Next steps:

1. Use the CRAAP model to finish critically evaluating my sources used and unused, which
will be used for an integrative literature review.
2. Write my main paragraphs (Nurture, Nature, and Nature and nurture interplay).
3. Integrate my literature review into my main paragraphs.
4. Write my introduction and conclusion.
5. Check word count.
6. Write my abstract and any limitations / recommendations.
7. Finish by the end of the Christmas holidays.
8. Complete my end of project review.
9. Start making my presentation.

Title Page:
“To What Extent is Childhood Obesity a Matter of Nature Rather Than Nurture?”
Contents:
Abstract:
Introduction:

 Definition of overweight and obese in terms of BMI.

- No sources needed
- Body mass index (BMI) is calculated by a person’s weight (kg) divided by their height
(m) squared to determine if someone is of healthy weight. A BMI of 25 to <30 is
considered overweight. A BMI of 30 or higher is considered obese. A BMI of 40 or
higher is considered severe obesity.
 Prevalence of childhood obesity in past and present, including future predictions.
- Source 23: A survey by Public Health England found that “28% of children aged 2 to
15 are overweight or obese” and that “of children aged 4 to 5, 9.3% were obese” in
addition to the fact that “19.8% of children aged 10 to 11 were obese”. (Health
matters: obesity and the food environment, 2017)
 Published recently. Assesses the scale of the problem of childhood obesity.
Information comes from Public Health England which is a very reputable
organisation. Information is free from emotion and can be verified by data
from other sources (e.g., source 25) on showing the increase in childhood
obesity. There is a clear purpose to teach and inform and can be viewed as
fact.
- Source 25: Aged 5 to 19 years old, the prevalence of childhood obesity has gone
from 0.9% of boys and 0.7% of girls in 1975 to 7.8% of boys and 5.6% of girls in
2016. Although childhood obesity rates in the UK are stabilising, millions of children
are still obese or overweight which can lead to various health risks in their future
years.
  Published recently. Compares the past with the present to show the impact
of change, and only focusses on children. The source is reliable as it was
carried out by researchers at NCD Risk Factor Collaboration (a well-known
network of health scientists), where the lead researcher is located at
Imperial College London. The article comes from the medical journal The
Lancet, which has been peer-reviewed. However, one limitation is the fact
that the researchers categorized obese and overweight in reference to a
population of the same sex and age rather than fixed categories based on
optimal weight for health – this can bring up the question as to whether this
would misjudge the proportion of children considered as obese.
- Source 26: By 2030, in the UK, the prevalence of childhood obesity is predicted to
rise to 12.4% of all children aged 5-9, with 10.3% of children aged 10-19 becoming
obese. (Lobstein and Brinsden, 2019)
 Published very recently. The information is at an appropriate level and
related to looking at the future of childhood obesity in the UK. The
organisation is non-profitable and is very well respected as to have formal
consultative status by the World Health Assembly. The language is free of
emotion, where only statistics are used on the whole. The authors have a
clear aim to achieve global obesity related targets.
 Definition of energy balance and what main factors that affect it.
- No sources needed
- Obesity occurs when more energy in taken in than it is given out over a long period
of time, where the energy taken in is stored as fat. Energy (calories) is taken in
through the consumption of food and drink, where the amount of energy is
dependent on the energy density and quantity consumed. Energy is given out
through physical activity, where the amount of energy is dependent on the
frequency and intensity.
 Economic cost of childhood obesity.
- Source 23: The rise in overweight and obesity-related ill health is costing the NHS roughly
£6 billion in 2014-2015, where, by 2050, it is predicted to increase to about £10 billion per
year. Furthermore, the overall societal costs of obesity are £27 billion, and is estimated to
reach almost £50 billion per year. (Health matters: obesity and the food environment, 2017)
 Same as Source 23 in ‘Prevalence of obesity’.
- Source 28: In 2006-2007, it was found that it costs the NHS £5.1 billion to treat ill health
due to being overweight and obese. (Scarborough et al., 2011)
 Published fairly recently. The article is relevant it shows how the impact of
obesity affect the wider society, however it does include adults as well as
children in their study. The authors are respected researchers, with some
working at Oxford University. Comes from the peer-reviewed Journal of
Public Health. The purpose of the article was to update the economic costs
of obesity, as comparable estimates were from 1992-93.
- Limitations: Costs are likely to be underestimates as not all the diseases caused by obesity
are likely to be considered as it would be very difficult to measure, as well as different
sources measuring different factors.
 Importance of understanding the extent of nature and nurture.
- No sources needed
- The understanding of how our genes and environment interact is an important
framework when introducing policies and practices towards the prevention of
childhood obesity.
 What the research paper will cover.
- No sources needed
- This article will review and evaluate a variety of sources on the nature and nurture
of childhood obesity.
 How and why the research has been narrowed.
- No sources needed
- My research has been narrowed down to focus on the obesity of children in high
income countries due to the vast amount of literature from different types of
country economies.
Nurture:

