One in 10 children in urban areas such as Colombo and the main cities is overweight, sending out danger signals about current lifestyles and also the long-term impact on the health of the children themselves.
There has been a marked increase of overweight children from the 7% found earlier in urban areas to 10%, says Dr. Shanthi Gunawardana, Consultant Community Physician and Acting Director of the Nutrition Coordinating Division of the Health Ministry, explaining that this upward trend could be a harbinger to more children falling into the “obese” category which is already an alarming 1-2%.
The confirmation has come in detailed graphs plotted in a nutrition assessment carried out among the children of Year 1, 4 and 7, on guidelines set by the Family Health Bureau along with the Medical Research Institute on the reference values for weight and height for the two groups girls and boys, The Sunday Times learns.
Why?
Changes in lifestyles which have had a bearing on the eating pattern of children and lack of exercise seem to be the main culprits, according to Dr. Gunawardana, with the whole picture being complete when you add stress that children are facing in their daily lives.
“Classes here and classes there, children simply have no time to play or even eat and only snack in-between. The little leisure time they have is spent before the TV or the computer,” stresses Dr. Gunawardana.
And the answer against children becoming overweight and subsequently obese lies in a balanced diet, exercise in the form of play or sports and reduction in stress.
Fast foods, instant meals, fizzy sugary drinks and meals prepared without much thought to the “balance” that is vital in our food intake not only for physical growth and wellbeing but also for mental development are the cause, The Sunday Times learns.
Ask the question: “What is a balanced diet?” and most parents and also children will parrot the words, “Carbohydrates, proteins, fats, vitamins and minerals”.
The answer is absolutely right but Dr. Gunawardana cites the example of a domestic scene. Lunch time in a household…….with the mother balancing a plate, coaxing a child to open her mouth and popping balls of food into her mouth. A closer look at the plate shows there is a little rice, many pieces of fish and a lot of dhal.
Once the plate is empty, the mother is satisfied. But is it a balanced meal that the child has had?
“No,” says Dr. Gunawardana explaining that a balanced meal should consist of both macro (carbohydrates, proteins and fats) and micro (vitamins and minerals) nutrients . “As much as macro-nutrients are essential so are micro-nutrients. Although they may only be necessary in minute quantities they are invaluable in the metabolic process.”
Metabolism is the set of chemical reactions that occur in living organisms to maintain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. (See box for disruption of metabolic process)
Before dealing with what is wrong in feeding a child a little rice, many pieces of fish and a lot of dhal, this expert gets down to the brass tacks of nutrition and what each component does for the human.
- energy-giving food – carbohydrates such as cereals, yams and jak and fats such as oil, butter and nuts.
- body-building food – proteins such as fish, meat, eggs and pulses like dhal,cowpea, soya
- body-protective food – vegetables, greens and fruits
Going back to her example of a meal with a surplus of protein both in the form of fish and dhal and dearth of carbohydrates and lack of fats, if continued for a long period, Dr. Gunawardana says, the body will automatically fill the energy requirement first.
“Such a meal will first meet the energy-requirement of the body and give the remaining little for body growth including such crucial organs such as the brain.”
Explaining that childhood obesity means accumulation or deposit of fat (extra energy) mainly in sub-cutaneous tissue or under the skin and in adult males around the abdomen (giving them an apple shape) and in adult females on the buttocks (giving them a pear-shape), she underlines the fact that some people take drastic steps such as cutting out the fat altogether in their diets. “You need all the nutrients in the right balance for healthy-living. You need the fats but not excess fat.”
In the case of proteins, a child will need two grams protein per kilogram of body weight daily, says Dr. Gunawardana, adding that a 20 kg child would need 40 grams protein, while adults would need about one gram of protein per one kilogram of body weight.
Dr. Gunawardana has some advice for parents. “If you are healthy now, think of what you ate when you were young. Look back to your childhood and follow the same for your child.”
Educating parents and children
All is not doom and gloom though. Several projects are underway to start with the child and then educate the parent.
One such is a pilot study being done in eight Colombo schools to prevent obesity by mobilizing the children in Years 4 and 5.
“We have taken their weights, heights and waists at the beginning and then made them aware of the need for a balanced diet, urging them to make diary entries on what they eat throughout the day. At the end of the study too, we will take these values,” says Dr. Gunawardana, adding that starting with the children, the teachers are brought into the circle next and finally the parents.
In another project in Homagama, Year 9 students are setting up home-gardens in their schools to improve nutrition, with home science teachers chipping in by helping them make balanced meals and kola kenda with the produce.
Nutritional facts
- If someone does not get adequate iodine daily and that is just the quantity of a pin-head (150-200 micrograms), the production of thyroxin is affected. Thyroxin is needed for each and every bodily function such as mental, physical, reproductive and intellectual growth and a lack would impact throughout that person’s life. In our daily food, iodine would come from sea fish, water, greens and iodised salt.
- Iron-deficiency, where there will be less production of haemoglobin resulting in low oxygen, would also have serious consequences. Take the case of a woman who realizes that she is pregnant when there is morning sickness, well into the second month. If she is malnourished and iron-deficient, the baby growing inside her will begin with a disadvantage. The baby’s physical as well as brain development will be affected.
The result of anaemia in children would be that their immunity would go down, they would be more prone to infections such as cold, coughs and diarrhoea, they would lose their appetite and finally their growth would be affected. Immunity, intellectual growth, cognitive behaviour et al.
“The weaning of babies begins after six months,” says Dr. Gunawardana. “There is a delay in the introduction of animal proteins such as fish, meat and egg because of misconceptions and contradictory messages. This affects the baby’s haemoglobin levels because proteins provide iron and also enhance absorption of iron from other food. Is it surprising that so many children fail their maths at the OLs? This could very well be an indication of a long-term effect of anaemia.”
- Although there has been an improvement in Vitamin A deficiency in under-5s since 1995-96 from 35% to 29% due to policy and awareness campaigns, this is another issue that needs addressing. People’s diet should include leafy vegetables, yellow and orange fruits and vegetables and animal proteins such as milk and fish, otherwise growth is once again affected.
- Food in raw form along with fibres (such as red rice or vegetables and fruit) as opposed to refined and processed food is also vital to allow slow and gradual digestion.
With gradual digestion, blood sugar levels would rise slowly and the pancreas would secrete insulin slowly. However, if one eats fast food, the lack of fibres etc would ease digestion but make one hungry very soon. If one keeps eating junk food there would be rapid rises in the blood sugar levels with the pancreas having to work overtime, sending it into a stressful situation. Ultimately insulin production would drop and one would end up as a diabetic. Sugar would also deposit itself as fats, says Dr. Gunawardana.
- Another danger is pre-cooked chips, The Sunday Times understands, which are freeze-dried and then fried at very high temperatures. This results in a texture change in this carbohydrate which could affect the mucus membranes of the stomach making people not only prone to cancer but also cholesterol, heart disease, stroke etc.
- Salt is another essential we need about 6 grams each day. One pizza, without counting the salt from all the other food we eat each day, would give us around 7 grams. Excess salt would cause water retention and the heart would attempt to deal with that by working hard, ultimately getting overloaded along with the kidneys. The body is then under stress.
|
E-mail