Puppy fat or obe­sity?

More and more chil­dren in South Africa are over­weight and the con­se­quences are alarm­ing, writes Pearl Rantsekeng

Your Baby & Toddler - - Contents -

YEARS AGO, while grow­ing up and play­ing the tra­di­tional games of diketo and dibeke in our then- dusty town­ship streets, an obese child was an un­com­mon sight.

It was so rare that they were teased with names like Fatty Boom Boom or Tsekeleke, af­ter the late kwaito star An­thony “Tsekeleke” Mo­taung.

How­ever, these days over­weight and obese chil­dren are ev­ery­where.

The sad re­al­ity is that the prob­lem no longer lies only in the ‘burbs where we con­sid­ered them to be suf­fer­ing from “rich peo­ple’s prob­lems”. Now the prob­lem is ev­ery­where.


It’s be­cause chil­dren no longer play out­side, says Kath Me­gaw, a reg­is­tered di­eti­tian who runs a pae­di­atric prac­tice in Cape Town. Par­ents are un­der pres­sure from the de­mands of life and no longer even have time to pre­pare a sim­ple healthy meal for the fam­ily. Also Cape Town based di­eti­tian Jes­sica Kot­lowitz says child­hood obe­sity is be­com­ing a global epi­demic. In South Africa alone, 14% of pri­mary school chil­dren are over­weight or obese. And it is pre­dicted that, at this cur­rent rate, a whop­ping 3.91- mil­lion school chil­dren will be obese or over­weight by year 2025. The wor­ry­ing fac­tor is that child­hood obe­sity pre­dis­poses them to in­sulin re­sis­tance and type 2 di­a­betes, hy­per­ten­sion, hy­per­lip­i­daemia, liver and re­nal dis­ease, and re­pro­duc­tive dys­func­tion. This con­di­tion also in­creases the risk of adult- on­set obe­sity and car­dio­vas­cu­lar dis­ease. Jes­sica says over­weight tod­dlers face the risk of be­ing an over­weight child and adult.


Kath be­lieves in or­der to curb the scourge par­ents will have to start amend­ing their life­styles from the time the mother thinks about be­com­ing preg­nant.

“The minute you con­sider fall­ing preg­nant start think­ing about your health. A mom’s health prior to and dur­ing her preg­nancy and when breast­feed­ing will have a di­rect im­pact on the fu­ture health of her baby,” says Kath.

She says risk fac­tors for the above­men­tioned lifestyle dis­eases all start prior to and dur­ing a preg­nancy.

“The im­pact of a mother’s diet on her un­born baby is pro­found on many lev­els. A mom who has a healthy body weight and main­tains her blood sugar and in­sulin lev­els dur­ing her preg­nancy will be more likely to de­liver a healthy weight baby,” she ex­plains.

She says both ba­bies born ei­ther big or small for ges­ta­tional age are at a risk of obe­sity later in life.

“Be­ing un­der­weight for a preg­nant mom is as much of a risk fac­tor as be­ing over­weight. Ba­bies born too small for ges­ta­tional age are sim­i­lar to us go­ing on a diet and re­strict­ing our calo­rie in­take. Then when we re­sume an ad­e­quate in­take our body stores food in lieu of fu­ture ‘famines’.

“We then gain more fat weight. It is sim­i­lar when ba­bies born too small or too big are then pro­grammed to hold onto fats as they grow. So a preg­nant mother should re­ally use this op­por­tu­nity to es­tab­lish healthy eat­ing pat­terns,” Kath ad­vises.

Both Kath and Jes­sica say ba­bies are in­tu­itive eaters, mean­ing they eat when hun­gry and stop when full.

That is why, says Kath, it is im­por­tant that par­ents feed their chil­dren ap­pro­pri­ately in the first 1 000 days (from con­cep­tion to tod­dler years).

“We are a so­ci­ety of struc­ture and rou­tine and very hur­ried. We have set meal times and also lim­ited time for meals. Our ba­bies and chil­dren are sched­uled, which to­tally negates in­tu­itive eat­ing,” says Kath.