 Abundance of high energy foods.

- https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/800675/Calories_Evidence_Document.pdf
- Children who are overweight / obese are consuming up to 500 excess calories on
average per day. (Page 5)
 Government document and recently published
- Source 18: Supermarkets have been getting closer to homes between 1975 and
2005 by a mean distance of 1.351km, where grocery stores have increased, with a
mean distance of 0.602km from homes. Within a 1500m radius of a person’s home,
the mean count of fast-food restaurants has increased by 4.9. (James et al., 2017)
 Published recently. Relevant as it shows how accessibility of types of food
establishments has changed over time. The authors work in well-respected
institutes, with the majority working at Harvard Medical School. The article
comes from the peer-reviewed International Journal of Behavioral Nutrition
and Physical Activity. The purpose of the article is to inform and teach,
where there is no personal bias.
- https://pubmed.ncbi.nlm.nih.gov/19467279/ or
https://dro.dur.ac.uk/10157/1/10157.pdf
- A study found that between 1980 and 2000, the number of food outlets in the UK
had increased by roughly 80%.
 Although the article has been published over 10 years ago (2009), I have
used it in my research as it shows data from the comparison of two dates
which makes the data of publication less significant. The authors all work at
Newcastle University and the article has been peer-reviewed.
- https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0589-5
- It was found that more frequent consumption occurring out-of-home resulted in
higher daily energy intake. Children who, at least once per week, ate a takeaway at
home consumed up to roughly 170 calories more than those who seldom did.
  Published recently. Comes from the peer-reviewed International Journal of
Behavioral Nutrition and Physical Activity, where the majority of authors
work at Newcastle University, and one at University of Cambridge.
The development of an obesogenic environment has increased the quantity of high energy
foods to the point of it being an abundance. Not only have the number of food outlets
increased by roughly 80% between 1980 and 2000, but it has also seen to increase the
availability of unhealthy food stores and decrease that of nutritious whole food stores. In a
study between 1975 and 2005, it was found that the distance between homes and
supermarkets had decreased by over a kilometer, while this distance for grocery stores had
increased by roughly half a kilometer. These statistics show that the ever-changing food
environment is encouraging people to shop at establishments filled with a variety of
unhealthy processed foods. It was further discovered that the quantity of fast-food
restaurants in a 1.5km radius of homes had increased by an average of 4.9. This is increase
has been found to directly relate to an increase in energy intake in children, where the
average child who ate a takeaway at least once per week consumed roughly 170 calories
more per day than children who seldom did, equating to roughly 1200 calories per week.
However, the impact of the food environment on the excess calorie consumption of children
is not limited to outside their homes.

