estimated in 2020 and is expected to reach 2025–2035.

*Definitions based on World Health Organization child growth reference charts[9]

After analyzing 2147 titles and abstracts, a meta-analysis of 21 research including 1,86,901 children in India between 2003 and 2023 revealed important data on childhood obesity. It was projected that the combined prevalence of childhood obesity was 8.4%, and the combined prevalence of childhood overweight was 12.4% [10].

For our analysis, first, we collect raw data sets which depend on some factors. In addition, we pre-process those data, then we applied machine learning supervised algorithms to check the accuracy, sensitivity, specificity, precision, recall, and F1-score. Then we found which algorithm works more optimal and detect the actual outcome[11].

Figure 1: A sketch of Risk-prediction of Childhood obesity using Artificial Intelligence (AI) techniques

Risk factors for Childhood Obesity

The potentially modifiable risk factors for developing excess weight are related mainly to nutrition and physical activity. These two essential factors have to be incorporated in daily lifestyle practices to determine the importance of developing regular habits to prevent childhood overweight and obesity.

To improve the spectrum of health, childhood obesity must be identified and treated as soon as possible. Along with many other chronic conditions in adults, it increases the risk of obesity in adulthood.

National and international approaches should be part of the treatment policies that are adhered to. Multidisciplinary approaches become necessary, though, when the causes of pediatric obesity are examined. Enhancing the environment, promoting education, and promoting lifestyle modifications are also crucial [12,13].

Nutritional Factors associated with Childhood Obesity

According to the World Health Organization (WHO), a growing percentage of children and adolescents in both low- and high-income nations is slightly and severely obese, and the majority of boys and girls in underdeveloped countries experience undernourishment when they enter adolescence . Long-term effects of being overweight on a child's social life, physical condition, and psychological well-being are reported [14,15]. Patients' social and environmental issues should be taken into account during the course of treatment, in addition to the health issues linked to pediatric obesity. In addition to having a good impact on children's health and body composition, healthy eating and dietary practices can lessen psychological issues and cognitive stress in kids. A major community health issue is the rise in the prevalence of overweight and obesity among kids and teenagers, which is linked to the psycho-social and behavioral pattern related to nutrition[16].

An imbalance in energy balance, or an excess of calories consumed without an equal amount of calories expended, is the most frequent cause of obesity in children and adolescents. Early-life obesity rebound (AR) increases the likelihood of obesity in adolescence and adulthood.

Comorbidities such as Type 2 Diabetes Mellitus, Hypertension, Non alcoholic Fatty Liver disease (NAFLD), Obstructive Sleep Apnea (OSA), and Dyslipidemia that were previously only found in adult populations are on the rise in relation to the rising prevalence of children and teenage obesity. Clinicians have typically focused on food advice and exercise because there isn't a single therapy option for obesity [17].

Physical activity and childhood obesity

Preventing the increase of childhood obesity is an international health priority. The first years of life are essential for starting preventive approaches of appropriate physical activity and diet that can have an impact on lifestyle and on arresting overweight or obesity. In the case of young children, prevention strategies should concern parents, family, primary caregivers, schools, social networks, media, and the wider community [18]. All of these groups should promote a healthy lifestyle or by providing an example to follow by  through providing/favoring a supportive environment.

The European Childhood Obesity Group and the European Academy of Pediatrics encourage health care professionals, teachers, parents, and guardians to promote physical activity to all children, from birth to adolescence[19,20,21].A task force from the Eastern Cooperative Oncology Group and the Extended Access Program, have agreed on recommendations for infants (<1 year) to adolescents(18 years of age) as well as guidelines for school-based interventions.

Although getting enough sleep is crucial for children's healthy growth and development, changes in lifestyle have led to a decrease in sleep over time, which may be linked to a rise in childhood obesity. To support children's healthy development, the American Academy of Sleep Medicine has created guidelines specifically for sleep.

Children are specifically advised to get between nine and twelve hours of sleep every day [21].

Sleep is an essential requirement for healthy growth in children, both in terms of quantity and quality. Despite the fact that sleep and its various aspects have been extensively studied in literature, there are still questions regarding appropriate sleep patterns. Children have been observed to adopt sleep patterns that are restricted in recent years. Parents need to be made aware of the protective role that adequate sleep duration plays in preserving their children's weight status [22].

