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Childhood obesity: A growing problem


Dr. Bassier
Dr. Mardeyah Bassier, at Melomed Bellville.


Childhood obesity: A growing problem
Childhood obesity has become a serious epidemic that has gripped South Africa and the world. In the last decade, the obesity rate in children in South Africa has increased from one in 20 to one in eight children. Some forecasts suggest that South Africa will have the 10th highest level of childhood obesity in the world by 2031, affecting over 4 million children aged 5 to 19 years.

The Basics Of Tuberculosis (TB)

IS YOUR CHILD OVERWEIGHT OR OBESE?
Overweight and obese are defined as "abnormal or excessive fat accumulation that may impair health". Body fat is determined by the Body Mass Index (BMI), obtained by dividing a person’s weight(kg) by their height (m) squared or BMI = kg/m2.

As part of a regular check-up, a doctor calculates your child’s BMI and determines how they compare with other children of the same sex and age (your child’s percentile). For example, you might be told that your child is in the 80th percentile. This means that, compared with other children of the same sex and age, 80% have a lower BMI.

Cut off points on growth charts help identify overweight and obese children:
• Overweight if plotted between the 85th and 95th percentile,
• Obese if above the 95th percentile for age and gender.

In addition to checking BMI, the doctor also evaluates:
• Your family’s history of obesity and weight-related health problems
• Your child’s eating habits and kilojoule intake
• Your child’s activity levels
• Other health conditions your child may have

WHAT ARE THE RISK FACTORS FOR THE DEVELOPMENT OF OBESITY IN CHILDREN?
The most common causes of childhood obesity are related to environmental or lifestyle factors, with a small number (less than 1%) linked to genetic diseases or hormonal disorders.

Lifestyle risk factors:
• HIGH KILOJOULE INTAKE: Eating energy-dense foods like sugar-sweetened beverages (including fruit juice), high fat and high salt foods, instead of nutrient-dense foods.
• SEDENTARY LIFESTYLE: Children typically gain weight when they spend too much time sitting and watching screens.
• SHORTENED SLEEP: Mounting evidence points to an association between shortened sleep duration and obesity through possible alterations in the hormones which are involved in the regulation of appetite.

COMPLICATIONS ASSOCIATED WITH CHILDHOOD OBESITY
A 2019 study showed that childhood obesity mostly remains in adulthood and leads to non-communicable diseases, like diabetes and cardiovascular diseases at a younger age. Overweight children are at more risk for high blood pressure, asthma, liver disease, joint problems, and sleep disorders.

WHAT MEASURES CAN PARENTS TAKE TO PREVENT CHILDHOOD OBESITY ?
• Exclusive breastfeeding for the first 6months of life, followed by the introduction of complementary foods at six months
• Reduce intake of energy-dense foods (foods with a high caloric content)
• Increase consumption of fruits and vegetables
• Decrease sugar-sweetened beverages and increase water intake
• Maintain appropriate portion sizes and avoid adult plates when serving meals
• Encourage regular physical activity or active play which will increase energy expenditure
• Limit screen time (less than two hours of TV per day): no TV while eating and no televisions in the bedrooms
• Ensure a good night’s sleep

OVERCOMING OVERWEIGHT AND OBESITY
Addressing overweight and obesity early on could prevent the development of other non-communicable diseases. If you are concerned that your child is at risk, have their weight and height monitored regularly by a doctor or dietitian.

Sources and references consulted:
• Diabetes SA at www.diabetessa.org.za/obesity-in-children/
• Health-e News at health-e.org.za/multimedia/childhood-obesity-on-the-rise-in-sa
• Rossouw, H.A., Grant, C.C. & Viljoen, M. (2012). Overweight and obesity in children and adolescents: The South African problem. South African Journal of Science, 108(5-6), 31-37
• Pillay, K. (2004). Obesity in Childhood. South African Paediatric Review, Vol.1 Issue 2.
• Baker, J.L. et al., Childhood Body Mass and the Risk of Coronary Heart Disease in Adulthood. New England Journal of Medicine, Vol 357:23 2329–2337.
• Ludwig, D.S. (2007). Childhood Obesity – Shape of things to come. New England Journal of Medicine 3576–232325–2327.