 The effect of food advertising:

- Source 19: After watching food advertising, children were found to eat up to 45%
more than those who did not. This shows how impactful food advertising is at
priming the viewer’s automatic eating behaviour.
 Despite being published in 2009, the article and its findings are not out of
date. The article is only one of few which covers the material at this level of
specificity. The authors are respectable psychologists and researchers at
universities, and the article is part of PMC which only includes peer-reviewed
studies.
- https://pubmed.ncbi.nlm.nih.gov/20634464/
- Unhealthy food was found to be between roughly 50% and 90% of all food
advertisements, where they were more likely to be shown during times when
children are most likely to be viewing.
 Published recently, where authors are respectable researchers, working in
institutions such as Leeds University and University of Liverpool. The article
has also been peer-reviewed and published in the American Journal of Public
Health.
The rise in a child’s energy intake may also be due to the increase in exposure to food cues. A
study uncovered that the food being advertised was predominately unhealthy, making up
roughly 50 – 90% of all food advertisements, and were more likely shown during children’s
peak viewing time. An example of the impact food advertising has on the food intake of
children was seen by Harris in 2009, when, after watching food advertising, children ate up
to 45% more than those who did not. The prevalence of junk food advertising, as well as its
marketing strategies, prime children to change their eating behavior, where the rise in
technology creates greater opportunity for these food cues to appear.

 Impact of the cost of healthy and unhealthy on the socioeconomic disadvantaged.

- https://www.gov.uk/government/news/record-high-levels-of-severe-obesity-found-
in-year-6-children
- PHE found that the prevalence of childhood obesity in year 6 in the most deprived
areas is over double compared to the least deprived areas, with the frequency being
26.8% and 11.7% respectively.
 Published recently and by Public Health England which is highly reputable
organisation due to being set up by the UK government. There is no sign of
any bias.
- https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30045-8/
fulltext
- Children ages 10-11 in 1946 were found to be an average of 36.2kg if they were upper class,
compared to 33.9kg if they were lower class. However, in 2001, children aged 10-11 were
found to be an average of 39.8kg if they were upper class, compared to 41.8kg of they were
lower class. This shows how the change in food environment, where energy-dense and
nutritionally poor foods are cheaper and easier to prepare, has led to a greater BMI for
children in economically deprived areas.
 The article has been recently published and contains so sign of bias. Being
published on the Lancet means the article has been peer-reviewed to a high
standard. The authors are reputable members of Loughborough University
and UCL.
The financial aspect of a family has now become a factor in the increased occurrence of
childhood obesity. In 1946, upper-class children were on average a weight of 36.2kg,
whereas lower-class children were 33.6kg on average. However, 55 years later, upper-class
children of the same age were 39.8kg on average, compared to 41.8kg for lower-class
children. These results show that, not only have both groups become heavier after 55 years
of environmental development, but that children of a more deprived background have now
become heavier than their counterparts. A more substantial piece of evidence shows that
year 6 children from the most deprived areas are more than twice likely to become obese
than those in the least deprived areas, with the frequency being 26.8% and 11.7%
respectively. The reasoning behind this is thought to be due to more energy-dense foods
being cheaper and easier to prepare and are hence of greater convenience for families of a
lower socioeconomic area.

 Current and future plans to reduce the changes in the food environment.
- https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/718903/childhood-obesity-a-plan-for-action-chapter-2.pdf
- A goal set by the UK government was to reduce the sugar content of food eaten
most by children by 20% by 2020. As sugar is not the only cause of children
consuming excess calories, the government has started work on reducing the
number of calories in foods from all organisations selling food and drink by 2024, as
 well as making it legal for the government to demand all out-of-home restaurants to
consistently label calories.
 Government document and recently published.
- https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/925027/SugarReportY3.pdf
- Between 2015 and 2019, it was found that the overall sugar reduction of the most
common foods eaten by children has only been reduced by 3%. (As the data was
collected before COVID-19, it is therefore important to note that it has not had an
impact on the results).
 Government document and recently published.
- https://www.gov.uk/government/consultations/total-restriction-of-online-
advertising-for-products-high-in-fat-sugar-and-salt-hfss
- In addition to a ban on HFSS adverts on certain TV shows, the government has also
consulted on the ban of HFSS adverts online, due to findings that there has been an
increase of 450% spent on food and drink advertising online between 2010 and
2017.
 Government document and recently published.
Evidence shows that there is an increasing about of strategies being put in place to reduce
then energy consumption of children, such as reducing the sugar content of food eaten most
by children by 20%, with a target date of 2020. However, this strategy will need some
altering as a follow-up study found that between 2015 and 2019, the sugar reduction had
only reached 3%. As sugar is not the only cause of an increase in energy intake, the
government is working on reducing the calorie content of products sold by all food and drink
establishments by 2024. A further strategy will be to make it legal for the government to
demand all out-of-home restaurants consistently label calories, with the desired effect of
making customers more mindful of calories they are consuming and hence make healthier
choices. Actions on food advertising has been recently made by the government, with bans
of HFSS (High Fat, Sugar, Salt) adverts online, in addition to their ban on certain TV shows
made previously. This was put in place after a study found that there had been an increase
of 450% spent on online food and drink advertising between 2010 and 2017, showing how
marketing strategies are adapting to get maximum advertising coverage.

