by S Sharma | 11 OCT 2017
Childhood obesity is a complex health issue. Obesity during childhood can have a harmful effect on the body in a variety of ways, says bariatric surgeon Dr Lakshmi Kanth T.
In 2015, obesity affected 2.2 billion children and adults worldwide, or almost one in three of all people. This includes nearly 108 million children and more than 600 million adults with BMI exceeding 30, the threshold for obesity, according to the study. China had 15.3 million children with obesity and India 14.4 million.
About 14 to 16 % of children and adolescents are either overweight or obese. This is on the increasing trend.
Parents are concerned about their children weight because most of the parameters of these children are normal. Extensive Evaluation with investigations is usually normal. Not many options available except modifying the activity and diet. But most often this is not possible because of the availability of time and the school environment which is not in the hands of the parents.
The most precise way to measure obesity in a child is by using BMI-for-age percentiles. You cannot measure children’s weight using solely BMI. You must calculate BMI and then plot it on the BMI-for-age percentile graph to find the child’s weight status.
The Body mass index (BMI) is the accepted standard measure of overweight and obesity for children two years of age and older. BMI provides a guideline for weight in relation to height and is equal to the body weight (in kilograms) divided by the height (in meters) squared. Reference standards vary by age and sex).
For children between 2 and 20 years of age, the following weight categories are used
Overweight – BMI between the 85th and 95th percentile for age and sex.
Obesity – BMI ≥95th percentile for age and sex.
Severe obesity – BMI ≥120 percent of the 95th percentile values, or a BMI ≥35). This corresponds to approximately the 99th percentile, or BMI Z-score ≥2.33.
Main culprits of weight gain
Increasing trends in high sugar contents in foods, sugar-containing beverages, portion sizes for prepared foods, fast food service and home delivery of foods and food apps, diminishing family presence at meals, decreasing structured physical activity, increasing use of computer-oriented play activity, school meal nutrition content, and non availability of sidewalks and playgrounds. All these have an influence on the rise in obesity.
Genetic factors play a permissive role and interact with environmental factors to produce obesity.
We should counsel parents in various aspects. We should advocate improvements in nutrition quality for children, including consumption of a diverse, nutrient-dense diet, emphasizing vegetables, fruits, and whole grains; with quality protein sources and low-fat or non-fat milk and dairy; limited intake of sugar-sweetened beverages; modest fat content; and moderate portion sizes. We should discourage access to sugar-sweetened beverages in schools, including soft drinks and beverages marketed for rehydration during sports.
Children who have obesity are more likely to have:
High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD).
Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes.
Breathing problems, such as asthma and sleep apnea.
Joint problems and musculoskeletal discomfort.
Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).
Childhood obesity is also related to
Psychological problems such as anxiety and depression.
Low self-esteem and lower self-reported quality of life.
Social problems such as bullying and stigma.
Prevention is better than cure. It should start at a very early age . Obesity with genetic predisposition along with environment play a important role in development of obesity. So we should take lot of effort to modify the environment . Modifying should start at home and the school. Children should be encouraged to be given demand feeds rather than over feeding. Nutritional diet should be encouraged . Activity in all forms of sports and daily activity should be encouraged. Teachers and parents should take a active part in over all development of the child rather than education alone.
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