Childhood obesity is a known precursor to obesity and other non-communicable diseases (NCDs) in adulthood. The term overweight refers to excess body weight for a particular height whereas the term obesity is used to define excess body fat. Overweight and obesity primarily happen either due to excess calorie intake or insufficient physical activity or both. Furthermore, various genetic, behavioural, and environmental factors play their undeniable role. Childhood obesity is a forerunner of metabolic syndrome, poor physical health, mental disorders, respiratory problems and glucose intolerance, all of which can track into adulthood. So, it is an attack on the foundation of good health, from which the individual may never recover.
The magnitude of the problem
Developing countries like India are still fighting malnutrition and so we presume that childhood obesity is the disease of the affluent west. Nothing can be more wrong as has been borne out in a recent research published in Indian Journal of Medical Research. Prevalence data from 52 studies conducted in 16 of the 28 States in India were crunched and the results were astounding! A combined prevalence of 19.3 per cent of childhood overweight and obesity was observed, which was a good 3% higher than a similar study conducted ten years ago! The latest National Family Health Survey (NFHS-5, conducted in 2019-21), the most comprehensive household survey of health and social indicators by the Government of India, found that 3.4% of children under five were overweight compared with 2.1% in 2015-16. More than 14.4 million children are obese in India, second only to China according to another study published in the journal Nutrients in 2022. So, there is convincing data to infer that overweight and obesity rates in children and adolescents are increasing not just among the higher socio-economic groups but also in the lower income groups where underweight still remains a major concern.
According to UNICEF's World Obesity Atlas for 2022, India is predicted to have more than 27 million obese children, representing one in 10 children globally, by 2030. It ranks 99th on the list of 183 countries in terms of preparedness to deal with obesity and the economic impact of overweight and obesity is expected to rise from $23bn in 2109 to a whopping $479bn by 2060.
This is a global problem and the prevalence of childhood obesity is constantly on the rise. The International Association for the Study of Obesity (IASO) and International Obesity Task Force (IOTF) estimate that 200 million school children are either overweight or obese. India is a fast growing economy, currently undergoing major epidemiological, nutritional and demographic transitions. These transitions tend to promote obesity in all age groups. With childhood malnutrition still more common India faces a double whammy, with urgent crises at both ends of the nutrition scale. Our people are under-nutritioned and over-nutritioned at the same time. We need a balanced and sensitive approach addressing economic and nutrition transitions to effectively tackle this double burden paradox in India.
The nutritional illiteracy
If children are given balanced meals that include carbohydrates, proteins, vitamins, fruits and vegetables, then it would prevent both under-nutrition and over-nutrition. But people don't know what good food is, they eat to fill their bellies. Those who can afford are giving their children more carbs, more convenience food. This it is more common in urban richer families where children are being fed a diet of food and drinks high in fat, sugar and salt. Youngsters sleep late and often resort to midnight binging, mostly on unhealthy snacks. They do not burn any calories after eating late at night as they sleep after that and during the day, they are lethargic which means they burn few calories. Moreover, children are spending a lot more time on computers and phones instead of running around and playing. I have talked about this in one of my previous blogs: https://surajitbrainwaves.blogspot.com/2022/03/limiting-screen-time-for-children.html
Market forces are not helping
Food apps and online gaming are driving up childhood obesity. If you watch TV now for half an hour, you will see many advertisements about junk food and those glorifying soft drinks. This constant false messaging about benefits of unhealthy junk food must stop, and it can only be done by the government.
City planners are also victims of market forces. They want to squeeze every square inch of space for commercial purposes. Our cities have no footpaths, there are no safe cycle tracks, and there are few playgrounds where children can play. I have mentioned this issue in one of my previous blogs: https://surajitbrainwaves.blogspot.com/2022/11/the-pleasure-of-walking.html
Our schools are mostly the only places that offer a safe place for children to play, so schools must play their part in combating obesity. But many, if not most, of our schools do not have playgrounds or sports periods. We do not realize the heaps of benefits sports can have on the development of our children besides fighting childhood obesity.
Don’t nag the child
It is essential to understand the emotional consequences that children are subjected to when their guardians fail to handle the issue of obesity correctly or with consideration. All a child really needs is to be regarded with love, respect, and admiration irrespective of his/her body shape. So, how concerned parents should handle their child's weight in a way that doesn't damage their self-esteem is truly challenging. How to speak to a child regarding their weight is an issue that must be approached with both sensitivity and bravery. There isn't a single answer that works for everyone, but there should be no deception about the situation. Lying about the problem will make it difficult to discuss and can lead to incorrect conclusions. It's important not to ignore the subject, but also not to make it the focus of the entire home. Whenever in doubt talk to your pediatrician and seek professional help. When parents themselves become nutritional advisors to their children and nag them all the time, you can be assured that there is trouble ahead. Parents should set up a system with reasonable rules, but without going overboard and they must shop intelligently and stack their refrigerators responsibly.
Personal example and good parenting
You cannot be an irresponsible food gulper and expect your child to be a responsible eater. You cannot sit in front of the television and have your dinner while watching your favourite soap opera and expect the child to have his/her dinner on the dining table. A personal example has an influential effect. The power of saying 'come and see there's a cucumber here' becomes background noise, but if you eat a bowl of salad with every meal, and really enjoy it and not pretend, and serve as a positive personal example - your children will start eating salads if not this week, certainly in days to come. The fact is that parents have tremendous influence over the child, and as soon as the child feels that they are not happy with their appearance or eating - this is a very difficult event for the child. How to channel this discomfort constructively, without nagging, with lots of useful information and dietary tips from authentic sources is what good parenting is all about.
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