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Childhood Obesity

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As children of today make the future of tomorrow, we  aim to tackle an epidemic that’s plaguing them without their knowledge, or ours…

‘Malnutrition Mapping Project’ by GAIN (Global Alliance for Improved Nutrition), in association with Amway, stated that India was home to the third highest number of obese people after USA and China.

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–  In a 2011 study conducted by N-DOC (National Diabetes, Obesity and Cholesterol Disease Foundation), Dr Anoop Misra, Chairman, N-DOC and Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, and Dr Seema Gulati, Head, Nutrition Research Group, Center for Nutrition & Metabolic Research (C-NET), and N-DOC, say, “The overall prevalence of abdominal obesity in urban Indian school children was 4.5%. The prevalence of overweight and abdominal obesity was significantly higher in females than males. On extrapolating these data, more than 15 million children would currently be overweight and 4 million abdominally obese in urban India.”

As per the first study, we are almost topping the obesity chart in the world. The second indicates the rising rate of obesity even amongst children. Look around yourself for proof! In the following pages, we bring you an in-depth look at how the epidemic is attacking children, and how to be on guard as a parent.

 

Understanding Childhood Obesity

Dr Asmita Mahajan, pediatrician at S L Raheja Fortis Hospital, Mahim, Mumbai, says, “A mother will immediately approach a doctor for consultation if she feels her kid is looking thin, but never if the child looks fat, because she feels ‘healthy’ or ‘chubby’ is good.”

But one first needs to understand the difference between overweight and obesity. Overweight means excess weight for that height in terms of fat, muscle, bone and water; while obesity is excess fat. The cause, Dr Asmita believes, can be explained by an imbalance of energy intake and energy expenditure. That is, kids have too many empty calories (high calorie and low nutrition foods) and don’t do adequate physical activity to spend these calories. A host of factors have contributed to this:

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Increasing availability of energy-dense, high-calorie foods and drinks.

Increase in dual-career or single-parent working families have increased the demand for food away from home orpre-prepared foods.

Children spend more time viewing television and using computers rather than playing outdoors.

The Paradox

Though over-feeding may lead to obesity, the opposite is also true. Says Dr Asmita, “A kid who is under-fed can also be obese. It sounds self-contradictory, but possible. Poor nutrition right in the mother’s womb may remodel the brain circuitry of newborn babies and predispose them to become obese in later life.”

Dominic Schofield, Director and Senior Technical Advisor, GAIN, on the other hand, says, “Malnutrition, or the state of being poorly nourished, is not only determined by the amount of food but also the types of food children eat. For instance, children who eat low-quality foods such as high processed snacks and sugar-sweetened beverages may be consuming a lot of calories, but little vitamins and minerals needed for healthy growth and development.”

He adds, “The co-existence of under-and over-nutrition, is known as the double burden of malnutrition. It is not exclusive to India, but affects most countries in the world. Overweight and obesity are increasing due, in part, to increased caloric intake and decreased physical activity that resulted from industrialization, urbanization, and economic betterment.”

Diagnosis A doctor can distinguish whether your baby is obese or just chubby by body measurements, like body weight and height in addition to Body Mass Index (BMI). This helps indicate if your child is overweight for his or her age and height.The doctor also considers the family history of obesity and the child’s eating habits. Certain blood tests like blood sugar, cholesterol and hormonal levels may also need to be checked.

 

Food Pyramid for Young Children

A daily guide for two-six-year-olds

Food Pyramid for Young Children

Hidden Perils
Although the risks of childhood obesity are manifold, it has both immediate and long-term effects on the kids’ health and well-being. Dr Asmita lists a few:

Immediate health effects:

Obese youth are more likely  to be at risk of cardiovascular disease, such as high cholesterol or high blood pressure.

Obese adolescents are more likely to have pre-diabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes.

Children and adolescents who are obese are at a greater risk for bone and joint problems, and sleep apnea.

Long-term health effects:

Children and adolescents who are obese are likely to be obese as adults and therefore more at risk for adult health problems such as heart disease, type 2 diabetes, stroke and osteoarthritis.

Overweight and obesity are associated with increased risk for many types of cancer – breast, colon, endometrium, oesophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix and prostate, as well as multiple myeloma and Hodgkin’s lymphoma.

Emotional Turmoil
The risks don’t end there. Dr Asmita notes that a child does not just suffer physically; it also takes an emotional toll:

Various studies show that children as young as six years of age may associate negative stereotypes with excess weight and believe that a heavy child is simply less likable.

Obesity has also been linked with low self-esteem which translates into a lack of self-confidence thereby leading to poor performance in school.

