HOW TO AVOID CHILDHOOD OBESITY

As obesity creeps into preschool, and hypertension, and type 2 diabetes becomes pediatric problem for the very first time, the case for starting preventive health care  in the cradle has become too compelling to keep ignoring – Heidi Murkoff

An obese child or childhood obesity is “when a child is well above the normal weight for his age and height”.

Nnenna called her son Nnamdi “chubby” The exit of chubby came in his 2^nd year when he went from chubby to fat. Now at 8 years, his weight has gone up to 55kg.

At a recent birthday party, the children were engaged in a group game of sack race. Nnamdi could not keep up and his group lost the game. The children laughed at him and called him names. He ran to his mother in tears. He clung to her and refused to play. They left before the end of the party. On their way home, Nnenna took him to a fast food restaurant and bought ice cream and chocolate to console him.

Obesity is “abnormal or excessive fat accumulation that presents a risk to health” This definition was once reserved for overweight adults. The ever increasing weight of our children has become a huge cause for concern for parents, government and various health institutions.

Every day, in schools, shopping malls, social events, you see these children. You may see them with parents still picking junk into their shopping cart. It may leave you wondering “are these parents blind that they are unable to see what their lifestyle choice is doing to their child”  Cant they see the psychological pain and emotion turmoil, these children are going through. Most of them are bullied in school, they are called names that they do not care for like “biggie” “humpty dumpty” During recreation time they might find it difficult to keep up with others and become the object of painful jokes.

In 2013, the number of overweight children under the age of 5 was estimated to be over 42 million. Close to 31 million overweight children are living in developing countries. Nigeria is a developing country.

The global prevalence of childhood obesity is also estimated to reach 60 million in 2020.

Childhood obesity in Nigeria is more prevalent in urban and middle class families.

“I bought pizza and ice cream to make Michael feel that he belongs. Other children talked about what they ate and I wanted him to experience those things too. Unfortunately, the experience has turned into a demand. He demands for pizza all the time and if I don’t give in to his demands, he will make me mad and uncomfortable till he gets his way. I know that it is wrong but sometimes it’s better for me to just give him pizza then sit through his tantrum” said Kate a mother of two overweight kids.

Childhood Obesity is caused by certain factors that work together. These factors include;

# 1 The increasing trend and adoption of western lifestyle of eating fast foods which are high in saturated fat and carbohydrate is one of the leading causes of childhood obesity.

#2 The sedentary lifestyle of children leads to energy imbalance between the calories consumed and calorie output. The result is weight gain.

#3 Distributions and aggressive marketing of fast food and over processed noodles make them attractive to children and convenient for parents. The attractiveness and convenience of the food does not change the fact that it puts garbage into your child’s body.

#4 Genetics factor contributes to childhood obesity. Overweight or obese parents are more likely to give birth to an obese child.

Why is childhood obesity a big problem?

• High blood pressure and diabetes

It was rare globally to see young children diagnosed with High blood Pressure and Type 2 Diabetes, but now, it has become a norm. The excessive weight puts them more at risk for health problems that were once confined to adults such as cardiovascular disease (disease of the heart and blood), type 2 diabetes, high cholesterol and stroke. Obesity can contribute to the buildup of plaques in the arteries. The plaques may lead to the narrowing and hardening of the arteries which could lead to heart attack. Children are now diagnosed with Type 2 diabetes which is caused by lifestyle.

• Obese children are likely to become obese adults

Obese children most times grow to become obese adults. Parents may be unconcerned because they believe that it is baby fat that will go with time. In some cases the baby fat disappears as the child gets older but sometime it does not. The child will keep adding more weight as he gets older until it becomes a big problem that could lead to disability in adulthood.

• Bone and Joint problems

The spinal cord, hips, ankles are subjected to consistent strain because of the heavy weight they carry on a daily basis. It ultimately leads to early onset of arthritis which announces its coming with joint pains which gradually gets worse.

• Psychological and social problems

Depression and low self-esteem are some of the issues that obese children deal with every day. They are bullied and teased by children and some insensitive adults. It could make them withdrawn or disruptive. Most of the obese children I have trained always seem disconnected and unwilling to receive or show emotion. They feel judged by their weight. No one sees who they really are or their talents, just the fat. They become judgmental in return. Any attention given to them is seen as pity and disgust.

The clothes they chose are mostly oversize to hide their body. Depression and low self-esteem is capable of making a child’s performance in school to suffer.

• Sleep and respiratory disorder

Obese children are more likely to have sleep and respiratory disorders like asthma and sleep apnea. Sleep apnea causes a child’s breathing to stop and start repeatedly the child is sleeping. An obese child is also more likely to snore when sleeping.

