Childhood obesity is at crisis point, affecting every country in the world.
As parents, we’re bound to find these numbers alarming. In just 40 years, the number of school-age children and adolescents with obesity has risen more than ten-fold, from 11-million to over 124-million. The World Health Organization (WHO) reports that nearly one in five children and adolescents are overweight or obese. The vast majority of overweight and/or obese children live in developing countries, where undernutrition also persists. Without intervention, obese infants and young children are likely to continue to be obese during childhood, adolescence and adulthood.
So, let’s discuss the ins and outs of childhood obesity and what can we do to ensure our own kids are healthy and active.
What causes obesity in children?
There are many reasons why kids become overweight. Let’s start at the beginning. Before birth, gestational diabetes (diabetes during pregnancy) may result in increased birth weight of the child and the risk of obesity later. After birth, feeding energy-dense, high-fat, sugary and salty foods to babies and infants is also a big problem. There is a general belief (especially amongst well-meaning adults) that a chubby baby is happier and healthier and we, of course, don’t want little ones to look too thin! Another bad habit that stems from the best intentions is being brought up to eat everything on the plate, which can be force-feeding. This is a problem, especially at a young age, as it can shut off the satiety centre of the brain. As the child grows up, they ignore the signal sent by the brain to stop eating and continue even after satiety sets in. All these habits over time lead to an increase in weight.
As children get older, unhealthy eating habits, family history, inborn errors of metabolism, hormonal imbalance, inadequate sleep and stress start contributing. It’s important to note that a family history of obesity only means children will acquire that gene, however, the child will not become overweight unless influenced by environmental factors (unhealthy eating and physical inactivity). Today, many kids have an increasingly sedentary lifestyle which also leads to weight gain early in life. Most of them would rather play with their video games (or any electronic gadget, like your mobile phones!) than run around outside. As the child becomes a teenager, the pressure of studying kicks in and along with it the expectation to put in more hours hitting the books. Their social lives have also moved online, leading to even more sedentary lives. Then there’s the loss of incidental exercise, which is regular physical activity that should happen in our daily routine. As that has been replaced by equipment and machines, we all now need to make a conscious effort to get moving.
Normal healthy weight is simple mathematics – calories in = calories out! If this balance is tilted in either manner it can result in overnutrition (when the calories in exceed the calories out) or undernutrition (when the calories in are less than the calories out).
Is my child obese?
If this is a worry you have, it should be relatively easy to assess and act upon.
Children under 5 years of age*:
- Overweight is weight-for-height greater than 2 standard deviations above the WHO Child Growth Standards median.
- Obesity is weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median.
Simply put, WHO has a Child Growth Standard. If your child falls over that median (allowing for accepted deviation), there is a chance that he or she could be overweight or obese. Check where your child falls using this WHO chart for boys and this chart for girls.
Children aged between 5–19 years*:
- Overweight is BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median.
- Obesity is greater than 2 standard deviations above the WHO Growth Reference median.
(*Source: World Health Organisation Obesity Fact Sheet)
Consequences of childhood obesity
No one would wish any of these consequences on any child, but they are something that all parents must consider. Those who are obese can develop many health problems in childhood and later in life, including:
- Cardiovascular disease
- Insulin resistance leading to diabetes
- Cancers like breast and colon cancers
- Musculoskeletal disorders (osteoarthritis – bone deficiency)
- Behavioural issues
- Sleep disorders
- Eating disorders
- Respiratory problems
- High blood pressure
- Low self-esteem and lack of confidence
(Source: Ranjani Harish et al. Determinants, consequences and prevention of childhood overweight and obesity: An Indian context. International Journal of Endocrinology and Metabolism.2014 Nov;18(Suppl 1):S17-25)
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Mamas, don’t worry! The good news is that this issue is largely preventable. The easiest way is to encourage healthy food choices and regular physical activity. As parents, it’s our responsibility to give our children adequate nutrition by introducing them to healthy foods early in life. Here are some easy tips:
Healthy dietary habits:
- Do not introduce junk food, packaged and convenience food until the age of at least two years. They are rich in additives and artificial flavours which are addictive and can alter your child’s taste. It may cause them to find home food boring and bland. Instead, introduce fresh home-cooked meals to your baby and continue this through infancy.
- Swap soft drinks, sodas and other high-calorie drinks for fresh fruit juice. Better yet, offer a piece of fruit (full of fibre) over juice!
- Give them small and frequent meals. Children have tiny stomachs that can digest only a given amount at a time.
- Increase the consumption of whole foods like fruit, vegetables, legumes, whole grains and nuts.
- Restrict the intake of trans fats (margarine/lard).
- Limit the intake of refined sugars.
- Choose fibre rich foods.
- Use whole cereals and grains, instead of refined flours.
- Replace packaged snacks with healthy salads, fruits and nuts.
- Encourage the kids to eat in a calm environment and do not allow the use of gadgets while eating.
Physical activity: The WHO recommends at least 60 minutes of regular, moderate to vigorous activity each day for children and adolescents. Encourage your child to take up a hobby that involves physical activity. Instead of screentime, push them to go out and play. Playing also improves the child’s social skills, teaches team spirit and discipline. Even better, why not lead by example and get out there with them and go for a family walk?