Well-informed parents are key to healthy preschoolers
Parents need a little encouragement and some simple intervention to help switch their children to a healthier diet, says Dr Dana Al Tarrah, the lead researcher of a rare study on preschool children.
Few previous studies have explored risk factors of obesity, and the research in the UAE found that poor diets for toddlers, and parents’ lack of nutritional education, were the key health risks for the condition.
Dr Al Tarrah, an assistant professor at Kuwait University’s faculty of public health, social and behavioural sciences, looked at preschool children in Al Ain, where 97
per cent of those in the study were Emirati, and tested the effect of a six-month lifestyle intervention, in collaboration with UAE University and University College London.
A simple intervention proved effective in encouraging parents to switch children to a healthier diet and physical-activity habits.
“I was aware of the cultural factors around childhood obesity in the region and the lack of parental recognition of their child’s weight status,” said Dr Al Tarrah.
“Children are a sensitive population, so we tried to avoid the terminology of obese and fat.
“Most parents were unconcerned about the heaviness of a child, and one noticeable trend was that plumpness was viewed as a sign of prosperity. “Overall, parents were not aware of obesity being a problem in children.”
While the rising prevalence of childhood obesity in the UAE is a major public health concern, this study explored its risk factors.
Dr Al Tarrah aimed to identify the risks linked to preschool obesity in the UAE, describe children’s dietary intake and, in a random controlled trial, investigate the effectiveness of the Eat Right Emirates tool, a simple leaflet intervention to encourage a healthy lifestyle and prevent pre-school obesity.
“The misclassification of their child’s weight status among parents was about 80 per cent, which is comparable to other studies in Saudi Arabia and the UAE,” Dr Al Tarrah said.
“While the school had 402 preschool children, only 150 were willing to participate. It is a cultural issue – not many people in this region are exposed to this kind of research.
“Mothers generally were not aware that children tend to refuse unfamiliar foods and only through repeated exposure will they influence their child’s acceptability.”
After the study, many mothers wanted more information on obesity, particularly on portion sizes for preschool children.
The study found a longer duration of breastfeeding and later introduction of complementary foods were associated with a lower BMI score – body fat index, based on height and weight – in toddlers.
When compared with British dietary guidelines, researchers also found preschool children in the UAE exceeded intakes of protein but did not meet recommended intakes for fibre.
A high carbohydrate intake as a percentage of energy was associated with a lower BMI score, and high fat intake with a higher reading.
Researchers concluded that intervention offering parents simple and concise information on healthy dietary habits and physical activity was an effective in preventing obesity.
In December, the first Abu Dhabi Childhood Obesity Forum vowed to take dietary education into the classroom.
“We envision the UAE school environment to be one that promotes the health of the children, healthy food options, physical activity opportunities and mental well-being,” said Dr Shatha Al Ghazali, head of cancer prevention at the Department of Health Abu Dhabi.
“We are proposing to transform the classroom design in schools to include different kinds of physical activities that children like and will be engaged in.”
The long-term vision is to equip all schools with technology-driven solutions that reduce the number of children who are overweight and obese, and get the teachers and parents more involved.
Dr Gowri Ramanathan, chief medical officer at King’s College Hospital London in the UAE, said one of the reasons childhood obesity has grown to such high levels is because parents have trouble spotting it.
“In the UAE the problem is compounded by a majority of parents who self-diagnose,” he said. “Self-diagnosis bypasses primary care by professional healthcare providers and often leads to the loss of valuable information.”
A study last year by Sharjah Education Council’s healthcare division showed that of 40,770 students in Sharjah’s 125 public schools, 410 suffered from asthenia (abnormal physical weakness or lack of energy), 586 pupils from asthma and 2,425 from obesity.
The survey also revealed that 357 students suffer from anaemia, 74 students were found to be diabetic and of these most suffer from type 1 diabetes.
Rajaa Basheer, supervisor of Sharjah Health and Safety department, said that surveys covering all Sharjah public schools are carried out annually.
“We also organise awareness campaigns in co-ordination with the Ministry of Health about the types of the most prevalent diseases,” she said.