 Government recommendations for physical activity.

- https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/832868/uk-chief-medical-officers-physical-activity-
guidelines.pdf (page 24).
- The government recommends children take part in an average of at least 60 minutes of
moderate physical activity per day.
 Government document and very recently published.
 Decrease in physical activity of children.
- Source 8: A study at the University of Bristol in 2019 found that the MVPA (medium
to vigorous physical activity) of 2000 children aged 6 to 11 years old decreased,
while their sedentary time increased per year while at primary school. This was
shown when, on average, healthy weight 11-year-old spent an average of 6.6
 minutes less MVPA per day than healthy weight 6-year olds, which stacks up to over
¾ hour less MVPA per week. (Jago et al., 2019)
 Published very recently, with the authors working at either the University of
Bristol or University of Birmingham. The article comes from the peer
reviewed International Journal of Obesity.
- https://www.heart.org/en/about-heart-disease-in-women/latest-research/
childrens-cardiovascular-fitness-declining
- A study led by Grand Tomkinson, revealed at the American Heart Association’s
Scientific Sessions 2013 found that children are currently less fit than those roughly
40 years ago. This was proven when children in 2010 ran a mile 90 seconds slower
on average than the children in 1964. This is further explained by findings showing
that a child’s cardiovascular endurance has decreased by around 6% each decade
from 1970 to 2000. This decrease in fitness was said to be 30%-60% due to the
increase in fat mass.
 As the conference video was not available, I have used the website of the
organisation who conducted the research (American Heart Association) as
opposed to the many news websites who have written on it. The study had
been conducted fairly recently and by respectable researchers, such as
Grand Tomkinson, who is the senior lecturer in the University of South
Australia’s School of Health Sciences.
 Increase in very low energy behavior.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282352/
- The convenience of screen-based activities, such as video games and TV viewing,
has encouraged an increase in very low energy behavior among children (sedentary
behavior). However, the weak relationship shows that it does not displace the
amount of physical activity but can encourage a decrease in it to some extent.
 Article published fairly recently and on PMC, therefore showing it must be
peer-reviewed. The authors are reputable, working in institutes such as
Loughborough University and University of Cambridge School of Clinical
Medicine.
- https://www.nature.com/articles/0803064#Sec12
- Evidence shows that an increase in very low energy behavior leads to a gain in
weight and fatness in children, showing a causal relationship.
 Although the article has not been published that recently (2005), its results
are very relevant to my research. The article comes from the peer-reviewed
International Journal of Obesity, with the authors working at Tufts
University.
 How physical environment can be changed to increase physical activity.
- https://academic.oup.com/abm/article/52/3/239/4815762#
- It has been found that a change in physical environment can change the physical
activity of the population living in it. For example, a strong overall positive increase
in physical activity was found when: new infrastructure was built for active travel
and public transportation, an increase in accessibility to typical destinations (e.g.,
parks and sport facilities), as well as improvements to parks and playgrounds.
  The article has been published recently and comes from the peer-reviewed
medical journal Annals of Behavioral Medicine. The authors all work at the
reputable institutes of University of Oulu and University of Eastern Finland.
Nature:

 The influence of genes on BMI.

