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Obesity is a significant problem among all age groups and it occurs due to excess fat deposition in the adipose tissue. Various factors contribute to childhood obesity which has made it a global problem. This report will focus on the prevalence of obesity in Amsterdam, the capital of the Netherlands. Other than that, a discussion will be done on several organisations that carry out the program on childhood obesity. An analysis will be done on the effective childhood obesity policies in Amsterdam. Furthermore, the rationale behind all these programs and policies will be discussed to understand their implementation phases and the important people associated with this implementation.
Obesity is a condition, which is caused by excess fat accumulation in the body. Various factors contribute to this chronic condition. As the findings of Saeed et al. (2018), genetics play a significant role in obesity. In the case of “Monogenic cause,” a single gene mutation in the leptin-melanocortin pathway can cause obesity by disrupting the synthesis of Leptin. Leptin is considered a hormone that releases from the adipose tissues to help in regulating hunger by providing a satiety feeling after consuming food. However, due to genetic mutation, the genes that are responsible for the synthesis of the leptin hormone get disrupted (Fairbrother et al. 2018). Hence, as a result, leptin does not synthesise or release following a meal, the reason why people do not get a satiety feeling and tend to consume more food. Excess energy accumulates in the body and creates a positive energy balance, ultimately leading to obesity. Other than this genetic cause, any types of malformation of the organ or system and even neurodevelopmental abnormalities are the reason for syndrome obesity (Durmaz et al. 2021). The primary cause of obesity is the accumulation of excess fat in the adipose tissues.
A “body mass index” (BMI) over 25 is regarded to be overweight and a BMI over 30 is considered to be obese. Obesity has been acknowledged as a major issue in public health as it poses a threat to the population's physical as well as mental health. It is thought to be one of the most significant health challenges of the 21st century. It has been determined as a risk factor for other chronic health conditions like diabetes, cancer, cardiovascular diseases (CVDs), as well as osteoarthritis (Piché et al. 2020). Obesity among children has been a significant problem in society that affects physical activities. Some major factors that contribute to childhood obesity include less physical activity, a sedentary lifestyle due to more indoor activities, eating junk, and ignoring eating healthy nutritious food. Genetic factors can also contribute to this childhood obesity. Children who suffer from obesity have a higher risk of developing T1DM or “Type 1 Diabetes Mellitus,” also known as IDDM or “Insulin Dependent DM” (Corbin et al. 2018). Other than diabetes, respiratory problems like asthma, sleep apnoea, and elevated higher bad cholesterol in the blood significantly enhance the chances of the development of early CVDs. Some children even develop mental disorders like excessive body consciousness, anorexia, bulimia like eating disorders and even depression.
The Childhood obesity policy of Amsterdam has been divided into 3 major categories as a tool for sorting the policies on childhood obesity based on their purpose in combating childhood obesity.
The very first approach or policies have been made as preventive strategies aimed at controlling children from becoming overweight or obese, a major risk factor for other chronic disorders. The preventive strategies aim to screen infants to identify those who have a huge risk of developing obesity. Moreover, it has been found that some expectant mothers gain weight abnormally and sometimes more than they should ideally gain. In this context, the preventive policy has considered providing counselling on nutritional knowledge so that one can indulge in eating healthy food to gain a healthy weight during pregnancy (Goldstein et al. 2017). Cycling is another important strategy or policy that can engage children in some type of physical activity that can help them to shed excess gained calories to maintain a balanced energy level in the body. Hence, safer cycling routes are mandatory to prevent childhood obesity. Other than that, making primary schools healthier can incorporate healthy eating habits from a very early phase of life (Vasiljevi?et al. 2020). A good eating habit following a healthy diet can impact fully reduce childhood obesity rates. Other than that, engaging children in some school activities by arranging some interesting games and a reduction of adverts for unhealthy food under the supervision of experts like dieticians can significantly prevent childhood obesity in Amsterdam.
Curative and facilitative policies
Curative policies are aimed at supporting children, who were already overweight and for that, it is necessary to ensure an appropriate level of care for the overweight as well as obesity. Moreover, as a curative strategy healthcare nurses can be assigned to the youths so that they can take PCC to combat obesity and obesity-related complications such as diabetes, elevated blood cholesterol levels, a risk factor for CVDs and so on (Mead et al. 2017). Other than that, the facilitative policies are helpful as it applies to a shared commitment to learning. This is aimed at analysing and learning with technology to fight against obesity. In this regard, it has been found that the investigation of determinants of healthy sleep, as well as intervention assessment, can help to mitigate sleep disturbance problems among obese children. In this regard, digital tools and observation methods can be used to monitor sleep apnoea among obese children, a very common problem.
