Childhood obesity: the coming pandemic | Cashmere amount


Malnutrition is a major public health problem and a complex problem to solve. Undernutrition and obesity are both high risks of premature death and disability. On the one hand, undernutrition levels have decreased by 10 percent according to the National Family Health Survey (NFHS) 2016, there is a marked increase in the frequency of obesity on the other side of the spectrum, which is an independent risk factor for various noncommunicable diseases. diseases such as hypertension, diabetes mellitus and the resulting heart attacks and strokes.

Obesity has reached epidemic proportions worldwide and its prevalence has doubled over the past two decades. Over the past 5 years, most developing countries have reported prevalence rates of obesity (including overweight)> 15% in children and adolescents aged 5-19 years. Childhood obesity is increasing at an alarming rate in India, causing diseases in adults among young people, such as high blood pressure, type 2 diabetes (T2DM), heart disease and joint disorders.

The increasing frequency of obesity in children is due to the following factors:

Unhealthy diet

The comparatively low cost of high-energy foods, improved purchasing power, TV commercials targeting children, and junk food sold in school canteens are shifting children’s eating habits from healthy foods to fatty fried and processed foods.

Parents’ professional status

Parents these days are working and having busy lives. They are often overworked and it is easy to let children order “quick meals” and have little time to monitor a balanced diet for children.

Lack of physical activity

Move from outdoor play to indoor entertainment; watching television, the Internet and playing computer games have all contributed to the increase in obesity in children. Children no longer want to ride a bicycle, and parents think it is safer to drive a car than a bicycle in a chaotic city.

Academics

The growing burden of academic competitiveness among students has led to a decrease in participation in sports and all other forms of physical activity. This is especially true for girls who have been sedentary since school years. Numerous studies conducted in India show that women have more obesity and metabolic syndrome than men.

Improved socio-economic status

The increase in purchasing power in the form of daily allowances (pocket money) to purchase food / snacks available in school cafeterias or nearby fast food restaurants could be a major reason for this.

Wrong parenting approach

Parents in India and other developing countries generally have the misconception that an obese child is a healthy child. And that if the child is big, the “big baby” will disappear over time. In an effort to keep the child “healthy”, he is overfed. Many of these children remain obese their entire lives.

Technology

More importantly, with the advancement of technology, especially in the field of entertainment, more time has been spent watching television, computers and video games at the expense of sports and physical activity, making it a sedentary lifestyle for children.

The worrying situation is that Covid lockdowns have led to an increase in various disorders in children, such as increased screen time, a sedentary lifestyle and its detrimental consequences on weight and behavior. The increase in screen time among children as a result of online classes has resulted in eye strain, behavioral changes, sleep disturbances, and weight gain.

Due to the confinement, children remain confined to their homes and their only hobby is watching videos on cell phones and / or other gadgets. On the other hand, people, in general, lack knowledge about a balanced diet and daily requirements for energy, carbohydrates, fatty proteins, macro and micronutrients. They eat whatever they can afford and it pleases their taste buds. People eat as much as they can afford without worrying about excess or lack of calories.

Research reveals obese children under confinement in Italy ate more junk food, watched more television at the expense of physical activity. “First of all, online classes increased stress and a sedentary lifestyle in children. On average, locking increased screen time in children up to three times compared to the pre-covid era. “

This study, published in April on obesity, looked at 41 overweight children confined in March and April in Verona, Italy. Compared to the behavior recorded a year earlier, the children ate one extra meal per day; slept an extra half hour a day; added nearly five hours a day in front of phone, computer and television screens; and dramatically increased their consumption of red meat, sugary drinks and junk food. Physical activity, on the other hand, declined by more than two hours per week and the amount of vegetables consumed remained unchanged.

There is no doubt that the lockdowns that have been put in place across the world to contain the COVID-19 pandemic have had a negative impact on children’s diet, sleep and physical activity, according to news. research.

The Body Mass Index (BMI) is a measure that uses height and weight to determine whether a person is healthy or obese. An ideal BMI is between 18.5 and 24.9 and over 30 is defined as obesity.

