Overweight children and malnutrition

India carries a double burden of both malnutrition and obesity in children, signifying the extreme socio-economic disparities in our country. Malnutrition manifests in several forms including stunting, wasting and micronutrient deficiency. There is an increase in the number of children and adolescents who are obese or overweight or who have high blood levels of sugar, salt, fat or cholesterol.

According to the WHO, overweight and obese children tend to stay obese into adulthood, are more likely to develop non-communicable diseases like heart disease and diabetes and are at increased risk of premature death and disability in adulthood.

Parents are the primary decision makers for what their children eat so it is important for them to be aware about the combination of food items that will provide full nutrition and ensure that there is no excessive weight gain. In the face of numerous outside influences, especially advertisements for junk food, parents must encourage their children to make healthier eating and lifestyle choices.

A common error parents make is using their child’s weight alone as an indicator of whether the child is overweight or obese. Instead, the correct estimate of body fat is given by the Body Mass Index (BMI) which is calculated using both the weight and height of a child.

Causes and risk factors of childhood obesity: Lifestyle factors such as excessive consumption of junk food and calorie dense drinks, little or no physical activity and stress are the main contributors to weight gain and obesity in children.

Certain studies have indicated that genes also play a role in the development of obesity. A child who comes from a family of overweight people is more likely to gain weight if not careful.

Compared to some of the western countries like the United States where the prevalence of childhood obesity is higher in the lower income class because junk food and drinks are part of their daily diet, in India it is higher in children belonging to the upper-middle and high income classes.

A primary reason for this is that children from middle and high class families have easier access to packaged junk food that has flooded the Indian market.

High-calorie foods such as candies, chocolates, chips, biscuits, noodles and soft drinks have become the preferred snacks for children.

And with the rapid expansion of global fast food joints and discounts, burgers and pizzas are increasingly replacing home cooked meals. We can prevent childhood obesity from becoming an epidemic in our country by fostering a healthier environment for our children.

Guidelines for parents
Here are some tips for parents to help their child lose weight and maintain a healthy weight:
Facilitate healthier eating habits: Parents should make a balanced and sustainable eating plan for their children. Children should primarily eat home cooked meals.

Simply telling children to eat healthy is not enough, parents need to set a good example and actively introduce children to healthier food items. Completely depriving kids of junk food can also be counter-productive.

Discourage children from overeating: Consuming more calories than the child needs for staying active through the day can be harmful. Encourage your child to consume smaller portions, eat slowly and to stop eating when she/he feels full. This point is particularly important in the Indian context as many parents, grandparents and relatives believe in stuffing children with food as a sign of affection.

Encourage regular physical activity: Some level of physical activity is essential for your child’s growth and development and maintenance of a healthy weight. Parents should limit screen time for their children and sign them up for physical activities they will also enjoy such as sports, swimming, cycling and dancing.

With children having access to gadgets like mobile phones and tablets at a much younger age today, and little to no access to play grounds near homes, the concept of going out to play with neighbourhood children has become almost non-existent.

Avoid sweetened beverages: Soft drinks and packaged juices are full of preservatives and sugar and should be discouraged.

The future of our children is in our hands. Giving them sound eating and living habits are valuable gifts which can carry them through into a healthy adulthood. Parents may need to change their own lifestyles in order to do so because children learn best by watching what their parents do.

(The writer is a paediatrician, Cloudnine Group of Hospitals, Bengaluru)