Saturday, November 23, 2013

Obesity in Children

Childhood Obesity is a condition where excess amount of body fat negatively affects the child's health and development. It is alarming to note that around 10 percentage of world's school aged children are carrying unnecessary excess fat in their body. Due to the rising prevalence of childhood obesity and its adverse health impact, it has been acknowledged as burning health issue. 

Health impact of childhood Obesity
Childhood Obesity is a potential dangerous seed which can sprout into various ailments such as diabetes, Hypertension, sleep disorders, liver disease, early puberty, skin infections, respiratory problems, etc… Over weight children are more likely to grow up in to over weight adults. Obesity in adolescence is an indicator of reduced health status in adulthood. Recent studies have revealed that obese adolescent girl have higher risk of PCOD (poly cystic ovary disease) and infertility in adulthood. More over obese children suffer from social seclusion, discrimination, teasing, and resultant low self esteem, poor performance and depression.

Thus obesity has a significant health consequence for the child and adolescent group both in short term and adult life.

Causes
Obesogenic environment is the medical term which includes mosaic of all causative factors of obesity.
·         The greatest risk factor is the obesity of both the parents. Obese parents have 45% more chances of begetting obese offspring when compared to non obese parents.
·         Psychological factors also play pivotal role in obesity causation.
·         Easy availability and access to energy loaded food coupled with reduced energy requirement in daily life.   
·         Childhood obesity is nourished and celebrated by the fast food industry which spends a lavish amount of $ 4.2 billion on advertisement for luring young children.
·         Physical inactivity and engagement in immobile activities such as watching television, computer and video games are the major culprits. Sedentary habits cause the unused energy in the body to be converted into fat.
·         Genetic factors and endocrine factors are also contributory.

Investigation
·         In case of moderate obesity and associated physical signs the test for blood glucose, serum lipid, liver function test, ultrasound of liver, thyroid function test can be done.
·         A fasting lipid profile should be considered in obese children and adolescents especially in those with the family history of cardio vascular risk. 
·         A fasting insulin and glucose test should be considered in obese children with the family history of type 2 diabetes.

Management
Obesity management is an essential lifestyle modification. Since it has to be pursued for a lifetime, continuous motivation and family involvement is inevitable. Before problem is addressed it has to be ascertained whether the parent and the child unanimously agree that there is a problem to be tackled. Realistic change cannot be expected without consent and motivation in a family setting. As far as childhood obesity is concern family factors, whether psychological, physiological or cultural are relevant.
The domain of weight management is encompassed by mainly 3 components
·         Change in attitude
·         Change in diet
·         Change in activity level

Attitude
·         A positive attitude is the first step towards fighting obesity.
·         Parents should have a realistic body image of their children. Blind comparisons are futile. For ex: it is normal to see the child’s rib unless and until the child is weak and less active.
·         Avoid giving food as a reward to children. For ex: Burger, pizza as gifts.
·         Food choices and selections must be taken up by adult in the family.
·         Breast feeding helps to counter childhood obesity.

Diet
·         Appropriate food and eating habits have a key role.
·         Breakfast, lunch and dinner time should be fixed as far as possible.
·         Munching snacks in between meals should be strictly discouraged.
·          The time duration between meals should be a minimum of 4 hours.
·         Avoid the dreadful combination of food and television.
·         Avoid over feeding.
·         Use less processed and tinned food.
·         Substitute noodles, chips, chocolates, sweets, soft drinks and bakery items with homemade snacks, salads, fruit juices
·         Bakery and commercially marketed food items contain maida, transfats, artificial sweetners, colorings agents and preservatives, all of which are least nutritious and hazardous to health.
·         Encourage eating legumes, fruits, vegetables and cereals.
·         Contrary to the belief that planned diets are bland and boring, obesity diet can be prepared in a very tasty and interesting manner. Addition of ginger, garlic, onion can do the trick.
·         Drink water, fruit juices, butter milk, etc… Water cannot be substituted by tea, coffee, etc…

Activity              

·         Reduce sedentary habits such as long hours of television and computer watching more than continues 4 hours.
·         Avoid day sleep after meal
·         Encourage physical activity such as brisk walking.
·         Regular exercise for minimum 20 min session 3-4 times a week
·         Children and adolescent group should engage regular physical exercise both at school and home. Clumsiness should be identified and curbed by parents and teachers as early as possible.

Yoga
The age old tested methodology of yoga is well suited for children. Yoga is a simple, economic, therapeutic modality that is beneficial adjuvant in obesity management. It works on all aspects (physical, mental, and emotional domains) of obesity. It makes the body agile and slim. It helps to control the mind in combating food habits. Yoga is safe and stable. Some of the asanas that can be done are mentioned below.

Childhood obesity is dangerous immediate attention seeking health problem. It has to be identified estimated and tackled carefully. Judicious combination of right food, optimum activity and positive attitude are the powerful weapons in this battle for health and happiness. Let us remember that growth of our children should be graceful, not gluttonous.

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