In most obese children, environmental and hereditary factors play a major role. Only less than 1% of obese children have an underlying pathology of childhood obesity.

Childhood obesity is associated with significant complications. Obesity is responsible for the development of insulin resistance due to the deposition of fat in skeletal muscles and the liver. Insulin resistance predisposes a person to develop type 2 diabetes, polycystic ovary syndrome, metabolic syndrome, and nonalcoholic fatty liver disease.

The cardiovascular effects of obesity in children are due to a higher prevalence of dyslipidemia, hypertension and the resulting atherosclerosis, especially in the coronary arteries that supply blood to the muscle and tissues of the heart. Childhood obesity is one of the main risk factors for premature coronary atherosclerosis and heart attack at a young age.

In addition, obesity is a risk factor for many orthopedic conditions such as flatfoot, genu valgum and osteoarthritis. The most debilitating complication of obesity is the slip of the capital femoral epiphysis which results in groin pain and abnormal gait.

Obesity is associated with frequent gastrointestinal complications, including gastroesophageal reflux disease and non-alcoholic fatty liver disease. Fatty liver disease is present in 40 percent of obese children. About 2% of obese children develop gallstones and can lead to life-threatening complications like pancreatitis.

This higher incidence of obesity and associated complications requires mass awareness programs.

Malnutrition is the leading cause of death and disease in the world. The developmental, economic, social and medical impacts of malnutrition are severe and long lasting.

A balanced diet is defined as an adequate and appropriate nutritional intake of foods that provide all macro and micro nutrients in desirable amounts. Inexpensive foods tend not to be healthy foods; we need government policies that make healthy food more available and affordable. We need to see changes in the public sector so that government organizations ban all unhealthy food, especially outside or inside schools.

Health education and investment in food research will be critical over the next five years. “One of the biggest obstacles is the availability of good food, which is always dictated by the big producers. We need to find a way to engage with the food industry to change the content of food products. In some countries, the desire to eat the right food cannot be satisfied due to the choice of food available in the supermarket and its price.

It is high time for a thorough review of diet and technology, and people need to know how food is produced, how many calories it contains, and what percentage of carbohydrates, fat and protein in particular is food. . It’s time to educate people on the benefits of polyunsaturated fats and the cons of saturated fats.

The top three reasons for heart attacks in young people are obesity, smoking and drug addiction and it is time to deal with them holistically as soon as possible so that many young lives can be saved.

Depending on the length of confinement, the excess weight gained may not be easily reversible and may contribute to obesity in adulthood if healthier behaviors are not restored. “This is because obesity in children and adolescents tends to track over time and predict weight status in adulthood.”

Generally speaking, Kashmiri people have a good price and good accessibility to food. The erratic eating habit in Kashmir is one of the main reasons for the increase in obesity among the masses and children in general. The people of Kashmir are voracious meat eaters and high consumption of butter, ghee, poultry and its products has increased the increasing levels of obesity and its subsequent metabolic complications.

For the prevention of obesity, especially in childhood, the emphasis should be on a healthy and active lifestyle and on creating a stimulating environment that helps young people to recognize their own worth and respect cultural eating habits. It is recognized that obesity, eating disorders, dangerous weight loss, nutritional deficiencies and height discrimination are all interrelated and need to be addressed holistically, thus requiring a multi-layered approach.

Conclusion

Childhood obesity is associated with a number of health problems such as hypertension, T2D and high cholesterol, stroke, heart attacks, which were once reserved for adults.

It is also associated with other significant morbidities, including gallstones, dyslipidemia, obstructive sleep apnea syndrome, early puberty or menarche, eating disorders, skin infections, orthopedic disorders, asthma and other respiratory disorders.

In addition to having a medical impact on the individual, childhood obesity also has a negative impact on the psychosocial development of the child as well as on the financial economy of the individual household as well as the country.

Community-based interventions should aim to provide an enabling environment for children to adopt healthy lifestyles, promote healthy food alternatives, and raise awareness of increased physical activity.

Other sporting activities should be encouraged across Jammu and Kashmir and the government will develop all facilities for these activities in villages and towns.

(The author is Professor of Pediatrics, GB Pant Children Hospital Srinagar)


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