YOU ARE WHAT YOU EAT - UNDERSTANDING CHILDHOOD OBESITY
A child's height and weight should increase proportionately as he or she grows. This is known as a healthy height-weight trajectory. If the weight gain is disproportionate to the height increase, the accumulation of body fat occurs.
Since there is no way of directly measuring body fat volume, doctors use a guideline called the Body Mass Index (BMI) to determine if the child is overweight. The formula is : BMI= Weight (kg) / height (m)2.
- If the BMI is:
- 25 -29 the child is overweight
- 30 -35 the child is obese Class 1 and at mild risk
- 36 - 39 the child is obese Class 2 and at moderate risk
- 40 and beyond the child is obese Class 3 and at high risk
The Risk Factors
- Genetics - if the parents are obese, the child may have a tendency towards obesity.
- Diet - consuming large quantities of food, snacking on high calorie fast foods, sweets, baked foods, chocolates and drinking surgery beverages can all lead to obesity.
- Physical activity - inadequate amounts of exercise and an excess of sedentary activities such as watching TV, sitting in front of the computer, playing excessive amounts of video games and over use of mobile devices all contribute to obesity.
- Psychological factors - personal, family, academic and other related stress and trying to avoid boredom can contribute to obesity.
- Medical issues - medical conditions like hyperthyroidism and intake of certain medicines can also be a cause of obesity.
The Consequences
- Obesity can have major physical consequences such as:
- High blood pressure and cholesterol levels
- Diabetes
- Joint problems and posture and balance issues
- Breathing problems
- Sleeping difficulties
- Skin rashes
- There are also psychological problems like:
- Low self esteem
- Depression
- A low or bad quality of life
- Poor academic performance
The Treatment
- Intervention is the core of obesity treatment. The intervention, to be effective should be at 3 levels:
- Family Intervention should be from parents and other care givers. This includes:
- Setting a good example for children in terms of maintaining a healthy diet and getting enough physical exercise.
- Ensuring that meals are well balanced and contain the right amount of proteins, fibre, multivitamins, minerals, antioxidants and healthy fats rather than stressing on a carbohydrate heavy diet.
- Avoiding the serving of processed and sugary foods in the home.
- Limiting the time spent watching TV, using the computer and playing video games.
- Encouraging at least 2 hours of exercise in the form of skipping, swimming, cycling etc. per day.
- Inculcating the use of yoga, meditation and other stress relieving techniques.
- School Intervention is an essential part of the process because of the amount of time spent there. Schools should help students tackle obesity problems by:
- Including nutritious food on the cafeteria menu and avoiding junk foods.
- Working to stop the sale of unhealthy and unclean foods near the schools which can tempt children in bad eating habits.
- Providing adequate amounts of physical education and exercise in the form of unstructured play, especially for older children.
- Using "health education classes" etc. to work with parents to promote healthy eating and exercise.
- Community Intervention plays a role by promoting the creation of parks and play spaces near residential areas. Community health awareness programs will help in making people conscious about the need to look after the health of both children and adults.
- The childhood years are when the foundation of future health is created. Paediatricians are today devoting an increasing amount of time to preventing childhood obesity. This takes the form of stressing the need for exclusive breast feeding for the first 6 months of life and then monitoring a child's growth so that if intervention is called for, it can be provided in a timely manner. Parents are being told about the importance of diet and the need for a child to be healthy and active rather than dull and obese.
- Childhood obesity is a global epidemic. Early detection of the problem will enable multifaceted intervention of begin early so that the problem can be dealt with most effectively and the child, the family and the community may benefit.
Article by Dr. Pushkala.M.S.
MBBS, MD, PGDID (Australia)
Consultant Paediatrician, Kauvery Hospital