They could also be victims of teasing and bullying. Clamp It DownDominic says, “It is recognised that prevention is the most feasible option for curbing the childhood obesity epidemic. The goal in fighting it is to achieve an energy balance, which can be maintained throughout the individual’s life span. This can be done by consuming a healthy diet and practicing physical activity.

Focus on good health, not a certain weight goal. Teach and demonstrate healthy and positive attitudes towards food and physical activity without emphasising on body weight.

“The World Health Organization recommends increasing the consumption of fruits and vegetables, as well as legumes, whole grains and nuts and limiting the intake of sugars (such as sugar-sweetened beverages),” he adds.

Dr Asmita points out three ways one can prevent and fight childhood obesity: 1) TV viewing time 2) Minimum one hour of outdoor activity and 3) Parents’ lifestyle choices. She elaborates, “TV viewing leads to obesity. One way, is through the advertisements of junk food that are promoted as ‘happy foods’. Children under two years of age should not be allowed to watch TV and after two years of age, TV viewing should be free of advertisements and should be focused on education. The increased number of hours spent watching TV reduces going outdoors.

“Secondly, outdoor games should be introduced to children at an early age. Every day, a child should spend at least an hour outdoors. Also, playing video games should not be encouraged.

“Thirdly, parents serve as role models to their children; hence they should make sensible lifestyle choices. Parents should focus on spending more quality time with their kids.”

Our thoughts go back to the popular saying, ‘Common sense is very uncommon’. The reason: All of us down the line have always known the various causes and prevention techniques of the epidemic. But probably, we just never looked closer home to realise how it’s affecting our own children.

Let’s all vow to make the right choices this Independence Day, and let children relish the freedom from extra flab.

family run

Tips for Parents

Focus on good health, not a certain weight goal. Teach and demonstrate healthy and positive attitudes towards food and physical activity without emphasising on body weight.

Involve the whole family and work to gradually change the family’s physical activity and eating habits.

Plan sensible portions. Use the Food Guide Pyramid for Young Children by the US Department of Agriculture Center for Nutrition Policy and Promotion, as a guide.

Provide education on the three cornerstones for managing or preventing childhood obesity: Healthy meals and snacks, daily physical activity, and nutrition.

 

WHAT COUNTS AS ONE SERVING?

GRAINS
1 slice of bread

1/2 cup of cooked rice or pasta

1/2 cup of cooked cereal

1 ounce of ready-to-eat cereal

VEGETABLES

1/2 cup of chopped raw or cooked vegetables

1 cup of raw leafy vegetables

FRUITS

1 piece of fruit or melon wedge

3/4 cup of juice

1/2 cup of canned fruit

1/4 cup of dried fruit

MILK

1 cup of milk or yoghurt

2 ounces of cheese

MEAT

2 to 3 ounces of cooked lean meat, poultry, or fish

1/2 cup of cooked dry beans, or

1 egg counts as 1 ounce of lean meat.

2 tbsp of peanut butter count as 1 ounce of meat

FATS AND SWEETS
Limit calories from these

 

SERVINGS FOR A TEENAGER’S DIET

 

BREADS/ STARCHES: 5-10 servings per day. 1 serving is…

½ cup cooked cereal, pasta, potatoes, or rice

3/4 cup dry cereal

1 bagel or muffin

2 slices bread

FRUITS: 2-3 servings per day. 1 serving is…

½ cup canned fruit or fruit juice

1 piece fresh fruit, like apple, orange, peach, or pear

1-1½  cups fresh berries or melon

15 to 20 grapes

MEAT/ MEAT SUBSTITUTES: 3-5 servings  per day. 1 serving is…

½  cup cottage cheese

3/4  to 1 cup cooked dried beans or legumes

1 egg

1 ounce low fat or regular cheese

2 to 3 ounces meat, fish, or poultry

2 to 3 tbsps peanut butter (after age 2)

DAIRY PRODUCTS: 4-5 servings per day. 1 serving is…

1 cup low fat milk or yoghurt

If your teenager does not like milk or yoghurt, ½ cup of cottage cheese or 3/4 cup of cheese may be used as an alternative

VEGETABLES: 2-3 servings per day. 1 serving is…

½ cup cooked or 1 cup raw vegetable

1 cup vegetable or tomato juice

2 cups salad greensYour teen should eat only enough of the following foods to meet their calorie needs.

FATS: 2-4 servings per day. 1 serving is…

1 tsp oil, mayonnaise, or butter

2 tbsps cream cheese, avocado, or low  calorie salad dressing

6 almonds or 10 peanuts

SWEETS AND DESSERTS: 1-3 servings per week. 1 serving is…

½ cup ice cream

½ cup pudding

2 small cookies

a 3-inch pastry

ARCHANA IYER

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