Puppy fat or obesity?

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

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.

WHY IS THAT?

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.

WHAT CAN BE DONE

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.

WHAT DOES THIS MEAN?

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.

CHILDREN NEED TO PLAY

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