Obesity: It is a condition where excess body fat negatively affects a child’s health or wellbeing.
It
is usually determined by calculating BMI ,ie weight in kg / height in cm square.
There
are charts of BMI for age percentile for boys and girls 2 to 20 years of age.
Malnutrition
is a condition that results from eating a diet in which one or more nutrients
are either not enough or are too much, such that diet causes health problems.
It may involve calories, proteins, carbohydrates, vitamins or minerals.
From
above definition,it is clear that Obesity as such is a malnutrition (excess)
involving calories and can also have associated imbalance of othernutrients .
Why talk about Obesity?
It
is very important to be aware as Obesity in childhood has a range of effects on
health short term as well as long term.
·
Psychological/ Emotional
·
Physical
Psychological/ Emotional
v Bullying by Peers
v Harassment / Discrimination
by family members
v Low self Esteem
v Depression
v Eating disorders like Bulimia
or anorexia
v Anxiety
Physical;
v Diabetes Mellitus
v High Blood Pressure
v Heart Disease
v Sleep problems like apnoea
v Early puberty / menarche
v Skin infections
v Asthma
v Gall stones
Long
term effects in adulthood, they are at increased risk of
o Obesity
o Heart Disease
o Diabetes Mellitus type II
o Stroke
o Osteoarthritis
o Shorter life span due to
these diseases
o Infertility
o PCOD
o Metabolic syndrome
Let’s
look at the causes of Obesity as Malnutrition. It can be brought on by a range
of factorswhich act in combination ‘Obesogenic Environment’.
Ø Personal
Ø Familial
Ø Social
Ø Environmental.
PERSONAL:
·
Sedentary life style – This has been a new NORM in recent
years. The children are dropped to school, classes without giving them a chance
to walk .
·
Exercise deficiency – The daily routine of child as young as
3 years is so rigid , that the schooling starts and it also carries with it tuitions
as early as from Lowe KG. They have no time to go out and play.
·
Sleep deficiency looms large as children have to adhere to
school / tuition timings, then get tired by evening, rather bored, so sit and
watch TV shows along with the parents, hoping to get some attention from them.
In the bargain bedtime gets delayed. This inadequate
sleep has adverse effect on a child’s health as adequate sleep is need for
normal growth and development.
·
Multimedia addiction / compulsion- the children spend a lot
of time in front of tv or using the smartphones to play games. Older children
are hooked on social networks, that consumes energy, time and another reason of
inadequate sleep , disturbed sleep.
·
Diet – the children are snacking most of the time on junk
foods, fast foods as they watch tv, thus loosing on eating healthy food. The
diet is rich in fats, sugars and salt, energy dense foods.Large portion size of
meals.
·
Stress – this plays a major role in the life from an early
age, i.e of going through the grind of school, tuitions, peer pressure,
parental pressure.. This leads to disturbed hormonal environment from an early
age, which goes unnoticed , and undetected. The over stimulation of sympathetic
nervous system due to stress leads to release of cortisol in the blood ,, which
is a hormone that leads to increased hunger, weightgain , high blood sugar
levels.
Family :
·
With Decreasing number of mothers who breast feed, babies are
reared on infant formula instead.
·
Nuclear family, both parents working , increases the childs
pester power to force adults to do what they want, leading to easy access to
calorie packed foods .
·
eating out /less home
cooked food is often common. Choice of junk foods.
·
Quick fix meal menu, less of traditional foods
·
Smaller houses, so less physical movement once home.
·
Less time with family members as all have home-office/school-home routine, hence sharing
stress becomes a problem.
·
Outings to malls or theatres rather than to beaches or
gardens.
Social Factors:
·
Lack of parks or open spaces for children to play.
·
Emphasis of school on physical activity.
·
Party time, late nights, diets rich in fats and salts, sugars.
·
Prices of healthy and unhealthy foods
·
Advertising of unhealthy foods on TVs, Magazines, newspapers.
Genetic conditions;
·
Prader – Willi syndrome
·
Congenital Leptin deficiency
Management:
Food
Ø Do not skip Breakfast
Ø Rainbow coloured food
plate, means eat all varieties of food
Ø Cut on Fat, Sugars, Salt.
Ø Add fruits, nuts
Vegetables to diet.
Ø Use various spices like
Nutmeg,mint cinnamon to get different flavours
Ø Check on portion size
Ø Cut on food orders fromrestaurants.
Ø Dine together as a family
Ø Do not eat in front of Tv,
or while on cellphone.
Exercise
Ø Indulge in active games in
and out of house
Ø Walk to school, park
Ø Do family chorus together
Ø Sign for sports activity
Surgery
Ø Bariatric surgery is also
being offered in severe forms of obesity
There
is an increasing evidence that manging the GUT flora has a very big role in
manging Obesity. Hence having variety of food, havingtraditional food helps a
long way.
The
best part of the whole thing is that,most of the timesOBESITY is preventable as
well as treatable if one takes charge of it.
Childhood
obesity has actually become MALLnutrition rather than MALnutrition.
CONTACT DETAILS
DR.
MEDHA PRABHUDESAI BAKHLE
MD
PAEDIATRICS,
CONSULTANT
PEDIATRICIAN ESI HOSPITAL MARGAO
EMAIL:
medha65@yahoo.co.in
Ph.no.
9422058525