HEALTH
Paediatricians arm parents in the battle against rising obesity in youths
ARUSA PISUTHIPAN
A lot of parents believe that when it comes to raising children, the chubbier they are, the better. Some parents believe that these adorable cute tubbies are not only cute but healthy. This is, to some extent, completely wrong.
"Being fat is not equivalent to being healthy," commented Dr Pisit Pitukcheewanont, a paediatrician from the Children's Hospital in Los Angeles and associate professor of clinical paediatrics at Keck School of Medicine, the University of Southern California.
According to the World Health Organisation (WHO), approximately 22 million children worldwide under the age of five are reported as being overweight.
In Thailand, according to statistics from the Ministry of Public Health, during the past 20 years, the incidents of obesity in children have doubled. In the past five years alone, there has been a 40 per cent increase in the development of obesity among Thai children under the age of six.
Dr Pisit, a paediatrician from the Thai-American Physicians Foundation, says the prevalence of obesity in children should not be underestimated - as almost 100 per cent of obese children grow up to become obese adults. Obesity therefore has a tremendous health impact on both youths and grown-ups.
Firstly, let us define obesity.
According to Dr Lalita Khaodhiar, assistant professor of medicine at Boston University School of Medicine, obesity does not just mean excess body weight - a popular misconception by many people.
"Obesity is an excess of body fat that is a result of the imbalance of energy intake and energy expenditure. If left unattended, obesity can lead to more serious illnesses ... everything that you can imagine," said Dr Lalita, also a member of the Thai-American Physicians Foundation.
The occurrence of obesity in children today is entirely different to that of the past, Dr Pisit notes. In the past, obesity was not so closely related to nutritional factors. On the contrary, present diets are the first thing to be blamed for obesity.
"Before, junk food was not as widely available like it is today. In some places people even had to hunt for food. As a result, children then were not at a high risk of developing obesity. Today, convenience stores such as 7-Eleven are everywhere. Food is cheap and is more readily accessible. Western food and high-fat diets are out there. And when children have easy access to these types of food, they are more likely to become obese," explained Dr Pisit.
Obesity in children notably goes hand-in-hand with the current eating trend, which involves a wider variety of fat-laden foods from vendors and lack of fruit and vegetable intake, not to mention the addiction to calorie-dense soft drinks and fast food.
It's also noticeable that, according to Dr Pisit, the older a child becomes the higher the chance they develop obesity. This is because when they are independent enough to buy food for themselves their eating habit is almost entirely out of their parents' control. And they tend to choose food and drinks that escalate the risk of obesity, especially carbonated sugary drinks and junk food.
There is a close connection between children's behavioural patterns and obesity. With the widespread availability of computer games, Internet and television, youths these days prefer to be couch potatoes instead of going outside and doing physical activities.
The risk of developing obesity increases by 50 per cent in children who spend more than two hours straight on a chair watching TV or playing computer games every day, Dr Pisit observes.
Apart from a child's lifestyle, genetic factors play a significant role in the development of obesity in children, too.
"For kids whose mother and father are both obese, the chance of them becoming obese is as high as 90 per cent. And if either parent is obese then the likelihood of becoming obese goes down to 30 per cent, depending on the child's lifestyle as well. However, even if neither parent is obese there's still a small chance - eight per cent - that the kids will fall prey to obesity," Dr Pisit explained.
"Despite such genetic factors it is still important to bear in mind that a child's behavioural pattern can double or even triple the risk," he added.
Not only does obesity result in children's excessive weight and rotund figures, it also leads to a fair number of serious physical and mental conditions. Obesity magnifies children's risk of developing diabetes following glucose intolerance, hyperlipidemia following high blood cholesterol and high triglyceride, hypertension, early puberty and abnormal menstruation.
Obesity in children can affect the body's gastrointestinal tracts, cardiovascular as well as the urinary and respiratory systems. Additionally, obese children are more likely to suffer a mild to moderate degree of sleep apnea as they cannot breathe properly while sleeping.
Besides, obesity causes bone and joint complications; knee joints are easily damaged in overweight children compared to their non-obese counterparts. Worse, obesity can trigger cancer in several organs such as breasts, liver, stomach, ovaries and kidneys.
Last but not least, obesity considerably affects a child's psychological state.
Children who fall victim to obesity generally have low self-esteem due to their physical appearance, according to Dr Pisit.
"A lot of obese children do not like to participate in swimming classes because they do not want to take off their clothes and be gawked at by their peers. As a result, many fat children do not like physical education classes. This seemingly small problem should not be neglected because the less physical activities they do, the more damaging it will be."
Even though these days there are several ways to treat obesity in children including pharmacotherapy or surgery in severe cases - according to Dr Pisit and Dr Lalita - preventive measures are still crucial. Schools and families must play a pivotal role in the prevention of paediatric obesity.
"Child obesity prevention must start in schools," Dr Pisit advised, adding that academic institutions can reach to as high as 95 per cent of its students as they spend the majority of their time there, and average one to two meals per day.
Regular physical activity is one of the strongest shields against obesity. In schools, physical activities should be emphasized and be a part of the school's academic programme. And while at home children must be encouraged to eat healthier food, and it should also be a family effort.
"Children must be encouraged to regularly do low-intensity exercises for at least one hour every day. This will help to decrease the fat-free mass associated with weight loss. Furthermore, it helps to maintain the proper weight and improves cardiovascular health," Dr Lalita affirmed.
Apart from exercise, a child's eating habit is a much-needed armour when battling obesity.
"It is essential to eat appropriate proportions of food each day," said Dr Pisit. "Children should eat a small amount of food but eat often. This is much better than eating a huge amount at one sitting. And don't eat as if there's no tomorrow!
"Try to eat a wide variety of healthy foods such as fruit and vegetables. Remember that reducing the calorie intake is more important than food composition itself," added Dr Lalita.
To overcome obesity and keep it at bay it is vital that patients first realise and accept the fact that they are obese.
"Patients who are obese usually do not visit a physician because they know they are obese. More often they come in with other complaints that are in fact closely related to obesity. So learning to live with obesity is paramount ... because after all, the key to weight loss lies in the patients themselves."
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