Dr Mahesh Hiranandani
Nearly three decades back, a sick-looking, famished three-year-old girl with shrivelled skin, sparse hair and sunken eyes was the patient allotted to me in my MD paediatrics final exam. The little girl later died in the wards of PGI, Chandigarh: cause of death — malnutrition — in other words the child did not have enough to eat.
Even after 30 years, India, which comes under the category of developing nations, is still home to about 50 per cent of undernourished children of the world, according to a 2017 joint study by Assocham and Ernst & Young. The study found that towards the end of 2015, 40 per cent of the Indian children were undernourished.
Ironically, the study also found that urban India is faced with the challenge of over-nutrition. India is ranked as the third most obese nation in the world after the US and China.
Every third child in urban India is overweight. Another study, “Adolescent obesity in Asian Indians — a rising menace”, observed an alarming rise in obesity — both among urban and rural children. The World Health Organisation has also declared obesity as the fastest growing epidemic. In India, an estimated 50-100 million people are overweight. This number closely parallels the number of people who are diabetic.
It is also feared that this current generation of overweight children is not likely to live as long as their parents and this could have colossal health, social and economic implications. It is unfathomable that the situation in India has changed so much even when there has been no change in the genetic pool of the population in last 30 years. That can only mean that epigenetics (It literally means in addition to changes in genetic sequence. Any process that alters gene activity without changing the DNA sequence and leads to modifications that can be transmitted to daughter cells) are to be blamed. In simple terms our changing eating patterns, food habits, climatic conditions, rising pollution through use of heavy metals, pesticides, diesel exhaust, tobacco smoke, etc. are to be blamed.
A food obsessed nation
Among the most crucial determinants for childhood obesity is the ubiquitous supply of unhealthy, processed and ready-to-eat junk foods that unfortunately do not love your child as much as your child loves these. Also, sometimes it is not surprising to see parents force feeding their children in initial years of their lives. And then these children spend the rest of their lives struggling to lose the excess weight, gained as a result of this misconception that chubby babies are healthy. Overweight children are far more likely to grow up to be overweight adults. Research has also shown a proven link between overweight children and many health problems they face as adults.
Low birth-weight babies may be obese
Low birth-weight babies are another serious cause of concern. Adaptation to adverse conditions during pregnancy (diabetes, hypertension, malnutrition, etc.) evokes a survival response from these low birth-weight babies resulting in their being growth compromised. Later when these babies get abundant nutrition, they are at a great risk of gaining excess weight and developing various ailments like heart problems, strokes, diabetes, etc.
As a parent, you have a huge impact not only on your child’s lifelong food choices, but also on other factors that can contribute to or prevent obesity. Always lead by example and be a role model by leading a healthy lifestyle.
Who is the real culprit?
Too much food to eat and too little inclination to burn it are the reasons for this current epidemic which has changed the way we live.
- Unhealthy food is cheaper than healthy food.
- Energy dense food and sugary drinks are available all over.
- Portion distortion leads to subconscious overeating.
- Vanishing family meal times.
- Unsafe neighbourhood parks discourage physical activity of any kind.
- Academic pressure shrinks playtime at school too.
- Unacceptable screen time is a universal habit.
- Role model celebrities exert advertising pressure on young minds.
- Perception of being overweight is denied by most.
Knowledge about nutrition
In the best interest of the future of our nation, we as adults must get over this "feeding mania" and learn more about nutrition and healthy eating practices. Here are some of the tips for parents to prevent obesity in their children:
- Exclusive breast feeding for first six months.
- Addition of milk-free complimentary foods at six months along with continued breast feeding till 2 years.
- Age appropriate introduction of grains, pulses, vegetables, fruits and poultry in a systematic graded manner.
- Learn to differentiate thirst signals from hunger & encourage drinking of water/other healthy liquids in between meals.
- Respect your child's appetite & allow them to choose the food article time & quantity of food.
- Encourage children to eat only when hungry and to eat slowly
- Buy colourful vegetables and fruits rather than bakery.
- Keep a strict watch on salt, sugars and fats being consumed by the child.
- Restrict the amount of ready to eat, high salt-high fat junk foods.
- Do not punish, reward or bribe with food.
- Discourage watching TV while eating food to prevent unmindful overeating.
- Involve children in day-to-day household chores from a very young age.
- Enjoy impromptu physical activities as a family (walking, playing outdoor games, car washing etc).
- Allow your child at least 7-8 hours of good quality sleep.
— The writer is head of paediatrics, Cloudnine Group of Hospitals, Chandigarh
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