- Source 2: The Chinese government had to separate the twins at birth, one to
Norway and one to California. After ten years, their height and weight were nearly
identical, as were their character and temperament, showing how impactful
genetics are even in such environmental differences. (Twin Sisters | Chinese Siblings
Separated at Birth | Independent Lens | PBS, 2014) 
 Released fairly recently by an award-winning director Good at visually
showing the impact of genes on the development of a child in different
environments. DNA tests were taken to prove they were twins.
 Genetic variation and susceptibility to an obesogenic environment.
- https://flowingdata.com/2016/06/14/growing-to-obesity/
- If obesity were solely down to our environment, the graph would go up but have the
same shape. As the shape of the graph has changed as well, this shows that
everyone has reacted differently to the change in environment which could only be
due to our genetics. (Graph from 1984 – 2014)
 Recently created and uses data from the Centers for Disease Control and
Prevention’s Behavioral Risk Factor Surveillance System. These surveys were
used which dated back to 1984, in which hundreds of thousands of people
were measured through the years.
 How twin studies are used.
- Source 16: The Gemini Study investigates the extent of which nature and nurture
impacts our characteristics. Twins are extremely useful in this by comparing
monozygotic (identical – 100%) twins and dizygotic (non-identical – 50%) twins. As
twins share most of their environments with one another, it can be estimated how
much of a contribution nature and nurture has on a particular trait. For example, if
MZ and DZ twins share a trait equally, it is likely to be influenced more by their
environment than their genes. (Fildes, 2020)
 This is primary research that I collected via interview, and hence the
accuracy and reliability of the source is down to the interviewee. Alison
Fildes is University Academic Fellow at Leeds University and currently deputy
director of the Gemini study, which aims to advance understanding of
genetic and environmental influences on obesity risk in children. The
information I have collected is extremely relevant to my title and does not
contain any bias.
 What heritability statistics show.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213088/
- A study using a questionnaire to score eight eating behaviors through a variety of
questions found that there was a strong correlation between certain types of eating
 behaviors and childhood obesity. (use both graphs to show the positive and
negative correlation).
 Published fairly recently and is part of the peer-reviewed Nutrition Journal.
All authors work in the Department of Nutrition at The Pontifical Catholic
University of Chile, and therefore have a high reputation.
- https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/
tileshop_pmc_inline.html?title=Click%20on%20image%20to
%20zoom&p=PMC3&id=3213088_1475-2891-10-108-2.jpg (image)
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213088/bin/1475-2891-10-108-
3.jpg (image)
- Source 16: To measure the appetitive traits of twins, they gave parents a
questionnaire with eight scales: Desire to drink, Emotional over-eating, Emotional
under-eating, Enjoyment of food, Food fussiness, Food responsiveness, Satiety
responsiveness, and Slowness in eating. The parents given statements where they
must answer to what extent it applies to their child on a scale of 1 to 5. This makes
it easy to measure on a large scale and at a low cost. (Fildes, 2020)
 Same as above.
 Statistics on twin children.
- Source 16: The gene contribution varies for each trait, as well as age. Food fussiness
was seen to be “80% heritable” at 3 years of age. Satiety responsiveness was found
to be “70% heritable” when they were babies. Emotional over-eating was only
found to be “7% heritable” (can link to how overeating can be psychological in
conclusion) at 5 years of age however, showing how it was mainly impacted by their
shared environment. (Fildes, 2020)
 Same as above.
 Link to variation in populations.
- No sources needed
- This shows that our genes play a key part in how BMI variates among populations
through influencing our eating behavior.
 FTO gene discovery.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646098/?
_escaped_fragment_=po=12.5000
- Study found that there is a strong relationship between the fat mass and obesity-
associated (FTO) gene and a person’s BMI. It was found that, compared to adults
with two low risk variants, people with one high risk variant were around 1.2kg
heavier, and people with two high risk variants were about 3kg heavier.
