Registered Nurses' Association of Ontario

Protective and Risk Conditions for Childhood Obesity

  1. Societal/Structural Conditions:
  • Refers to the inequitable distribution of resources, money and power, which are the “structural drivers of the conditions of daily life”.
  • Socio-economic status is associated with differential opportunities for healthy food and physical activity amongst communities.
  1. Obesogenic Environmental Conditions:
  • Refers to, “a social, physical or economic environment that promotes sedentary or less active lifestyles and the overconsumption of food, and in particular, a greater consumption of high-fat, high-calorie foods”.
  1. Individual-level Conditions:
  • Refers to the biological conditions that influence childhood weight.

Protective Conditions


Risk Conditions


  • Interventions that address income security, income inequalities, fair employment and decent work, social safety nets, healthy equity in systems, programs and policies, financing to address the social determinants of health and social inclusion.



  • The inequitable societal structures that perpetuate poverty in marginalized populations compared to others (e.g. Aboriginal people, stigmatized people, new immigrants, people with disabilities etc.



  • Parents/primary caregivers are role models. They shape children’s eating and physical activity behaviours
  • Development, promotion and implementation of comprehensive and enforceable healthy public policies that impact healthy eating and physical activity in all settings where children gather (e.g. daycare, schools, built environment)
  • Interventions that target children’s screen time, physical activity and healthy eating in the home, preschool and elementary-school settings




  • Pressures related to school, work, and family obligations that create time constraints
  • The inability to access and afford healthy meals (lower-income families)
  • Marketing of unhealthy foods and beverages;  
  • Lack of public policies  to ensure healthy eating in child-care centres and schools
  • Parents/primary caregivers who use vehicles, as opposed to walking, as a preferred means of transportation for their family
  • An increasing amount of time in front of screens
  • Non-existent or insufficiently integrated physical activity in schools and other child-care settings
  • Lower-income neighbourhoods which are less likely to be designed to support physical activity
  • Safety concerns which may deter individuals from engaging in healthy outdoor activities
  • Play areas that may not be accessible to all children, especially those with mobility limitations

Individual-level Conditions:


  • Exclusive breastfeeding for six months following birth is supportive of childhood health and may be positively associated with healthy childhood weights 
  • Interventions for the primary prevention of obesity that address sleep, mental health and pre-natal/preconception did not emerge as being effective in our systematic review, and may be due to the limitations of current evidence. However, the expert panel fully supports their importance in child health.


  • Genetics and human physiology may place children at risk for unhealthy childhood weights
Women and Children
Primary Prevention of Childhood Obesity
Background Information