Durban – With one in four girls and one in nine boys overweight or obese, experts are worried and some are taking steps to stem the tide.
At one Durban paediatric practice, children as young as 4 are being screened for high cholesterol levels, if they are from high-risk families.
Dr Das Pillay, a paediatrician who has been in practice for 20 years, says obesity in children has increased exponentially in the past decade and his practice, which incorporates obesity education and preventative management, screens children if their families have a history of high cholesterol. This can be treated effectively with diet and lifestyle changes, he says.
“Later on in life these patients often need cholesterol-lowering medications to prevent early onset heart attacks,” says Pillay.
At the other end of the spectrum, Pillay, who is based at St Augustine’s Hospital, says it is shocking to see the high levels of cholesterol and obesity in patients with no positive family history of high cholesterol, due mainly to poor diet and sedentary lifestyles.
“This is what contributes to early onset heart attacks in men between the ages of 35 and 50 years,” he says. “With a high incidence of elevated cholesterol and type two diabetes in the South African Indian community, it is something we need to watch from an early age.”
Children are weighed weekly and encouraged to exercise and eat a diet of moderate protein and vegetables, low carbohydrates and low GI carbs as well as foods rich in good fats, like avocados and nuts.
Pillay does not approve of restrictive diets.
“They are short lived,” he says. “Losing weight involves a change of lifestyle for the child and the whole family. It’s a family commitment to a healthy diet and exercise.”
He is aware of the demands on modern families, where both parents work and are often not able to monitor what their children are eating and drinking, as they fill up on junk foods and sugary drinks.
The 2014 Healthy Active Kids South Africa (Haksa) Report Card, published annually by Discovery Vitality, identified worrying trends of inactivity and obesity, even in the face of widespread poverty and food insecurity. In urban youth globally, obesity, overweight and inactivity are on the rise, it says, and not just in affluent countries.
The vast majority of overweight or obese children live in developing countries, where the rate of increase has been more than 30 percent higher than that of developed countries, it states. If current trends continue, the number of overweight or obese infants and young children globally will reach 70 million by 2025.
The global trend of childhood obesity has led to the shocking prediction that children born from 2000 onwards might, for the first time in many generations, have a shorter life expectancy than their parents, in line with Pillay’s concerns about the future of today’s obese children.
Obesity in children can have devastating health consequences, he says.
“It affects the brain, as they become depressed and lethargic and self-esteem suffers. It is a strain on the heart and raises blood pressure. It places a strain on the joints and stunts growth. Obesity can also affect growth in puberty.”
Besides the consumption of high-fat and high-sugar foods, sedentary behaviour is also to blame.
The Haksa report states that at least half of South African children are not active enough. The recommended amount of daily activity is 60 minutes and most children get less than 20 minutes a day.
Nearly 40 percent of high school girls in one study were insufficiently active and in all studies, boys were more active than girls. Less than a third of rural primary school children surveyed achieved the daily activity goal.
At best only 50 percent of pupils are active enough at home, at school or at play.
Participation seemed to be higher in urban areas where 66 percent of children played sport, compared with less than 50 percent in rural areas.
Physiotherapist Vaneshrie Moodley, co-founder of the ADDicted to Life support group in Durban, says inactivity is impacting on children’s physical and emotional development.
“Running, jumping and climbing is what children should be doing every day to strengthen their bodies and to maintain a normal weight,” she says. “Obesity affects the development of the bones and can affect the child’s breathing. It also causes depression, poor performance at school and irregular bowel movements.”
But while parents may be serving up healthy meals at home, many school tuck shops are selling unhealthy foods and some children buy sweet, fatty foods from street traders.
The annual Tuck Shop Truths survey, commissioned by Nestle South Africa, looked at the nutritional offerings in tuck shops in upper and lower income groups at former Model C primary schools.
It found that pupils and parents wanted more balanced food from tuck shops, like yoghurt, cheese, fresh milk, bottled water, biltong, nuts, brown or whole-wheat rolls and sandwiches – but in many cases they were not available, with chips, chocolates, popcorn and sweets on display.
“This encourages children to consume unhealthy foods and drinks,” says Naazneen Khan, health and wellness manager at Nestle SA.
Many upper LSM (Living Standards Measure) schools stocked bottled water and fruit juice, while fewer lower LSM schools did.
Children’s dairy needs were not being met and none of the upper LSM schools and one in 10 lower LSM schools sold fresh milk.
Cheese was stocked at only a few and yoghurt at 70 percent of lower income schools and 42 percent of upper income schools. Few schools offered fruit.
However, dried fruit, popcorn, nuts, fresh fruit and pretzels were offered at more lower LSM schools than upper LSM schools.
Khan says parents need to be more involved in what their children are eating.
“Repeated exposure to a wide variety of healthy foods and good eating behaviours of parents will help modify your child’s food preferences. Parents should realise that the nutrition their children receive now is an investment for their future health.”
Pillay says obesity is also commonly as a result of anxiety, traumatic stress and depression disorders.
If these underlying conditions are treated, obesity gets managed more effectively.
l Pillay and a team of professionals run a free support group for parents in Durban, called ADDicted to Life. It provides advice to parents on how to manage issues with children from ADHD to obesity. See Facebook Addictedtolifeteam or e-mail [email protected].
For the 2014 Healthy Active Kids South Africa (Haksa) Report Card, see www.discovery.co.za.
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