Since 2012, the Amsterdam municipality has conducted the program “A Healthy Weight for All Children”. Eric van der Burg, the deputy mayor at the time, was completely shocked by the available data on obesity. It has decided to develop programs or strategies for fighting against obesity. As per the findings of Seidell and Halberstadt (2020), childhood obesity is a significant problem in Amsterdam and as per the data, changing environmental factors in the Netherlands contributed to this childhood obesity. Only 20% of the children showed to have gene polymorphism that caused a significant increment in the BMI. Other than that, the study also found that epigenetics, as well as lack of development of good gut bacteria, contributed to childhood obesity (assets.amsterdam.nl, 2022). All these factors contributed significantly to a higher risk of children who are less than 2 years old living in Amsterdam. Taking these factors into consideration the government of Amsterdam has been taking several initiatives and programs since 2012. The most significant importance of this program is the rates of overweight children reduced from 27,000 to 24,500. This reduction was observed despite the addition of approximately 5000 children aged between 0-19 years in Amsterdam (obesityactionscotland.org, 2022). The city witnessed the best outcomes for children who belonged to a very low or low SES “Socio-economic status.”
In 2013, a study has been done that inferred that one in every four children in Amsterdam was either overweight or obese and to tackle this major problem, a long-term program called “Amsterdam Healthy Weight Programme.” It was taken by “The Council and Health Department of Amsterdam” (unicef, 2022) It is a long-term approach and for this program, the council members rewarded the program with various approval along with a structurally and sizeable budget until 2033 so that the targeted obese children can celebrate their 18th birthday as healthy individuals (amsterdam.nl, 2022). Therefore, it can be stated that the government or authorities of Amsterdam city of Netherland are very cautious to eradicate this childhood obesity.
This social model of health or Rainbow model by Whitehead and Dahlgren (1991) is considered quite useful in establishing the relationship between environmental factors, individual factors, genetic factors, and diseases that help to determine the cause of developing certain diseases or their increased rates. This framework is quite useful in delivering a system for expanding questions regarding the extent of the contribution of individual layers to health (unicef, 2022). Other than that, the feasibility of adjusting specific factors as well as the complementary activity that would be mandated to impact the linked elements in other layers. This framework assisted the leaders of Amsterdam to make urban food policies. Amsterdam, which is a multicultural society, has only half of the children being Dutch. Children of other non-western ethnic groups have double or triple the rates of obesity than that of other western and Dutch children (amsterdam.nl, 2022). Improving the physical activities sleep and diet of the obese and overweight children through various actions in school, neighbourhood, home as well as various parts of the city, helped to reduce the prevalence of obesity or overweight among 2 to 18-year-olds declined from 21% in 2012 to 18.7% in 2017 (Sawyer et al. 2021). This framework assisted to develop effective strategies to reduce childhood obesity.
Evaluation aim and questions
The main of this evaluation is to implementation of some policies through which the reduction of childhood obesity.
What is the concept of obesity among children?
What is the prevalence rate of obesity in Amsterdam?
What kinds of policies have been implemented for the reduction of childhood obesity?
What is the effect of the implementation of the policies?
For the evaluation of this research, mainly the thematic analysis has been chosen here which helps in properly executing the prevalence rate and all of the impacts of the implementation of those policies.
Obesity is a main excessive accumulation or diagnosis as the abnormal fact mainly in the adipose tissues, which helps in possessing with health danger. The accumulation of this factor is significantly occurring when the consumption of energy from the entail of drinks and food with higher energy can be required. In those recent days, obesity among children mainly in the UK has increased (Saha et al. 2020). As in different kinds of countries in the world, Amsterdam has shown the highest level of prevalence of obesity and overweight among children. In the age group of 1-7 years, aged children have a higher rate of obesity in this area. The data on "youth healthcare routine" from 2012 has shown that more than 21% of more than 135000 children between the age group of 2 to 18 years old in Amsterdam were highly classed as being obese and overweight. Apart from this, the distribution of obesity and overweight across this Amsterdam city is unequal with most of the affected being from minority and migrants ethnic backgrounds mainly for the low educational level of children and the income status of the family. The increasing trend of this obesity among children has been seen past 50 years (obesityactionscotland.org, 2018).
