Battling the bulge

Today, one in every five school-age children is overweight or obese. This figure has doubled in the last 10 years. The health and wellbeing of our children is vital but modern Indian society threatens children’s health. Eating habits have changed so that these days children’s diets are high in fat, salt and sugar. In addition, increased time spent in front of the computer or television or playing video games (often while snacking on ‘junk food’ and soft drinks) means that children spend less time being physically active. These changes have produced an increasing number of children who are overweight or obese.

Identifying ,Recognising and ACKNOWLEDGING the problem

Before we can deal with weight issues in childhood we must recognise the problem in the first place. Although most families are aware that Indian children are getting fatter and that this situation is of concern, parents often believe that childhood overweight and obesity affects other people’s children – their own children are just ‘a little overweight’, or have ‘puppy fat’. Children can develop different shapes at different ages as part of their growth and development and sometimes it can be hard to determine if they are overweight. However if a child is ‘huffing and puffing’ or going red in the face when walking up a hill, if they cannot fit into age-sized clothes and/or if extra rolls of fat can be seen around their waist, then that child is likely to be overweight and to need help.

Many people believe that fat children will ‘grow out of it’ – unfortunately, this is generally not the case. There is a high risk that problems with weight in childhood will persist into adulthood. Children do not usually grow out of their ‘puppy fat’ and ‘chubbiness’ – the weight problems remain and the longer a child is overweight or obese the higher the likelihood that weight problems will persist.

The vicious cycles

Most people understand the link between over-eating or poor nutrition and weight problems, but the link between decreased physical activity and overweight is less well appreciated. In simple terms, the food eaten each day needs to be matched by a level of physical activity that uses the energy provided by the food. Maintaining a balance between energy input and energy output is the key to healthy weight and good health. Overeating or excessive eating of junk food and/or too little physical activity leads to an unhealthy nutritional state. Children with weight problems are often unfit and not well co-ordinated, and this makes it harder for them to be active; there is a vicious cycle of further sedentary behaviour, decreased physical activity, and worsening states of fitness. At Ability Physiotherapy therapist can help as we have the training and experience in assessing motor skills and exercise fitness, and in advising suitable activity/exercise programs.

Children who are overweight or obese frequently have poor self-esteem as a result of being teased, bullied and ostracised. And there is the risk of other serious health problems. Lack of exercise, poor nutrition and resultant weight problems in childhood have serious health consequences both in the short term and the long term. This may include joint pain, asthma, sleep apnoea, raised blood pressure, high cholesterol, fatty liver disease and non-insulin dependent (Type II) diabetes. Some of these health problems, such as Type II diabetes, previously seen only in adults, are now being seen in children. It has been suggested that unless we reverse the weight problems in our children we run the risk that the next generation will have such serious health problems that their life expectancy will be less than that of their parents.
Some families believe that as long as their child seems a normal weight then poor diet habits and a preference for sedentary behaviour does not really matter. Physical activity is an important part of good health. Being active every day can protect against disease later in life and can help your child improve concentration, boost self-esteem and confidence, and maintain a healthy weight. Establishing healthy diet habits and engaging in regular physical activity from early childhood is a means of maximising health for life!

How to change undesirable habits?

Encouraging children to eat healthy food and be physically active can be a challenge. It requires patience, practice, and time. Start slowly. It is best to introduce one or two small changes successfully before moving on to the next idea.

A dietitian can provide ideas on how to introduce and maintain healthy food choices into your child’s diet. To increase the level of physical activity and to maintain your child’s interest in being active, try to introduce a variety of activities. Being involved in organised physical activity (sports and hobbies) is great, but remember that there are simple and cheap ways to be active too. Build up activity levels gradually and set goals – start by aiming to increase activity by 15–30 minutes a day, and each month increase the goal time until your child is physically active for an hour per day (up to 90 minutes is even better!). Being active for 10–15 minute periods a few times a day is fine and may make achieving total daily goals more manageable. Doing things together as a family is a motivating way to set up healthy habits – so get out and about with your children.

Children should be encouraged to:

  • Have at least an hour of physical activity/active play each day – and even more is better.
  • Limit time in front of the TV or computer to less than 2 hours per day.
  • Eat at least 2 fruit and 5 serves of vegetables each day.
  • Drink water instead of fruit juice or soft drinks.
  • Avoid snack foods that are high in saturated fats or have added salt and/or sugar.
  • Be aware about food advertising and packaging – read food labels to ensure you have made a healthy choice.

How to encourage physical activity

  • Talk with your child about how physical activity is an important part of being healthy
  • Provide simple equipment for your child to play with (balls, rope, ‘Frisbee’ etc)
  • Encourage your child to try new activities and be patient as they learn
    o Play ball games in the backyard-kick, hit and catch
    o Ride a bicycle
    o Take your child for a swim
  • Build physical activity into your child’s daily routine
    o Walk rather than drive to get around
    o Walk to and from the mall/ park . If neighbourhood safety is a concern, think about setting up a ‘walking bus’ in which a couple of adults walk a group of children to and from the school
    o Use the stairs rather than the lift or escalator
  • Be a role model by being physically active yourself
    o Take your child when you walk the dog
    o Go to the park with your child – encourage them to climb, swing and run
    o Involve your child in helping around the house and doing things that require participation and light effort.
  • Encourage any interest in neighbourhood or school sports and recreational activities – check out what group activities are on available
  • You do not have to be outdoors to be active – be imaginative with indoor activities
    o Dance to music
    o Adapt ball games using a balloon (balloon tennis or balloon soccer) or ping pong ball (indoor cricket)
    o Jump up the stairs
    o Use a hula hoop
    o Play ‘Simon Says’ or ‘Hide and Seek’