CHILDHOOD OBESITY

Childhood obesity is now an epidemic in India. With 14.4 million obese children, India has the second highest number of obese children in the world, next to China. The prevalence of overweight and obesity in children is 15%. In private schools catering to upper-income families, the incidence has shot up to 35-40%, indicating a worrying upward trend.

Causes of Childhood Obesity:

The fundamental cause of childhood obesity is an imbalance between calories consumed and energy spent. Indians are genetically predisposed to obesity. However, the rapid increase in childhood obesity is largely due to environmental influences. Economic prosperity leads to a change in diet from traditional to ‘modern’ foods, rich in fat and sugar. Urbanization leads to an increase in sedentary lifestyles and a decline in physical activity.

Heath Implication of Childhood Obesity:

Childhood obesity has serious health implications. Obese children are at increased risk of hypertension, osteoarthritis, high cholesterol and triglycerides, Type 2 diabetes, coronary heart disease, stroke, gallbladder disease, respiratory problems, emotional disturbances, and some cancers. Two in three obese children will remain obese as adults and at risk for adult lifestyle diseases. India is projected to become the diabetes capital in the world.

Prevention of Childhood Obesity:

According to WHO, childhood obesity is one of the most serious public health challenges of the 21^st century. Prevention of childhood obesity is vital, especially since we know that treatment of obesity is extremely difficult. Proven and simple strategies to prevent obesity include:

• Increase fruit and vegetable intake.
• Reducing TV viewing. Eating while viewing TV is a major cause of excess food intake. TV commercials lead children towards fast foods,
• Reduce sugar intake. Sugar is now called the new ‘tobacco’ and must be limited at all ages. Water is encouraged instead of sweetened drinks.
• Encourage physical activity. It is a struggle to ensure active lives in children, due to limited time and academic pressures. Parents need to facilitate physical activity in young children, and 60 minutes of daily vigorous physical activity in older children.

Parents as Role Models for Children:

• Children see what parents eat! Healthy eating includes consuming more fruit, vegetables, legumes and whole-grain and nuts. It is advisable to limit the number of fats and shift fat consumption from saturated fats to unsaturated fats. Skimmed milk is offered instead of whole milk after the age of two. Fresh foods are encouraged. Fast foods are rich in sugar, fats, and salt and should be restricted to occasions or weekends. Snacking and grazing is a major cause of excess calorie intake. Healthy snack options should be within reach for growing children.
• Healthy mealtime behaviors are learned by children. Forced and coaxed/coerced feeding often leads to poor self-control and later obesity. Parents need to ensure that children eat when they are hungry, and not when they are bored or tired. Food as a ‘reward’ is to be discouraged.

Awareness and education at the community level are important to tackle obesity. The SRCC- Children’s Hospital, managed by Narayana Health has now launched a special program for the promotion of healthy lifestyles and prevention and treatment of childhood obesity – NH iCAN: Improving Children’s Activity and Nutrition. The goal is to prevent Gen X from becoming Gen XXL!

Dr. Mahesh Balsekar | Paediatric Medicine | SRCC Children’s Hospital, Mumbai