Mediscene

Beware of body fat that a child doesn’t grow out of

By Smriti Daniel

Consultant Dietician Sigrid de Silva wants to correct the general assumption that obese kids “will grow out of it”. It’s not “baby fat” if a child is overweight when past their fifth or sixth birthday – that tender layer has usually vanished by that time. If a child is developing a little paunch around that age, you might want to consider an intervention. Left unchecked, childhood obesity can bloom into juvenile and adult obesity and leave kids struggling with problems like high blood lipids, fatty liver, insulin resistance, even high blood pressure, and type 2 diabetes. In the short term, it can have a negative impact on not only the child’s health, but his or her social life and academic performance.

Sigrid points out that many of the medical conditions that obese children must cope with, such as high cholesterol, fatty liver (NAFLD), hypertension, and insulin resistance were usually problems confined to the adult population. Ironically, overweight children might reach sexual maturity ahead of their peer group. In girls this leads to irregular menstrual cycles and fertility problems, often due to insulin resistance related poly cystic ovarian syndrome (PCOS).

In general though, these children appear much older than they look, influencing how adults treat them and this has been linked to depression and self-esteem issues. When the risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, and diabetes are already present in childhood it is almost inevitable that as adults, these children will have serious health issues.

“As we’ve probably noticed, obesity is increasing not just in the general public, but in children as well,” Sigrid says.

A great deal of this can be attributed to an increasingly sedentary lifestyle – one so devoid of natural opportunities to exercise that some of her patients list walking from the school gate to the classroom as their ‘exercise’ for the day.

For Sigrid, there’s an interesting divergence that has begun to make itself apparent among children. One group, the naturally athletic, are singled out early for sports teams and competitive events. These children might actually be getting more exercise than they should. Those that aren’t quite so physically adept are inevitably left behind. When children come home, Sigrid emphasizes the need to curtail watching T.V and internet use to only a few hours a week – if your child is a couch potato, that’s half the problem right there. It is recommended that children spend at least 60 minutes every day working up a sweat.

The decreased physical activity isn’t the only problem says Sigrid. She highlights an unhealthy diet, filled with junk foods and sugary drinks as one of the big contributors to childhood obesity. Children are being bombarded with advertisements for easily available but ultimately very unhealthy food – and they’re determining what’s on the menu surprisingly often.

Sigrid says many young parents today are not particularly skilled in the culinary department themselves and rely heavily on the likes of take out, frozen foods and ready to eat mixes for their menus. While there are those who are intensely health conscious and focus on organic food and balanced diets, for many the responsibilities of work can make it difficult to plan healthy meals. Pointing out that children’s vegetable intakes are worryingly low, Sigrid says, “Children are more and more determining the menu and parents are giving into that too often. Parental guidance on nutrition is declining.”

Children should be eating a minimum of seven different types of veggies a week, says Sigrid, adding that “Greens should be in the number one slot.” Unfortunately most children eat only two - one of which might be potato.

Other unhealthy combinations such as heavy dhal and chicken meals deliver a hefty dose of protein and fat. What happens in school is also a big part of the problem. School snack bars famously offer a choice between different deep fried dishes and sugary drinks. In most schools the choice of water is not even available!! Compounding that is that even if parents are willing to go the extra mile and pack a healthy snack, children simply don’t want to eat it. “There’s a lot of peer pressure,” says Sigrid, “it’s just not ‘cool’ to be eating something from home these days.”

Not only are genetic inheritances important, but families tend to share similar dietary patterns and levels of physical exercise. Various studies have linked a children’s risk of becoming obese to whether a parent is already overweight or obese. Most of us have the ability or genetic predisposition to gain weight, or else we would be extinct. But children with parents suffering from HT, DM, HD, will be at risk to get these non communicable diseases [NCDs] at a much earlier age than parents, especially if healthy food preparation and healthy living in general is ignored.

However, Sigrid believes that positive parenting can really help children make smart choices even in the face of peer pressure. Sometimes it can be as simple as teaching children to listen to their bodies. Don’t force your child to finish everything on their plate or ladle big portions in every serving.

Reinforce the idea that they should only eat when they’re hungry and stop eating when they aren’t hungry anymore. Don’t use food, especially unhealthy foods, as a reward for good behavior. Involve your children in preparing healthy food and remember that it’s all about setting a good example yourself, and making a healthy lifestyle a matter of habit.

With obesity comes disease

Overweight and obese children are vulnerable to a range of medical problems that can have far ranging consequences even as they affect their normal development and maturation:

  • High blood pressure, high cholesterol and abnormal blood lipid levels, insulin resistance, and Type 2 diabetes
  • Bone and joint problems
  • Shortness of breath that makes any physical exertion challenging, makes it harder to lose weight
  • Sleep related problems that can lead to a lack of proper rest
  • Tendency to mature earlier
  • Sub-fertility
  • Liver and gall bladder disease
  • Depression
  • Develop unhealthy dieting habits and eating disorders, such as anorexia ner- vosa and bulimia
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