Smart Changes That Can Help Fight Childhood Obesity

Written by Dr. Sanjay Borude

India has the second highest number of obese children in the world, with 14.4 million reported cases, according to a new study published in the New England Journal of Medicine. The country is the second most populous country in the world with 27.05% of its population in the age bracket of 0 to 14 years. The obesity ranking matches India’s world position in terms of population, but the numbers are alarming nonetheless.

It is commonly believed that obesity occurs due to consumption of junk food, unhealthy food, frying in saturated fats, etc. – the list is endless. But social and cultural factors are also responsible and often overlooked. The scarcity of playgrounds in urban areas means that children remain glued to screens with little physical activity. Their day is filled with extracurricular activities and classes, leaving no time or energy for play. Physical activity becomes minimal or absent from daily schedules unless obesity or its symptoms occur. Exercise is often perceived or practiced as a measure against obesity. Many forget that physical activity is important for physiological, mental and general well-being, whether the person is overweight or not. It cannot be repeated enough that obese children are at high risk of suffering from chronic diseases later in life.

When a family seeks help for their obese child, doctors usually start with a conservative diet-focused plan. Along with counseling, the family is advised on diets and daily caloric intake. For some children, the doctor may advise an exercise program combined with behavioral change, the expertise of a nutritionist and mental health professional, and doctor’s advice.

Studies suggest that lifestyle modification, combined with parental support, works best for most children. Obesity in children is not simple. It’s not just the result of overeating and not exercising. Many factors come into play here: the child’s genes, hormonal cycles that dictate metabolism, sleep cycles, family socio-economic status and lifestyle choices.

Years ago, I conducted a survey of the weight and BMI (body mass index) of children attending a school in a lower middle class locality in Mumbai. They lived in simple colonies; didn’t take many extra classes or clean gadgets that would keep them glued to the couches. This implied that most children would be of an appropriate weight. My happiness was short-lived because in a later interview, the students confessed to having a strong affinity for junk food, such as pastries and pizza. The apparently healthy group was clearly in poor health and at high risk of gaining weight in the future.

Get rid of the myths

Myth 1: Childhood obesity is genetic
Fact: Although genes influence weight, they are only a small part of the equation. Most children can maintain a healthy weight if they eat well and exercise.

Myth 2: Obese or overweight children should be put on a diet.
Fact: Unless your child’s doctor tells you otherwise, the treatment for childhood obesity is not weight loss. The goal should be to slow or stop the weight gain, allowing your child to reach their ideal weight.

Myth 3: It’s just baby fat. Children will exceed the weight.
Fact: Childhood obesity doesn’t always lead to obesity in adulthood, but it greatly increases the risk.

Healthier food choices

Start by taking small, gradual steps toward healthy eating. If the family is used to after-meal desserts, a fruit-based cake or pudding can be swapped for ice cream or fried treats. Parents can then move towards reducing the quantities of desserts or meal portions to balance the calories consumed. Similarly, if children tend to snack in front of the television, parents can offer fruits or snacks such as “kurmura” (puffed rice), seeds, etc. Add a salad to dinner every night or swap the fries for baked potatoes and later, baked potatoes with baked vegetables.

A visual treat

There are always ways to create interesting patterns for children. The diet can be designed to include red (beets, tomatoes), orange (carrots, squash), yellow (potatoes, bananas), green (lettuce, broccoli) and so on – just like eating a rainbow. Fruit can be frozen and served as popsicles; vegetables can be cut into strips and served to look like pasta etc. You can also explore recipes with your child and understand which tastes appeal to them and design foods accordingly. Picky eaters can be enticed to eat a variety of foods if presented in an appealing way, such as a bowl of ice cream topped with fruit or fun pasta with colorful vegetables like broccoli, purple cabbage, tomatoes, etc You can also do a color identification game with the younger ones.

For older children, the parent must connect with the aspirations that drive them. For someone it may be to excel in sports, another may wish for better concentration, better looking skin and hair or even “aesthetic” food that they can photograph and share on social media. . You can plug in foods that match their desires, communicate the role of food and nutrition, and embark on a joint effort to eat the rainbow.

