For the first time, more school children and adolescents worldwide are obese than underweight, according to a report released on Wednesday by the United Nations Children’s Fund (UNICEF).

One in five children and adolescents aged 5-19 globally are overweight (some 391 million), while one in 10 are obese – putting them at risk of life-threatening diseases such as high blood pressure and diabetes.

Only sub-Saharan Africa and South Asia have more underweight than obese children, according to the report which draws on data from over 190 countries.

The report, which is called Feeding Profit: How Food Environments are Failing Children, lays the blame for the changing shape of children on ultra-processed food that is high in sugar, refined starch, salt, unhealthy fats and additives.

“These products dominate shops and schools, while digital marketing gives the food and beverage industry powerful access to young audiences,” according to UNICEF.

UNICEF executive director Catherine Russell added that “ultra-processed food is increasingly replacing fruits, vegetables and protein at a time when nutrition plays a critical role in children’s growth, cognitive development and mental health.”

Since 2000, the prevalence of underweight children aged 5-19 has declined from nearly 13% to 9.2%, while obesity rates have more than tripled, rising from 3% to 9.4%.

Pacific Island countries have the highest global prevalence of obesity in this age group, with a 38% prevalence in Niue, 37% in Cook Islands, and 33% in Nauru. These rates have all doubled since 2000, and “ are largely driven by a shift from traditional diets to cheap, energy-dense, imported foods”, according to UNICEF.

High-income countries such as Chile (27%), United States (21%) and the United Arab Emirates (21%) also experience high obesity rates in children.

Undernutrition, including wasting and stunting, remains a significant concern among children under the age of five in most low- and middle-income countries.

“In many countries we are seeing the double burden of malnutrition – the existence of stunting and obesity. This requires targeted interventions,” said Russell. “Nutritious and affordable food must be available to every child to support their growth and development. We urgently need policies that support parents and caretakers to access nutritious and healthy foods for their children.”

Prolific junk food advertising

A UNICEF poll of 64,000 young people aged 13-24 from 170 countries found that three-quarters had seen advertisements for sugary drinks, snacks, or fast foods in the previous week.

“Even in conflict-affected countries, 68% of young people said they were exposed to these advertisements,” UNICEF noted.

In adolescents aged 15–19 years, 60% had consumed more than one sugary food or beverage during the previous day, 32% consumed a soft drink, and 25% consumed more than one salty processed food, according to data from the Global Diet Quality Project.

“Unhealthy foods and beverages, including ultra-processed foods and beverages, are widely available, inexpensive and aggressively marketed in the places where children live, learn and play. 

“The unethical business practices of the ultra-processed food and beverage industry undermine efforts to put legal measures and policies in place to protect children from unhealthy food environments.”

UNICEF’s research in Argentina, Brazil, Chile, Costa Rica and Mexico found that retailers were more likely to prominently display sweet snacks and sugary cereals at entrances and within children’s reach in poorer communities than in wealthier areas.

Meanwhile, 70% of government officials and civil society representatives polled in 24 countries identified industry influence as a major barrier to introducing government-led food marketing controls. 

“Studies have found that the industry uses a mix of political, scientific, reputational management and marketing practices to delay, weaken, block and evade government policies,” according to UNICEF.

Possible interventions

The UN agency warns that the long-term health and economic benefits will be expensive for many countries, projecting that, by 2035, the global economic impact of overweight and obesity is expected to surpass $4 trillion every year.

It proposes several possible interventions to transform food environments and ensure children have access to nutritious diets.

These include mandatory policies to improve children’s food environments, such as front-of-pack labelling, marketing restrictions, taxes and subsidies for healthy food.

It also proposes banning the provision or sale of ultra-processed and junk foods in schools and prohibiting food marketing and sponsorship in schools.
It highlights progress made by the Mexican government, which was one of the first countries to tax sugary drinks and recently banned the sale and distribution of ultra-processed foods and items high in salt, sugar and fat in public schools.

Image Credits: Health Ministry of Chile.