Junk food leads to more children being obese than underweight for first time | Global health

More children around the world are obese than underweight for the first time, according to a UN report that warns ultra-processed junk food is overwhelming childhood diets.

There are 188 million teenagers and school-age children with obesity – one in 10 – Unicef said, affecting health and development and bringing a risk of life-threatening diseases.

Catherine Russell, executive director of the UN agency for children, said: “When we talk about malnutrition, we are no longer just talking about underweight children.

“Obesity is a growing concern. Ultra-processed food [UPF] 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.”

While 9.2% of five to 19-year-olds worldwide are underweight, 9.4% are considered obese, the report found. In 2000, nearly 13% were underweight and just 3% were obese.

Sulakshyan, 10, and his brother Subharna, 7, watch videos at home in Kathmandu. Nepal’s urbanisation has made ultra-processed food more widespread. Photograph: Bishal Bisht/Unicef

Obesity has overtaken being underweight as the more prevalent form of malnutrition in all regions of the world except sub-Saharan Africa and South Asia, and is a problem even in countries with high numbers of children suffering from wasting or stunting due to a lack of food.

The report, Feeding Profit: How Food Environments are Failing Children, used data from more than 190 countries and sources including Unicef, the World Health Organization and the World Bank.

It revealed that one in five of those aged between five and 19 are overweight, with a growing proportion of those 291 million individuals falling into the obese category: 42% in 2022, up from 30% in 2000.

Obesity was highest in Pacific Island countries, where there has been “a shift from traditional diets to cheap, energy-dense, imported food”, the report found. In Niue, 38% of five to 19-year-olds are obese, and the figure is 37% in the Cook Islands. Rates were also high in richer countries, such as Chile (27%), the US (21%) and the United Arab Emirates (21%).

In the UK, the percentage of overweight children increased from 29% in 2000 to 30% in 2022, while the percentage with obesity rose from 9% to 11%.

The steepest rise in numbers of overweight schoolchildren and teenagers was in low- and middle-income countries, where the number has more than doubled since 2000, amid a corresponding rapid expansion of “modern retail outlets, online grocery stores and food delivery apps”, with UPFs being “relatively cheaper than fresh or minimally processed nutritious foods”.

Childhood obesity has been linked to higher risks of heart disease, type 2 diabetes and some cancers in later life.

There is growing international concern about the damaging health impacts of UPFs, which include cereals, biscuits and cakes, fizzy drinks and ready meals, which have been through industrial processes and include additives such as colours, emulsifiers and flavours, and can be high in added sugar, fat or salt.

UPFs “dominate shops and schools”, the report warned, and are heavily promoted to young people and parents digitally, creating an environment where they are hard to avoid, rather than a matter of personal choice.

Sweets on sale at a roadside stall in Nairobi. In the past 20 years, the percentage of obese adolescent girls in Kenya has more than doubled to 13%. Photograph: Amaury Falt-Brown/Unicef

Nomathemba Chandiwana, chief scientific officer at the Desmond Tutu Health Foundation in Cape Town, South Africa, said: “We often only think of malnutrition here as underweight or stunting, but obesity has the same long-term consequences.

“About one in eight children are overweight or have obesity, while one in four are stunted. That double burden is shaping a generation’s health,” she said, adding that children were targeted by “relentless” marketing of fast food, even in schools.

“It’s really tough trying to tackle both undernutrition and obesity at the same time. South Africa is a middle-income country, but still deeply unequal. Many children grow up both hungry and surrounded by cheap, poor-quality food.

“Most of the attention and resources go to undernutrition and stunting in the early years, which of course matters, but obesity isn’t always seen as malnutrition, so it slips under the radar,” she said.

Growing rates of childhood obesity will have a major impact economically. Unicef has previously estimated that by 2035, the global cost of overweight and obesity will surpass $4tn (£2.9tn) annually.

Children in Kampala, Uganda, consume snacks and sugary drinks during a school break. Obesity is not always seen as malnutrition. Photograph: Amaury Falt-Brown/Unicef

The report highlighted the positive action of Mexico’s ban on the sale and distribution of UPFs in schools.

But it added that “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 called on governments to act on this by using labelling, marketing restrictions, taxes and subsidies. It suggested banning junk foods and their marketing in schools, and better programmes for vulnerable families to afford nutritious diets.

There should be “strong safeguards to protect public-policy processes from interference by the ultra-processed food industry”, it said.