 Although it has not been published recently (2007), it is the research paper
that originally founded the effects of FTO genes on obesity, for which a lot of
other academic sources are based on. The article has been peer-reviewed
and published on PubMed Central.
 Impact on BMI.
- https://academic.oup.com/hmg/article/27/20/3641/5067845
- The use of genome-wide association studies of around 700000 participants has
associated 941 SNPs (single nucleotide polymorphisms) with BMI. However, these
SNPs are said to only account for about 6% variance of BMI.
 Published recently by reputable authors who work at The University of
Queensland, the University of Tartu, and the University of Exeter. The article
has been published in the peer-reviewed Human Molecular Genetics Journal.
This article is relevant to my studies as it shows the impact of common single
base mutations on BMI.
- Source 5: In 1994, the lab of Jeffrey Friedman reported that the obese mouse had a
gene mutation called “leptin” found in the bloodstream, secreted from fat. When
injected back into the obese mouse, it was said to have “stopped eating” and
“shrank dramatically”. This finding confirmed that the lack of leptin had led to the
mouse’s paunchy nature, showing for the first time that food intake was not merely
a matter of willpower. In 1997, Stephen O’Rahilly and Sadaf Farooqi at the
University of Cambridge conducted tests on two first cousins who were both
morbidly obese. The study found that they both had a “deletion of a single guanine”
in their DNA sequence which had led to the production of a non-functional leptin
protein. The scientists classified both children as “hyperphagic” (‘more eat’) with a
“body-fat percentage of around 57 per cent”. The scientists saw how regular leptin
injections were not having any effect on many different people if they had
functioning leptin systems. (‘The Hungry Gene?’)
 Published very recently. The book is written by the well-known and
reputable author Giles Yeo, who is a Principal Research Associate in the
Department of Clinical Biochemistry at the University of Cambridge.
Although the book is written in an entertaining manner, the content focuses
solely on facts and does not include any bias on the pages used. The
relevance of this book is to give a case study of the impact of certain genetic
causes of obesity.
- Source 6: Jeff Flier’s group at Harvard found that leptin functions when there is not
enough of it. This finding is because leptin tells the brain how much fat the body
has, so not enough leptin means the body goes into a state of starvation. As Doug
Coleman theorised, it is a “starvation hormone”. This process occurs when leptin
levels drop rapidly in response to a lengthened period without enough food,
creating the “starvation response”. This response is where the body shuts down
metabolically expensive functions to retain enough energy for the brain to make
coherent decisions. One of the functions the body shuts down is reproduction,
hence the infertility of the mice. Due to the two cousins having no leptin in their
bodies to sense how much fat they had, they were always starving. Hence when
leptin levels increased, their “hyperphagia” was suspended, leading to their loss in
weight as well as fertility and an improved immune system. 
 Published very recently. The book is written by the well-known and
reputable author Giles Yeo, who is a Principal Research Associate in the
Department of Clinical Biochemistry at the University of Cambridge.
Although the book is written in an entertaining manner, the content focuses
 solely on facts and does not include any bias on the pages used. The
relevance of this book is to give a case study of the impact of certain genetic
causes of obesity.
- Source 7: Five-year-old girl was “twice the average weight for her age”, and was
caught stealing food from the kitchen, including raw sausages from the freezer.
After undertaking some tests, they found that the girl’s leptin gene was not
functioning. This caused the girl to constantly feel as hungry as a normal person
would who had not eaten for 3 days. (100 Kilo Kids: Obesity SOS, 2020)
 Released very recently and although is not that well know, it is effective in
showing the struggles that occur when a child has a lack of leptin in their
bodies. The documentary was filmed in Bristol Royal Hospital for Children
where real medical staff were used.
- No source needed: The missing 94% of genetic variance of BMI is considered to be
due to common genes with small genetic effects, rare genes with large genetic
effects, such as congenital (present from birth) leptin deficiency (mentioned above),
and gene-environment interactions. (link to nature and nurture interplay).
Nature and Nurture Interplay:

