HEALTH / KIDS SPECIAL................................ OBESITY IN KIDS ON THE RISE IN MUMBAI

OBESITY IN KIDS ON THE RISE IN MUMBAI  In the last couple of years, the city has witnessed a steady increase in obesity among children. Here is all you should know about this potentially life-threatening condition...      ‘Cute’ is an adjective that is often used to describe chubby, plump and fat kids. The tendency, unfortunately, is to overlook the fact that the child in question might actually be heading towards morbid obesity. And, experts warn, obese children often slip into clinical depression. Says senior bariatric surgeon Dr Ramen Goel, “A marked reticence in going to school is also seen, especially in the 10-13 age group.” Often, parents wake up to the problem only after the child is diagnosed with a disease like diabetes.     Bariatric surgeon Manish Motwani says, “Living with morbid obesity is extremely difficult for any individual, especially an adolescent.” ON THE RISE According to Dr Goel, Mumbai has a high incidence of obese children in the age-group of 0-14 years. Says he, “Excessive consumption of caloriedense food, frequent eating out and lack of physical activity are the main reasons for severe obesity in young children.”     Dr Motwani agrees. “In fact, almost one in five children and adolescents are overweight; and the numbers are increasing,” he adds. Today, more children are being diagnosed with diabetes, hypertension and other co-morbid conditions associated with obesity - - similar to those seen in obese adults.     According to the National Diabetes, Obesity and Cholesterol Foundation, the prevalence of overweight/obesity among teenagers in Mumbai’s private schools is 33.9%. And, in public schools, it’s 8.4%.     Dr Goel explains, “Using past studies by the Indian Journal of Medical Research as a base, there’s an average 2.5% increase in childhood obesity in India, over a two-year period. Childhood obesity is more prevalent in the higher socio-economic strata. Obesity clearly demonstrates a familial tendency. A recent study demonstrated that the odds of children aged seven becoming obese if the father, mother or both had obesity were 2.93%, 4.66% and 11.75%, respectively.”     Pediatrician Dr Jayesh Sheth says that a simple thing like watching TV during meals can be harmful, “Most kids eat while watching TV, and so don’t realise that they are overeating,” he says. HOME REMEDY Ayurvedic physician Dr Smita Naram says, “Dried Garcinia fruit (available easily in Kerala stores; is called Kudampuli) or 3 pieces of Kokum are to be soaked in half a glass of water for ½ hour. Squeeze the kokum and filter the water. Add Cumin powder ½ tsp, Ajwain powder ½ tsp, Asafoetida one pinch and Fennel powder one tsp. Mix all well in the kokum water and drink. Drink this freshly made mixture twice daily. This improves metabolism remarkably and burns fat.” CAUSES Sedentary lifestyle Faulty food habits Loss of family meal concept Genetic factors TREATMENT Weight management programme includes changes in diet plan, limiting the time kids watch television and engaging them in physical activities like outdoor sports. Dr Goel says, “However, these work only temporarily; weight regain is seen in over 90% cases. Bariatric surgery is an option to sustain weight loss, but selection criterion for candidates is strict. The child’s understanding of the surgery and its implications are also important.” Dr Motwani says bariatric surgery may help avoid death when conventional treatment options have failed. Let’s take a look at conventional treatment plan. DIET THERAPY Dietitians can help children understand healthy eating habits and how to implement them in their long-term diet. They are taught how to identify healthy food, reduce portions, understand the food pyramid and eat smaller bites at a smaller pace, says Dr Motwani. PHYSICAL ACTIVITY Physical activity is an important longterm ingredient for children, as studies link inactivity during childhood to a sedentary adult lifestyle. Physical activity can decrease, or at least slow down, the increase of fatty tissues in obese children. Children should indulge in at least an hour of physical activity every day. BEHAVIOUR MODIFICATION Lifestyle behaviours are established at a young age. So, it’s important for parents and children to remain educated and focussed on making long-term healthy lifestyle choices. TIPS FOR CHILDREN Children can also modify their behaviour. Here’s how... Change eating habits Increase physical activity Become educated about the body and how to nourish it Engage in support group activities and set realistic weight-management goals HOW PARENTS CAN HELP Ensure five servings of vegetables and fruits daily Reduce high-calorie food Avoid snacking Reduce fat consumption Organise regular outdoor games     POINT TO PONDER BABY FAT VS MORBID OBESITY Baby fat is usually present in the early years and  cannot be equated with excessive fat deposits responsible for morbid obesity. Debarati S Sen TOI 131218