A child once told me that when her brother who was obese is sleeping, that he “snores so loud that it shakes the whole house” The brother is at his normal weight now.

• Hormone imbalance.

Hormonal imbalance caused by obesity manifests in different ways. It may lead to early onset of puberty and menstruation in girls. In extreme cases, I have seen obese teenage boys who develop breasts just like girls and may end up wearing sports bra to strap them down.

To know if your child is obese check his BMI. BMI is Body Mass Index. Simply check his height x 2. Then divide his weight with the number you got from his height. The number you get is his BMI. BMI over 25 is overweight, above 30 is obese and above 40 is morbid obesity.

 

Prevention of childhood obesity

• Parents must rise up in their role as primary care givers for their children. Children cannot choose what to eat or do. They have “limited ability to understand the long term consequences of their behavior” As an adult you understand the long term consequences.

Some parents often tell me that their children refuse to eat normal food, except fast food. My question to them is – How exactly did they develop the taste for fast food? Your child cannot develop a taste for soda and sausage, except you have been giving him soda and sausage regularly. Children learn by imitation. In this case, they are imitating what you have been feeding them or what you are eating. Introduce fruits, vegetables, nuts, legumes and wholesome food to them early in life and limit their intake of sugar. Prepare a healthy lunch for them, not prepackaged junk.

• Experts agree that children should have at least 60 minutes of regular, moderate to vigorous physical activity each day according to their age. Some schools in Nigeria do not have play grounds or space for recreation activities. School children stay in class all day; they have after school lessons and are further given home works. As soon as they get home they eat and continue with their homework. After completing their homework they watch TV or play video game. The next thing is dinner and bed. The next day the cycle continues.

There should be a balance in your child’s life. There is time for everything; academics, physical activity and rest.

• Schools should play a more active role and create a supportive environment that encourage and support healthy behavior. Opportunity for children to learn about proper nutrition and importance of exercise should be made available by schools
• Whenever it is possible, involve your children in meal planning and preparation. Don’t abandon them to the make believe world of video games and TV programs
• Get your whole family involved in physical activity. Set aside a day for everyone to workout. Choose a day that is alright for everyone. It could be a long walk, jogging or vigorous dancing by the whole family for 45 minutes to 1hr.
• As a parent resist the attempt by your child to become a television and remote control champ. Set the time for watching TV, reading and rest. Idleness creates obese children.
• Do not buy expensive toys mindlessly. Buy indoor and outdoor sports equipment they enjoy. Table tennis, table soccer, hula hoops, jumping ropes, portable basketball stand with hoop and ring will be a good place star.
• In desperation, giving your child appetite suppressant may seem like a good idea. It may not be a good idea.Talk to your Doctor before you resort to appetite suppressant for your child. Bear in mind that he will not take it forever and that it may cause future weight gain. Proper nutrition and physical activity is still the best option to prevent and manage childhood obesity.

Childhood obesity is a growing epidemic that comes with huge financial burden. Educating the public about it is not something to be left for the schools or the Doctors. Everyone has to work together. Government, NGOs, nutritionists, advertisers, schools, Doctors, parents, fitness trainers have to get involved in sustained education and public enlightenment on childhood obesity.

Childhood obesity is preventable. If you already have a child that is obese, do not give up on him or her. It is still possible to help them back to a healthy BMI.

Prepare a healthy lunch box for them. Give them healthy snacks. Foods can be pre prepared and kept in a freezer. Give out all the junk in your fridge and re stock with healthy fruits and snacks.

For busy mums, pre prepare foods.  Cut mixed vegetables for stir fry and salad, put them in separate container and store in a fridge. You can buy ground beans in shops which can be used for homemade moi – moi and bean balls. You can also check out our healthy food and snack recipe to help you in planning your meal.

Cooking and making healthy lifestyle changes for your child, has a rewarding ripple effect – it kick starts your own journey towards a healthy lifestyle. We have different workout videos for you to choose from and enjoy with your family. Find a gym near you and take your child with you on weekends.

Bellisima Fitness and Health studio has a fitness and nutrition program for children and teenagers. If your child is obese or you want to prevent it, then visit us and talk with us. Our group of supportive trainers is there to help you and your child on your healthy weight journey.

 

References

Daniels SR, Arnett DK, Eckel RH, et al. Overweight in children and adolescents: Pathophysiology, consequences, prevention and treatment. Circulation; 111; 1999 – 2002

Dietz WH. Overweight in children and adolescence. New England Journal of Medicine 2004; 350:855-857

www.mayoclinc/childhood obesity

www.WHO/ childhood obesity

Chantel S, Everitt H, Birtwistle J, Stevenson B, Obesity In: Simon C, et al, editors. Oxford Handbook of General Practice. 1^st ED Oxford University Press; 2002 p 166-7