Categories: Paediatrics

Obesity Is Rising Among Children In India

Obesity in childhood is known to have a significant impact on both physical and psychological health. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non‑communicable diseases like diabetes and cardiovascular diseases at a younger age. Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Worldwide obesity has nearly tripled since 1975. 39 million children under the age of 5 and over 340 million children and adolescents aged 5-19 were overweight or obese in 2020.

Once considered a high-income country problem, overweight and obesity are now on the rise in India. In India the prevalence of overweight and obesity among children and adolescents aged 5-19 years has risen dramatically from just 4% in 1975 to just over 18% in 2016. The rise has occurred similarly among both boys and girls. India continues to deal with the problems of infectious diseases and undernutrition, and experiencing a rapid upsurge in noncommunicable disease risk factors such as obesity and overweight, particularly in urban settings. It is not uncommon to find undernutrition and obesity co-existing within the same country, the same community and the same household.

Children in India are more vulnerable to inadequate prenatal, infant, and young child nutrition. At the same time, these children are exposed to high-fat, high-sugar, high-salt, energy-dense, and micronutrient-poor foods, which tend to be lower in cost but also lower in nutrient quality. These dietary patterns, in conjunction with lower levels of physical activity, result in sharp increases in childhood obesity while undernutrition issues remain unsolved.

The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Excessive sugar intake from soft drinks, increased portion size and steady decline in physical activity have been playing major roles in the rising rates of obesity in India and worldwide. Children learn by modeling parents’ and peers’ preferences, intake and willingness to try new foods. Availability of, and repeated exposure to, healthy foods is key to developing preferences and can overcome a dislike of foods. Mealtime structure is important with evidence suggesting that families who eat together consume more healthy foods. Furthermore, eating out or watching TV while eating is associated with a higher intake of fat. Parental feeding style is also a significant factor impacting a child’s behavior right from birth.

Childhood obesity can profoundly affect children’s physical health, social, and emotional well‑being, and self-esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. Childhood obesity is associated with a higher chance of adult obesity, premature death and disability in adulthood. In addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance which were the leading cause of death in adulthood. The risk for these noncommunicable diseases increases, with an increase in body mass index. Obesity and related non-communicable diseases are largely preventable. A slow and steady reduction in body weight be achieved by observing the following golden points

  • Eat small meals regularly at frequent intervals
  • Eat complex carbohydrates, low glycemic foods, fiber-rich foods
  • Consumption of 5 servings of fruits and vegetables per day, legumes, whole grains and nuts
  • Limit fat intake, Shift from saturated to unsaturated fats
    • Avoid trans-fatty foods (vanaspati, bakery products, sweets)
  • Use low-fat milk
  • Minimization or elimination of sugar-sweetened beverages
  • Physical Activity: 1 hour of physical activity per day. Alone without dietary intervention is less helpful. It is easier to reduce energy intake by 500 to 1000 kcal /day than to increase energy expenditure by a similar amount.
  • Limits of 2 hours of screen time per day
    • No television in the room where the child sleeps
    • No television viewing if the child is 2 years of age

Family matters:

  • Eating breakfast daily
  • Limiting meals outside the home
  • Eating family meals at least 5 or 6 times/week
  • Allow the child to self-regulate his or her meals
  • Avoid overly restrictive patterns
  • Concept Tri-color palette- Easy-to-follow diet for overweight children.
  • Divides foods by the colors of a traffic signal:
    • Green for low-calorie foods that can be eaten freely
    • Yellow for moderate-calorie foods- eaten occasionally
    • Red for high-calorie foods that should be eaten rarely.

Supportive environments and communities are fundamental in shaping people’s choices, by making the choice of healthier foods and regular physical activity the easiest choice (the choice that is the most accessible, available and affordable), and therefore preventing overweight and obesity.

Dr. Mridul Das, Consultant – Gastroenterology & Hepatology – Paediatric,  Narayana Superspeciality Hospital, Gurugram

Narayana Health

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