Watch what you eat
DR. S. YAMUNA
|
Obesity is a serious and growing problem among kids. It has serious psychosocial and physical implications.
|
Thirteen-year-old Nishanth, of Std. VIII has difficulty climbing up to his classroom on the third floor in school. He is breathless coming down one flight of stairs to get into his car. He weighs 75 kg and is 155 cm tall. His diet is — two eggs, a bowl of cornflakes with milk at breakfast, a can of soft drink during the morning break, two pizzas and fried chicken or gobi for lunch, a carbonated drink on the way back home at 3.30 p.m. Back home he ha his lunch. In the evening he watches television and snacks on chips. At six p.m. he drinks a glass of milk. He studies for an hour and then plays computer games till 8.30 p.m, when he has dinner. He completes his day with an ice cream. He is woken up at five a.m to drink a glass of milk but gets out of bed only at 7.30 a.m. Nishanth is an example of modern day nutritional obesity.
Obesity is defined as an excess of body fat. Body Mass Index (BMI) is the most widely used parameter to define obesity. It is calculated by the formula BMI = weight (kg)/height2 (m2). For individuals above 18 years BMI of more than 25kg/m2 is classified as at risk for obesity and those with BMI of more than 30kg/m2 are diagnosed as obese. But in children and adolescents we have age specific cut off values as percentile charts. Adolescents with BMI more than 85 percentile for age are considered as at risk for obesity while those more than 95 percentile for age are labelled as obese.
Babies become three times their birth weight at one year and four times around two years of age. Thereafter they have a slow gain of two to 2.5kg per year until adolescence. During adolescence they gain 50 per cent of the body weight. Hence a heavy prepubertal child becomes a heavy adolescent and then an obese adult.
Nishanth was of normal weight at birth. But he has been living in an obesity-promoting environment. From childhood, his diet includes large portions of energy- dense, fat food. His diet includes sweets and savouries. His parents too are obese and enjoy food. The family leads a sedentary life.
It is difficult to treat obesity. Therefore, the most effective way is prevention. This may be achieved by any intervention that results in a balance between energy intake and energy expenditure.
Obese kids should be evaluated for treatable causes. They should be assessed for already existing complications of obesity like dyslipidemia (high cholesterol), disorders of glucose metabolism like hyperinsulinemia, glucose intolerance, type 2 diabetes mellitus, hypertension, sleep apnea, depression, scholastic backwardness and so on. Atherosclerosis and coronary heart disease are common in adults who were obese as kids.
Treatment includes restriction of energy intake, increase in physical activity, behaviour modification, pharmacotherapy and surgery if needed.
Obesity is a serious and increasing problem It is a global epidemic. It has important psychosocial and physical effects during childhood and adolescence. Preventing obesity is a major task before all of us.
Keeping obesity at bay
Babies should be breastfed the first six months. Here the baby decides the duration, amount and the intervals between feeding. So the child develops healthy satiety cues and internal hunger control mechanisms.
The child should be offered food rich in essential nutrients only on demand. He/she should not be forced to complete the portion on the plate.
The child should not be given energy-dense foods like chocolates, ice creams, chips and so on as rewards for good behaviour.
The diet should be aimed at maintaining growth and preventing fat deposition. Diet should include vegetables and five servings of fruits everyday.
Style of living should be modified. Walk to the shopping complex, use public transport to school, vigorous physical activity for minimum of 30 minutes a day.
Have a good breakfast everyday.
Fast foods and soft drinks are rich in energy, hence should be avoided.
Watching television must be restricted. And no snacking.
Encourage outdoor games.
The author is a Consultant Paediatrician and Adolescent Physician at Apollo Hospitals and Child and Adolescent Clinic, Chennai.
Printer friendly
page
Send this article to Friends by
E-Mail
Quest