 The behavioral susceptibility theory.

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213088/
- A study using a questionnaire to score eight eating behaviors through a variety of
questions found that there was a strong correlation between certain types of eating
behaviors and childhood obesity. (use both graphs to show the positive and
negative correlation).
 Article published fairly recently as part of the peer-reviewed Nutrition
Journal, with the authors working at The Pontifical Catholic University of
Chile.
- https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/
tileshop_pmc_inline.html?title=Click%20on%20image%20to
%20zoom&p=PMC3&id=3213088_1475-2891-10-108-2.jpg (image)
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213088/bin/1475-2891-10-108-
3.jpg (image)
- https://jamanetwork.com/journals/jamapediatrics/article-abstract/1831292
- Study shows that a low satiety responsiveness can lead to weight gain in children.
 Published recently and part of the peer-reviewed JAMA Pediatrics journal,
where the authors working at UCL and King’s College London.
- https://www.sciencedirect.com/science/article/abs/pii/S0195666306005034
- A child with a high responsiveness to food was found to eat their food faster and
have an overall increase in energy intake. A high satiety responsiveness was found
to decrease the energy intake when eating without hunger, slower eating, better
caloric compensation (energy intake after a previous intake of energy), and a lower
overall caloric intake. Children with a higher enjoyment of food had a greater caloric
intake when eating without hunger, ate faster, and a larger overall caloric intake.
This shows that people who have inherited more appetitive traits are more likely to
 eat more due to the opportunities provided by the obesogenic environment, and
hence at higher risk to become obese.
 Although it has not been published recently (2006), it is relevant to my
research as it is the article which originally founded the behavioral
susceptibility theory of obesity, in which many more modern research
articles use for their own research. The article is part of the peer-reviewed
Appetite journal, where the authors both worked UCL during the time of
publication.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359365/#:~:text=Jane%20Wardle
%20proposed%20that%20the,(BST)%20%5B3%5D.
- ‘Obesity results from an interaction between genetic susceptibility to overeating and
exposure to an ‘obesogenic’ food environment.’
 Published recently as part of the peer-reviewed Springer Open Choice
Journal, with the researchers working at UCL and University of Leeds.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359365/bin/
13679_2017_247_Fig1_HTML.jpg (graph)
 Heritability of BMI in children differs based on environment.
- https:/ww.ncbi.nlm.nih.gov/pmc/articles/PMC4346225/
- Shows higher heritability of BMI in populations with a higher BMI, as well as in
countries with a higher GDP.
 Published fairly recently and part of the HHS Author Manuscripts on PMC
which means the article has been peer-reviewed, with the authors working
at John Hopkins University during the time of publication.
- https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0027135
- Shows that twins born later (closer to 1983) have higher BMI heritability than those
born earlier (closer to 1951) from use of Swedish conscripts. This shows that the
heritability of BMI has increased during the rise of an obesogenic environment, and
therefore suggests that an obesogenic environment accentuates the genes related
to adiposity.
 Article published fairly recently and part of the peer-reviewed PLOS One
Journal (published by the Public Library of Science), with the authors working
at Copenhagen University Hospital, The Karolinska Institute, and the
University of Helsinki.
 The impact of an obesogenic environment on BMI heritability among children.
- https://jamanetwork.com/journals/jamapediatrics/fullarticle/2703914
- Shows increase in heritability of BMI among children living in a more overall
obesogenic environment compared to those that do not, with an average
heritability score of 86% and 39% respectively.
 Published very recently in the peer-reviewed JAMA Pediatrics journal by
researchers working at UCL, Radboud University Medical Center, and
University of Leeds at the time of publication.
 The role of physical activity in BMI heritability.
- https://www.researchgate.net/profile/Kirsi_Pietilaeinen/publication/
23560940_Physical_activity_reduces_the_influence_of_genetic_effects_on_BMI_an
 d_waist_circumference_a_study_in_young_adult_twins/links/
0fcfd5108d6dd07bd2000000.pdf (Will use, but only data found on adults)
- The heritability of BMI was shown to decrease from 79% in males and 78% in
females to 55% and 54% respectively when physical activity was high. This shows
that undertaking more physical activity lessens genetic tendency towards a higher
BMI and is more beneficial for those with a higher genetic susceptibility for obesity.
 Although it does not include children in the article, it is the only research
paper I could find on how the heritability of BMI changes due to physical
activity, which is extremely relevant in showing the nature-nurture
interaction. The article has been published fairly recently as part of the peer-
reviewed International Journal of Obesity, with the authors working at the
University of Helsinki.
- https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001116
(will use, but only shows significant results for children.)
- Shows physical activity reduces the weight-increasing effects of FTO gene variants
by 27% for adults.
 The article has been published fairly recently as part of the peer-reviewed
PLOS Medicine journal, with the large number of authors working at a
multitude of well-respected institutes, such as Harvard University and the
Institute of Metabolic Science at Cambridge.
 Although children were also used in the study, there was found to be no
interaction between the FTO variant and physical activity on BMI, although
when body fat percentage was used instead, it was found that there was a
slight decrease in the risk of the FTO allele on physically active children
compared to sedentary.

