Overweight and obesity in children

OVERWEIGHT AND obesity can easily be classified as a pandemic. The rising incidence and prevalence in adults and children are alarming. Studies show that overweight and obese children continue to be overweight and obese in adulthood.

Contrary to popular belief, genetics and inheritance of ‘big bones’ play a very small contribution to an individual’s weight. Medical conditions causing excessive weight gain are quite uncommon. The majority of children will become overweight or obese due to energy intake (calories from food and drink) that consistently exceeds the energy that is actually used (physical activity).

Foods high in sugar and fat are the usual culprits. Knowledge about portion sizes is grossly deficient and most children overeat; they are encouraged from an early age to “eat up!” until the plate is clean. Pride is taken when the child looks ‘sturdy’ and if too ‘thin’, there is concern and request for vitamins to open the appetite.

Meals are often not eaten at the dinner table, and eating while watching the television, playing video games or using the computer is a common unhealthy practice which promotes snacking and overeating. Other unrecognised contributors to unhealthy eating practices are emotional and psychosocial issues such as depression, anxiety, parental discord or divorce, bullying and abuse.

EATING HABITS

Aerobic exercise is recommended for 30 minutes three times each week. Parents and guardians may have challenges enforcing this practice because extra lessons displace extra-curricular sports, families reach home late, or volatile communities make parks and playfields unsafe.

Overweight and obese children are at risk for several medical complications. These include type 2 diabetes mellitus, cardiovascular disease (heart attack, hypertension, and stroke), dyslipidemia, obstructive sleep apnea (snoring with pauses in breathing during sleep), early puberty, polycystic ovarian syndrome in female adolescents and stress on the growth plates of the bones at the hips and knees. Not to be left out are important psychological issues such as low self-esteem, teasing, stigmatisation and stereotyping.

Good eating habits and exercise make these complications completely preventable!

RECOMMENDATIONS:

Remove sweetened drinks and replace with water.

Aim to eat five servings of fruit and vegetables each day.

Increase fibre in the diet and avoid skipping meals.

Limit screen time to one-two hours per day.

Encourage walking in daily activities and exercise as recommended. Dr S. Clato-Day Scarlett Paediatrician