In contrast, as per the statement of Health–Europe, (2022), it can be stated that within the 3 years of implementation planning, the healthy approach in Amsterdam in 2012, the prevalence of childhood obesity in this country has decreased. Amsterdam mainly reported a fantastic more than 12% of drop-in childhood for obesity and overweight within more than 3 years of all of their “A healthy weight program for all children.” The three years program (2018-2015) has shown that the number of obese children is decreased from more than 28000 to 25000. However, it was despite some of the additional 5100 children who are 0 to 19 years in Amsterdam mainly in this time (obesityactionscotland.org, 2018).
During those days, Amsterdam tried to fall at the rate of childhood obesity. In most countries, the obesity rate in many countries in the UK has been increased day by day. In those recent days, the rate of obesity has decreased rapidly. The rate of obesity has been decreased by applying for the healthy-weight program. The prevalence of the rate of obesity has been decreased through the implementation of the healthy weight program in this area, which also helps in reducing the risk factors related to obesity among children (Mahase, 2022). The healthy weight program has been decreased by offering some dietary advice and joining a gym and all of those are free. The obesity problem in childhood within the Amsterdam area is consolidated in the poorer parts of this city. All of those have been seen among the immigrant communities from North Africa, Surinam, and Turkey. Between the years 2012 and 2015, the overall percentage of overweight and obese children has fallen from more than 21% to 19 %, which results in more than 12% of the overall dropdown in the total number of children who are obese or overweight (bbc.com, 2018).
All of the policies, which have been implemented here, are based on Preventive policies, curative policies, and facilitative policies. The implementation of the preventive policy in the case of childhood obesity in this area helps in the prevention of becoming overweight among children. Along with this, the implementation of curative policies helps in reducing the obesity rate among children who are overweight already (Mahase, 2022). The last policy, which is the facilitative policy, helps in learning and exploring some new technologies, which help in fighting against obesity among children. All of the implementations of the policies help in battling the childhood policies. The preventive policies help in infant screening for all obesity risks. Along with this, the preventive policy helps in providing pieces of information and counseling to the mothers about all of the healthy diets, which help in reducing childhood obesity. The implementation of this policy helps in the routine safer cycle. Along with this, the preventive policy helps in making healthier all of the primary schools and helps in arranging children in some schools that help in preventing childhood obesity. Through a “council-owned environment,” this policy helps in reducing the consumption of unhealthy foods among children. In contrast, the curative policy implementation helps in ensuring the level of suitable care for obese and overweight children. Apart from this, the curative policy helps in assigning the nurses who are included in healthcare to youths, which helps in reducing childhood obesity (Health–Europe, 2022). Along with this, facilitative policy implementation helps in investigating the determinants of healthy sleep and intervention assessments. Apart from this, the facilitative policy implementation helps in observing the intervention and digital tools that help in reducing childhood obesity. All of those implementations of policies have been done for eradicating poverty mainly over 20 years of period. The implementation of those policies has been implemented in some shorter phrases. Phase 1is begins from 2013 to 2018 among healthy-weight children who are 0-5 years old. Phase 2 begins from 2019 to 2023 among ill people who are 0-10 years old. Phase 3 begins from 2023 to 2033 among those children who are 18 years old.
The implementation of those policies gives huge benefits to the reduction of childhood obesity. All of the policies, which have been implemented here, are based on Preventive policies, curative policies, and facilitative policies. The implementation of policies helps in giving many advantages to the obesity control approach among children. The implementation of those kinds of policies works hugely for the reduction of childhood obesity and the intervention has greatly worked (Saha et al. 2020). The schools, councils of local government, and the community help in playing an important role mainly taking a part in raising children based on a community.
Programs like “A Healthy Weight for All Children” 2017, and the “Amsterdam Healthy Weight Programme” have helped to solve this issue to some extent. The most significant importance of this program was the reduction in childhood obesity from 27,000 to 24,500. Some policies and their implementation strategies have been discussed and in this context, I would be investigating these policies using the content as well as implementation process evaluation. While the policy is in the third phase and is currently still running, phases 1 and 2 have been effectively carried out with significant positive outcomes.
The focus of this report was to analyse the prevalence of childhood obesity in Amsterdam. It has been found that Amsterdam showed the highest level of prevalence of obesity and overweight among children. In the age group of 1-7 years, aged children have a higher rate of obesity in this area. This reduction was observed despite the addition of approximately 5000 children aged between 0-19 years in Amsterdam. Moreover, the second program has helped to reduce the prevalence of obesity or overweight among 2 to 18-year-olds declined from 21% in 2012 to 18.7% in 2017. Evaluation and the implementation of the policies have helped and can help in the management of the current scenarios.
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