Breakfast can be the meal the family eats together.

The sugar trap

Look for hidden sugar in foods like bread, canned soups, pasta sauce, pickles, frozen foods, low-fat meals, fast food, and ketchup. The main culprits are health drinks and dairy supplements, which are endorsed by A-list athletes and celebrities. They mislead people into thinking that milk alone does not contain enough nutrients and should be fortified with powders for extra nutrition. A major ingredient in these supplements is sugar. A popular brand of cornflakes implies that its packaged puff has more nutritional value than almonds. Likewise, several health drinks that claim to contain vitamin C are also loaded with sugar.

The body gets the required amount of sugar from natural foods like fruits, milk and even some vegetables like potatoes and grains like rice. Instead of buying milk drinks or supplements to add to milk, try creating healthier alternatives at home. Use cocoa powder and dates to recreate the appeal of chocolate milk. Even the traditional milk masala with cardamom, saffron and dried fruits is packed with nutrients.

Limit juices, sodas and coffee drinks. Soft drinks are loaded with sugar. Most juices offer few nutrients because the fiber is often discarded with the skin and pulp. Instead, offer your child sparkling water with a squeeze of lime, fresh mint, or a dash of fruit juice with pulp.

Don’t ban sweets. A “no sweets” rule invites cravings and overindulgence when the occasion arises. Instead, limit the cookies, candies, and baked goods your child eats and introduce fruit-based snacks and desserts.

Plan regular meal times. If your children know they will only get food at certain times, they will be more likely to eat what they get when they get it. Limit dining out. if you must eat out, try to avoid fast food.

Don’t go for low calorie sweeteners. According to a report from the Harvard TH Chan School of Public Health, “low calorie sweeteners (LCS)” have a higher sweetness intensity per gram than calorie sweeteners. These include artificial sweeteners, such as aspartame and sucralose, as well as plant extracts like steviol glycosides and monk fruit.

The good fat

Don’t go fat-free; go good fat. Not all fats contribute to weight gain. instead of trying to eliminate fat from your child’s diet, focus on replacing unhealthy fats with healthy fats. Avoid trans fats which are dangerous for your child’s health. Try to eliminate or reduce store-bought baked goods, packaged snacks, fried foods, and anything that has “partially hydrogenated” oil in the ingredients, even if it claims to be trans fat free.

It’s impossible to avoid the allure of the packaged cakes and chips that dot the markets. A better idea would be to create these goodies at home. Unsaturated or “good” fats include nuts and seeds like peanuts, almonds, and cashews. Eggs, avocados, olive oil, fatty fish, soybeans, tofu, flax seeds, etc. also contain healthy fats. But they are also high in calories, so their consumption should be limited. Cooking fats like butter, ghee, coconut oil, mustard oil, and unrefined oils are imperative for maintaining health.

Choose saturated fats wisely. The USDA recommends limiting saturated fat to 10% of your child’s daily calories. Focus on the source of the saturated fat consumed: a glass of whole milk or plain cheese rather than a hot dog, donut or pastry; grilled chicken or fish instead of fried chicken, etc. Some advertisements describe butter, ghee and traditional oils as “harmful” and promote margarine and factory-made substitutes in their place.

Some brands also package ready-to-eat foods as “trans fat free.” Although the claim is true, check their caloric value against their nutritional value. Be smart about snacks and sugary foods. Your home is where your child most likely eats the majority of meals and snacks. It is therefore essential that your kitchen is full of healthy but interesting choices. khakhras, millet-based snack foods, etc. Keep snacks small.

Easy tips

Watch portion sizes. To control calories, use the hand as the unit of measurement. For women, the size of their palm indicates how much lean protein they should consume; fist the size of vegetables or salad, one hand cuts the portion of carbohydrates such as rice or starches such as potatoes. Finally, the fat should only be a thumb-sized amount. Serve food on individual plates instead of putting serving dishes on the table. Divide food from large packages into smaller containers. The bigger the packet, the more people tend to eat it without realizing it.

(Excerpt from Generation XL, published by Penguin)

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