Childhood Obesity is a major health problem these days. Initially, it was supposed to be a disease of western countries and the affluent class, but data clearly shows that it is very rampant in middle-class families. The main reason as we all know is changing lifestyle with lots of junk food and minimal physical activity. It is important to be in touch with your pediatrician.
Definition: Simplistically, Obesity results from an imbalance of caloric intake and energy expenditure.
BMI (Body Mass Index): BMI charts are available which can be used in children > 2years old, BMI= Weight (in kg)/ Height (in meter)2
Obesity: BMI more than or equal to 95th percentile
Overweight: BMI between 85th and 95th percentile
Factors leading to obesity:
- Environmental factors:
- calorie-dense food
- consumption of processed foods
- limited physical activity
- sedentary interests: computers, TV, video games
- Genetic factors also play important role in some cases
Co-Morbidities associated with childhood obesity:
- Cardiovascular: Dyslipidemia, Hypertension
- Endocrine: Type 2 Diabetes Mellitus, Metabolic syndrome, polycystic ovary Syndrome
- Gastrointestinal: Gall bladder disease, Non Alcoholic fatty liver disease
- Psychosocial effects and stigma
- Orthopedic complications: joint pain etc.
- Respiratory: Sleep Apnea
- Neurologic: Pseudotumor cerebri
Interventions:
Successful intervention for obesity is challenging and is best accomplished using multimodal approaches to accomplish lifestyle change. In children, we do not want rapid weight loss as a child is in a growing phase and an adequately nutritious diet is needed. So it is best to try to retain the same weight or very slow weight loss.
- Catch them young – school-age children must be targeted
- Do not skip meals especially Breakfast
- Increase awareness: media; school teachers; governmental and NGO effort
- Minimize advertising pressure for “junk foods”
- School playgrounds; “Games periods”
- Health food in school canteens
Traffic light Diet Plan:
Features Green light food Yellow light food Red light food
Quality Low -calorie, high –fiber, low-fat, nutrient-dense Nutrient-dense, but higher in calories and fat High in calories, sugar, and fat
Types of food Fruits, vegetables Lean meats, dairy, starches, grains Latty meats, sugar, fried foods
Quantity Unlimited Limited Infrequent or avoided
Conclusion:
- India is in the midst of an escalating epidemic of lifestyle disorders associated with childhood
obesity.
- The important causes of the epidemic in India appear to be: unhealthy eating patterns, reduced
physical activity increased sedentary pursuits.
- Prevention must begin early in the form of a public health campaign directed towards lifestyle
changes of the family/society as a whole. The campaign requires strong social and political will.
- Health professionals must think about `prevention of obesity at all visits, monitor BMI and ensure that
‘nutrition messages’ are not conflicting and confusing.
- Special strategies for different ages and channels of interventions for the prevention of obesity have been outlined.
- Clinic-based individual assessment of the obese child and principles of therapy are provided.
Dr. Rahul Varma
Child Specialist
