Chubby can be cute, but it may not be healthy.
Did you know that childhood obesity is one of the most serious public health challenges of the 21st century? According to the World Health Organization (WHO), globally, obesity and overweight has more than doubled since 1980 and are linked to more deaths than underweight. Nearly 43 million children under the age of five were overweight in 2010. Close to 35 million of them live in developing countries while eight million in developed countries.
Back on our home front, the number of overweight and obese children in Malaysia is simply shocking. Childhood obesity levels in Malaysia are higher than in most Asian countries, and the problem is getting worse, says Prof Dr Norimah A Karim, vice-president of the Malaysian Association for the Study of Obesity (MASO).
Data from various research groups have indicated that as many as 15 per cent of toddlers and preschool children in the country could be overweight and obese. Among primary school children, 30 per cent of them could be overweight and obese. These statistics should come as no surprise. You can make your own personal observations when you go to shopping malls and eateries around the country. Notice the number of overweight children and youngsters?
If parents and children do not watch what they eat, the number of overweight or obese children will continue to increase, even to epidemic proportions.
So, parents and guardians, are your children reaching this point, or are they there already?
The root of the problem
There is no single cause of childhood obesity; instead it is a combination of various factors, such as behaviour, environment and genetics.
According to Dr Tee E Siong, president of the Nutrition Society of Malaysia (NSM), the "fat phenomenon" in our country can be attributed to a combination of poor eating habits, a diet high in calories, and a decline in physical activity, resulting in more caloric intake than is required by the body.
In addition, more meals eaten away from home, fewer family meals, and greater portion sizes may also have contributed to childhood overweight.
Dr Tee adds that the boom in technology and too much screen time has also contributed to children's sedentary lifestyles. Children now spend less time being physically active during school as well as at home. There has been an immense change over the years in children's entertainment; from physical or outdoor activities to indoor video games and television. To further compound this problem, there are not many safe or conducive places to play or be active outdoors, especially in urban areas.
Risks to their health
Children who are overweight or obese face an increased risk of developing serious health conditions like type 2 diabetes, high blood pressure, and high cholesterol - all once considered exclusively adult diseases.
"Overweight and obese children are also more likely to become overweight or obese teenagers, and if the situation is not addressed, they will turn into overweight adults, and obesity in adulthood is more severe, in terms of consequences", explains Prof Dr Norimah.
She adds that children who are obese are also more likely to have impaired glucose tolerance, decreased insulin resistance, suffer liver or gall bladder disease, gastro-esophageal reflux (GERD), sleep apnoea, breathing difficulties like asthma, joint problems, and musculoskeletal problems.
According to the Malaysian Mental Health Association, in addition to medical problems, obese or overweight children may also suffer psychological problems such as low self-esteem that stems from being teased or bullied by peers, develop unhealthy dieting habits and eating disorders such as anorexia nervosa and bulimia, be more prone to depression or are at risk for substance abuse.
Keeping them healthy
Practising healthy lifestyle habits and maintaining a healthy weight should start early in life.
Council member of the Malaysian Association for the Study of Obesity (MASO), Dr Zawiah Hashim, points out the importance of children consuming adequate calories and nutrients to support normal growth and development. However, this must be carefully observed so that children do not start to consume too many calories. The home is the best place to start promoting a healthier environment for children. Dr Zawiah ... Parents must practise what they preach and make healthy eating and physical activity a family affair.
"Parents should not underestimate the health risks associated with excess weight. The key to keeping children at a healthy weight is by taking a 'whole-family' approach. Members of the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes towards being overweight. Therefore, parents must practise what they preach and make healthy eating and physical activity a family affair," she explains.
Dr Zawiah recommends involving your children in the planning and preparation of healthy meals by letting them help and taking them along when grocery shopping so that they can learn how to make healthy food choices. This opportunity will also allow children to identify healthier foods in the school canteen.
"When eating out with your children, chances are they will choose food they crave for, and they almost always prefer fast foods. What you have to do as parents is to stand strong and not give in to their cravings as getting them to eat healthy foods now is the best way to ensure healthy eating habits later on in life," adds Dr Zawiah. In addition, parents should set some guidelines for the amount of time their children spend with sedentary activities like watching television or playing computer games.
"Limit your young child's screen time to not more than two hours per day as children who consistently spend long hours watching TV are more likely to be overweight. The Malaysian Dietary Guidelines (MDG) also recommends that sedentary activities such as watching television and movies, or playing video and/or computer games should be limited," she adds.
Dr Zawiah also recommends that you exercise with your child daily. Planning family activities that include hiking, bicycling, walking, simple yard work, or washing the car can keep your children active.
"Become the best role model for your children and help them shape healthy eating habits while practising an active lifestyle," she advises.
Fighting excessive weight gain
Parental involvement and support is crucial for successful weight management. For children who are overweight, consultation with a healthcare professional about weight management strategies is necessary to ensure the appropriate management of other health conditions.
"If you think your child may be becoming overweight, seek the advice of a paediatrician who can verify if your child is indeed overweight. Ask the paediatrician to then recommend or refer your child to a dietician or nutritionist for further consultation on weight reduction approaches," advises Dr Zawiah.
She also stresses the importance of monitoring your child's weight at home, so that any changes in weight can be detected early.
"Weigh and measure your child once every three months and keep track of his or her weight and height. There is no need to be obsessive about weight-watching, but as parents, you should know the healthy weight range for your child's age and height, and the approximate number of calories he or she needs each day," concludes Dr Zawiah.
To learn more about weight monitoring and Body Mass Index (BMI) for your children, please visit www.nutriweb.org.my and/or www.healthykids.org.my