Ac­cord­ing to Jes­sica, with modern life be­com­ing more de­mand­ing, most par­ents are forced to look af­ter their chil­dren while also work­ing full time and spend many hours com­mut­ing to and from work.

“This leaves lit­tle time for food prepa­ra­tion, lead­ing to most fam­i­lies re­ly­ing on con­ve­nience op­tions such as take­aways, ready- made meals and quick su­per­mar­ket snacks.

“Un­for­tu­nately most of these con­ve­nience op­tions are packed with added sug­ars, salt, preser­va­tives, trans­fats and a num­ber of other pro­cessed in­gre­di­ents which have a detri­men­tal im­pact on grow­ing bod­ies and de­vel­op­ing brains,” says Jes­sica.

She says in 2015 the World Health Or­gan­i­sa­tion added pro­cessed meat to a grow­ing list of recog­nised car­cino­gens, mean­ing that it has been found to cause

can­cer, while red meat was added to the list as a prob­a­ble cause of can­cer.


To be di­rect, says Jes­sica, this means that stan­dard child­hood favourites such as salami, vi­en­nas and polony have all been linked to the in­creased risk of can­cer.

“This is one of the many rea­sons I pro­mote a plant- based diet for chil­dren. Not only are plant pro­teins free of harm­ful car­cino­gens, heavy met­als, en­vi­ron­men­tal con­tam­i­nants and other things found in meat and dairy but they are also full of ben­e­fi­cial vi­ta­mins and min­er­als to help fight dis­ease and keep the chil­dren healthy.”

Kath and Jes­sica ad­vise par­ents to al­low chil­dren to man­age their hunger and full cues.

“Pro­vide the time to eat, present the food, and then how much they eat is up to them. We need to re­spect their feed­ing cues,” says Kath.

“This means some meals will be eaten all up and oth­ers less. We need to pro­vide at least six op­por­tu­ni­ties to eat dur­ing a 12- hour day and in this way if they are not hun­gry at the one op­por­tu­nity they will have an­other op­por­tu­nity to eat again soon,” she ex­plains.

Both di­eti­tians ad­vise plan­ning prop­erly and mak­ing good food choices. Take­aways, they add, ap­pear to be a quick fix, how­ever, in a re­cent ex­per­i­ment, the time taken to de­cide, or­der and fetch the take- away meal is about two thirds that of the time to pre­pare a sim­ple meal from scratch.

The dif­fer­ence, how­ever, says Kath, is that at home a prepped meal does take some pre- plan­ning of the in­gre­di­ents needed.

“The rule of thumb is keep it sim­ple and aim to have a ba­sic two-week cy­cle menu you can ro­tate. You can have one for sum­mer and one for win­ter,” she adds. That way you use sea­sonal in­gre­di­ents.


Lack of phys­i­cal ac­tiv­ity, says Kath, and a seden­tary lifestyle with too much screen time def­i­nitely con­trib­ute to an un­healthy lifestyle. Nu­tri­tion is the fun­da­men­tal re­al­ity with re­gards to man­ag­ing a healthy weight and avoid­ing other lifestyle dis­eases.

“Ac­tiv­ity helps our bod­ies to utilise this nutri­tional en­ergy and also gives our chil­dren a sense of well­be­ing on a psy­cho­log­i­cal level.

“Ac­tive chil­dren are less likely to overeat be­cause they are oth­er­wise oc­cu­pied. Chil­dren who sit in front of screens tend to eat more snacks, which con­tain higher sugar and fat con­tent.”

Im­por­tantly, though, ac­tiv­ity is not a “get out of jail free” card.

“The men­tal­ity of, ‘I’ve been ac­tive so I can now eat more, or eat junk food’ is not a good mind-set. Eat­ing healthy and be­ing ac­tive goes hand in hand and should be our fo­cus 80% of our time. For the other 20%, life hap­pens and re­gard­less of whether your child ran the school marathon or swam 100 laps, it’s fam­ily Fri­day night and ev­ery­one can en­joy an ice cream in this won­der­ful sum­mer heat.” YB

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