- file:///C:/Users/Jonoh/Downloads/
Beaulieu2016_Article_DoesHabitualPhysicalActivityIn.pdf (not used as only for
adult)
- https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2009.498
- Shows that physical activity plays a role in normalizing a child’s satiety sensitivity,
and hence decreases the number of daily calories consumed for those who had a
higher-than-normal satiety sensitivity.
 The article has been published fairly recently as part of the peer-reviewed
Obesity Journal, with the authors working at Nemours Children's Clinic,
Nemours Cardiac Center, and Wayne State University during the time of
publication.
- Limitations / Recommendations:
Conclusion:

 The biological and environmental roles in BMI variation.

- No sources needed
- The evidence clearly supports that childhood obesity is determined by both
genetics, primarily through the increase and decrease of particular appetitive traits,
 as well as our environment, through the encouragement of food consumption and
discouragement of physical activity.
 Nature via nurture.
- Source 21: Keeping Siamese cats in a freezing room will make their fur turn black,
and in a warm room their fur will turn white, whereas in a mildly cold room, their
fur will become a mixture of the two. This provides evidence that “nature and
nurture are working together”. Obese parents are
- more than likely to have an obese child which supports the view that obesity runs in
our genes.
 A fairly recent lecture by Professor Steve Jones, who has been the Head of
the Department of Genetics, Evolution, and Environment at UCL. The lecture
is relevant in understanding the nature via nurture connection.
 Summary of how obesity can be decreased from data above.
- No sources needed
- As shown, the factors that increase the risk of obesity in children can be mitigated
by the regulation of the food environment, such as sugar tax and food advertising
curfews, as well as by promoting more physical activity in the environment.
 Psychological perspective on obesity prevention.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556905/
- It was found that, during the first month of the COVID-19 pandemic, over 50% of
adults were subject to overeating. This would be due to a number of psychological
factors, such as anxiety and depression.
 Published very recently on PMC which only allows peer-reviewed articles.
This article is relevant in using current events to show the relevance of
psychology in obesity. Although the survey only uses adults, it must also
apply to children.
- https://www.bps.org.uk/sites/bps.org.uk/files/Policy/Policy%20-%20Files/
Psychological%20Perspectives%20on%20Obesity%20-%20Addressing%20Policy%2C
%20Practice%2C%20and%20Research%20Priorities.pdf
- A more holistic approach is needed to combat childhood obesity, where the stigma
of obesity should be reduced by the correct use of language and not framing obesity
as simply a choice.
 The article has been published very recently by the British Psychology
Society, which is an award-winning charity and representative body for
psychology in the UK. The publication does not contain any bias and
promotes the use of psychology through factual information.