Shortly after a baby turns one years old, he or she begins to crawl, toddle along and eventually walk.

Durban - South Africa’s toddlers and preschoolers are becoming the fattest of all age groups in the country, with almost one in four girls and one in five boys in that age range either overweight or obese.

These figures on two- to five-year-olds are from the recently-published South African National Health and Nutrition Examination Survey (SANHANES-1).

This week is National Obesity Week, and experts say they are worried about the health of these children and of the future health of the nation. Of concern to is the future cost of health care for the next generation of adults who are destined to have lifestyle diseases, such as diabetes and hypertension, which is strongly linked to cardiovascular disease (CVD).

“We know that weight in infancy and childhood tracks into adulthood and we are setting ourselves up for disaster,” said Suna Kassier, a lecturer and PhD candidate in Dietetics and Community Nutrition in the Discipline of Dietetics and Human Nutrition at the University of KwaZulu-Natal in Pietermaritzburg.

“We are already seeing raised blood pressure levels in young children and children in early puberty being treated for diabetes because of their obese state. Non-communicable diseases of lifestyle, like diabetes and hypertension, used to be prevalent in adults but now we are seeing them in children.”

In older age groups, being overweight and obese were higher in girls (22.3 percent) than boys (10.2 percent) – an increase on the National Food Consumption Survey’s figures of 2005.

Regional and international comparisons show that the numbers of overweight or obese preschool-aged children (22.9 percent) are more than double those in Morocco, Swaziland, Botswana and Nigeria, where the prevalence is 11 percent.

Our toddlers are fatter than those in America too – only 12 percent of children aged two to 5 years are overweight or obese in the United States – and we are where the US was in 2000.

Professor Demetre Labadarios, executive director of Population Health, Health Systems and Innovation at the Human Sciences Research Council, one of four principal investigators in the survey, said overweight and obesity in such a young age group was worrying.

“This is the first time it has reached this level and we must not ignore it,” he said.

“Overweight and obesity are emerging problems in this country and this study verifies the available data. There is evidence that fat children become fat adults, with associated health problems, like diabetes, hypertension and cardiovascular disease.”

There was no magic wand to address the problem, he said, and what was needed was good care that started before the birth of the child, throughout childhood and with the family.

“Too much food and not enough exercise is what makes people obese. We need to look at families, schools and universities, promote healthy food choices and encourage people of all ages to exercise. Diseases of lifestyle do not happen overnight and the overweight pre-schoolers of today will be the adults of tomorrow who carry the burden of disease in years to come.”

Anika Barnard, registered dietitian with the Heart and Stroke Foundation South Africa (HSFSA) described the obesity figures in the SANHANES survey as “alarming”.

“Overweight and obesity does not only impact on the immediate health of the child, but also cast a shadow over their futures,” she said. “As we see an increase in obesity in early childhood we can expect a greater burden of CVD in the future. It is estimated that premature deaths caused by CVD in people of working age (35-64 years) will increase by 41 percent by 2030.”

Experts said there were many causes impacting on the prevalence of obesity.

“We live in an obesogenic environment characterised by a lack of physical activity due to freely available public transport, lack of activity during leisure time due to activities like TV watching and computer games, and an inability of children to play outside due to a lack of safe public spaces,” said Kassier. “In addition, affordable foods are often the ones high in fat and sugar. Portion distortion is also to blame as fast foods are marketed in very innovative ways and offer a choice of very large portions, resulting in people no longer being in sync with their appetites, but eating until the plate or beverage container is empty.”

Dr Vash Mungal-Singh, chief executive officer of the HSFSA, said children were enticed into making unhealthy choices.

“Many overweight children are from families who have restricted budgets and commonly eat cheap foods from street vendors or fast food chains,” she said. “Yet these foods are most unhealthy, being high in saturated and trans fats, sugar and salt.”

The situation is often exacerbated at school. A study conducted by Nestlé at several primary schools showed that most children were consuming fattening foods and fizzy drinks at school. Toasted sandwiches were the best-sellers, with hot dogs, followed by pies, fizzy drinks, iced tea, chips and sweets. The SAHANES survey showed that more than half of school children did not take a packed lunch.

Sam Mkhwanazi, spokesman for the Department of Health in KwaZulu-Natal, said MEC Sibongiseni Dlomo and his department were concerned about the rise in overweight and obesity in children and adults and had rolled out the Healthy Lifestyle Campaign, aimed at educating adults and children about making the right dietary choices, exercising regularly and living a healthy lifestyle. - Daily News