Technology based childhood obesity management in recent times

Artificial Intelligence’s convergence with traditional obesity management techniques offers a fresh and exciting way to strengthen programs aimed at reducing childhood obesity.When it comes to enhancing the therapeutic and preventive measures used in the management of childhood obesity, machine learning techniques have demonstrated significant efficacy[23].

The importance of therapeutic and preventative treatments will fulfill the needs in the future to create a pool of safe and sustainable food system, given the broad acceptance of technology as a part of health care regime. Childhood obesity will change dramatically if artificial intelligence (AI) is integrated into the supply of safe and affordable nutritional solutions for better individual and population health (Figure 2) [24].

l

Figure 2: Artificial Intelligence (AI) mapping to enhance the nutritional profiles

It is suggested in figure 3 that in the future AI could greatly change the way physical health is approached, specifically in the context of childhood obesity, through the use of AI techniques. The idea is centered on machine learning and AI's ability to analyze inputs and identify patterns, leading to simulations that could potentially reach up to 95% accuracy [30].

Figure 3: Proposed framework of Artificial Intelligence(AI) application in physical activity in the background of childhood obesity

Economic burden of Childhood Obesity

The expense of healthcare has grown significantly for childhood obesity compared to overweight. Males were shown to have higher lifetime expenses than females due to childhood overweight and obesity, and the costs of indirect healthcare were much higher than the costs of direct healthcare. More work and funding ought to be devoted to supporting scalable and long-lasting programs to combat childhood obesity in light of the growing financial burden. The most promising approach to preventing and mitigating the long-term financial impact on healthcare and productivity losses associated with childhood obesity is prevention rather than treatment or care later on (25,26).

It is important to exercise caution when interpreting the relationship between the economic load and the childhood problem at hand due to the diversity of healthcare systems and insurance coverage across the globe (27), rising rates of obesity-related comorbidities, and declining quality of life from childhood to adolescence (26).

Artificial Intelligence has the potential to tackle major issues in the healthcare sector, such as a shrinking workforce and upcoming threats to public health, populations, and growing intricacy of health as a result of numerous chronic illnesses. Utilizing this powerful tool is essential, but it is equally important to reduce its potential dangers. Stringent supervision and strong and effective governance are essential to quickly address new challenges and capitalize on emerging opportunities [28,29].

In the realm of childhood obesity, AI and machine learning are widely acknowledged for their use in preventative, educational, activity-based, data screening, and treatment studies (Figure 4). Looking ahead, the development of a customizable intelligent robot could revolutionize personalized interactions based on a child's interests and obesity level [31].

Annual medical costs attributed to childhood overweight and obesity increased to $237.55 per person. The World Obesity Federation predicts that the economic consequences of obesity worldwide will exceed $4 trillion by 2035[32].

Potential savings of approximately 90 billion USD over the next decade could be achieved by utilizing AI at a lower cost. This estimate of savings matters a lot in cost reductions in medical expenses as well as decreases in productivity losses and sick days. AI could also assist in improving the effectiveness of self-monitoring to prevent obesity [33,34].

Figure 4: Proposed model of distribution of economic principles in Childhood obesity

Graphical abstract 1: The multifaceted challenges of Childhood obesity

Graphical abstract 2: Economic factors that influence overweight and obesity in childhood

Conclusion

A major public health concern, childhood obesity is a multidimensional and complicated health issue that involves biological, developmental, environmental, behavioral, and genetic variables and it reaches every corner of the environment for kids and adolescents. However the fact that this is a challenging health issue makes it important that the small steps in making potential changes become measurable to accomplish significant noticeable changes. A game changing focus will be to create the optimum environment where children make health decisions themselves as the easiest decision for them to implement in the short and long term basis. From the adult engagement point of view, raising awareness is one of the greatest contributions that the initiatives for prevention can uphold. To influence the psycho-social behaviour of children and adolescents and bring up a change, the different parts of the society need to get involved.The outcomes of the measures taken so far to combat childhood obesity should be compared to the different stages across childhood – across childhood development to adult formative stage, which may prove complicated at times. Making significant modifications will require a substantial amount of time in an individual child and the impressions of the learning to an adult stage whereby the example can be set for future references.

Disclosures

Acknowledgement: Dr. Barbara Bonk (Germany)

Funding: Nothing to declare

Conflicts of interest: The authors declare no conflicts of interest

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