Alarming Childhood Obesity Numbers Call for Urgent Action at Home
Mahesh Hiranandani
In my 30 years of clinical practice, I have witnessed India, a nation struggling with poverty and malnutrition, record the second-highest number of obese children in the world at 1.8 crore in 2020. This number is expected to double by 2030 and account for nearly 10 per cent of the total obese children in the world, with every third child in the urban area being overweight. What is even more alarming is the rising incidence of obesity in rural India, proving that this problem is ubiquitous and pervasive, independent of any demographic factors. The World Health Organisation has declared obesity as the fastest-spreading epidemic. It has become a colossal social and public health problem with disastrous consequences.
Red flags
- Parental obesity or history of obesity in family
- Higher than average birth weight or low birth weight
- Screen time of 8 hours or more at 3 years of age
- Rapid weight gain in first year of life and adolescence
- Early deposition of fat on body between 5 & 6 years of age
- Sleeping less than 10 hours per night when 3 years old
How to recognise obesity in children
Any child whose body mass index (BMI) is significantly higher than other children of his/her age and gender is defined as obese. The calculated BMI is plotted on BMI-for-age charts (available on the Indian Academy of Pediatrics website) to categorise children into underweight, healthy, overweight and obese.
Too much to eat, combined with too little calories being burnt, creates a state of ‘energy imbalance’, resulting in excess weight gain. But then, if only overeating is the cause, how did developed nations with good food reserves remain untouched by this epidemic for centuries? That’s because in the last few decades, there has been unlimited availability and consumption of unhealthy processed, ready-to-eat, calorie-dense foods, particularly by children.
Consequences of living with obesity
- Medical problems
- Type 2 diabetes
- Fatty liver disease
- Ischemic heart disease
- Sleep apnoea/COPD
- Orthopaedic issues
- Asthma
- Social and emotional
- Bullying/stigmatisation
- Low confidence
- Negative body image
- Depression and anxiety
- Anorexia nervosa/bulimia
- Body dissatisfaction
- Poor academic performance
- Increased Cancer risk
- Thyroid cancer
- Colorectal cancer
- Renal cell carcinoma
- Pancreatic cancer
- Liver cancer, ovarian cancer
- Gastric/oesophageal cancer
- Meningioma
- Multiple myeloma
India is a food-obsessed nation where parental love equates to showering their kids with food. Also, parents, particularly those working or unaware or from the lower strata, choose easily available, inexpensive and unhealthy food options to feed their children in the formative years. This leads to unhealthy food habits and choices, hence increasing the risk of obesity that persists into adulthood. When a child becomes obese, it is often through a complex interplay of genetic and environmental factors like socio-economic status, education level, basal metabolic rate, diet and lifestyle. In other words, certain genetic traits may predispose one to become obese. However, if a child eats healthy and gets plenty of exercise, the weight will remain in the normal range for age, despite a genetic predisposition to obesity.
Solutions:
- Early and exclusive breastfeeding for 6 months
- Home-based semi-solids from 6 months
- Include more grains/veggies instead of milk
- Teach your baby to differentiate between hunger and thirst
- Offer food and encourage to eat only when child is hungry
- Restrict junk food of all types
- Keep sugars of all types at bay
- Do not punish, reward or bribe with food
- Restrict screen time to less than 2 hours/day
- Ensure active playtime of at least 1 hour each day
- Allow minimum 8-10 hours of quality sleep
Dietary factors
Children of working parents in nuclear families may have a higher consumption of calorie-rich but nutritionally poor junk foods due to the convenience and cost factors. Aerated water/cold drinks, commercial fruit juices, shakes and energy drinks contain a high amount of refined sugar, while chips, fries, bakery products, pizza, burger and chocolates are loaded with trans-fat and empty calories.
Also, the average portion size served in modern food courts is 30-50 per cent larger than what is eaten at home. This ‘portion distortion’ results in the intake of more calories that ultimately leads to obesity in the long run. Irresponsible advertising of unhealthy foods also influences childhood dietary attitudes and behaviours.
