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Childhood Obesity: Large solutions needed for large problems

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The Heart and Stroke Foundation South Africa (HSFSA) shines a spotlight on ending childhood obesity.

Globally, obesity is rapidly on the rise.  For the first time in the history of mankind,  the number of people who are overweight or obese measure up to the number of people who are underweight due to hunger.  It has been estimated that if something is not done about the surge of obesity, half of all people will be overweight/obese by 2030. The most worrying is that this trend is not only seen amongst our adult population but also amongst children.  Over a decade, overweight has increased from 10.6% to 18.2% in South African children aged 2 – 5 years.  Consistently, girls and female adults are more affected.  South Africa further carries a double burden of malnutrition with not only rising rates of childhood obesity but also still high prevalence of child undernutrition.  Undernutrition places a child at especially high risk for developing obesity, which then promotes the vicious cycle which we are grappling with in the current socio-economic environment.

Being overweight or obese increases one’s risk of heart disease and stroke, high blood pressure, diabetes and certain cancers.  Overweight or obese children have an increased risk of developing these diseases earlier in life and are more likely to remain obese throughout their adult life.  Not only does obesity have far reaching health effects for a child, but it also has vast social and economic implications.  These can include bullying, teasing and low self-esteem, as well as increased healthcare costs and loss of income later in life.

So what then is the cause for the increase in obesity amongst our children?  Poverty, unhealthy diets and physical inactivity are largely to blame.  According to Dr Vash Mungal-Singh, CEO of the HSFSA, “Our children are being brought up in an obesogenic environment where unhealthy foods are aggressively marketed to them, time in front of computers and televisions are increasing and appropriate environments for children to be active, safely, are few and far between.”  With urbanisation we have also seen an increase in the consumption of sugar-sweetened beverages, energy-dense, nutrient poor foods and lower consumption of fruit and vegetables.

Poor feeding practises early in a child’s life further exacerbates the problem.  Studies have shown that there is a link between low birth weight and overweight later in life due to overfeeding as an infant.  The introduction of ‘weaning foods’ too early (<6 months of age) is another key driver of obesity later in life.  In fact a child’s risk starts even before birth with the health and diet of the mother, a concept referred to as the importance of the first 1000 days of a child’s life (from conception to 2 years of age).  Poverty has an overarching impact within this context.  Lower income groups tend to have higher obesity rates as they opt for foods that are cheap and the most filling, which often means high in energy, fat, sugar and salt with very little other nutritional value.  The pregnant mother and young child are most affected.

It is clear that obesity is in fact a very complex problem that requires a multi-pronged approach.  We are therefore very fortunate to have the support of the National Department of Health in tackling this epidemic with a clear strategy and bold target to decrease the prevalence of obesity by 10% by 2020.  This strategy builds on the guidelines of the WHO initiative on ending childhood obesity and includes a wide spectrum of activities including policy and legislative change, education, access to healthy foods and safe places to be active.

The HSFSA wants to encourage all parents and caregivers to take action and play their part to prevent overweight and obesity in their own children, starting with the pregnant mother.  It is imperative for all pregnant mothers to get appropriate care before, during and after pregnancy to ensure the healthy weight and growth of their babies.   Exclusive breastfeeding for the first six months of an infant’s life, followed by appropriate complementary foods is a very effective way in reducing the risk of obesity.  Providing healthy foods for young children and adolescents, limiting the intake of sugar-sweetened beverages and encouraging play time rather than TV time are all great strategies to combat overweight and obesity.

Sources:

For the first time in the history of mankind,  the number of people who are overweight or obese measure up to the number of people who are underweight due to hunger. (Global Issues. Obesity. (2010). URL: http://www.globalissues.org/article/558/obesity)

It has been estimated that if something is not done about the surge of obesity, half of all people will be overweight/obese by 2030 (Dobbs, R. et al. (2014). Overcoming obesity: an initial economic analysis. McKinsey Global Institute.)

Over a decade, overweight has increased from 10.6% to 18.2% in South African children aged 2 – 5 years. (Shisana, O, et al, & SANHANES-1 Team (2013) South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press.)

Studies have shown that there is a link between low birth weight and overweight later in life due to overfeeding as an infant. (Vasylyeva, T.L., Barche, A., & Chennasamudram, S.P. (2013). Obesity in prematurely born children and adolescents: follow up in pediatric clinic: Nutrition Journal 2013, 12:150, http://www.nutritionj.com/content/12/1/150)

Consistently, girls and female adults are more affected. South Africa further carries a double burden of malnutrition with not only rising rates of childhood obesity but also still high prevalence of child undernutrition.  (Arington, C. & Case, A. (2013). Health: Analysis of the NIDS Wave 1 Dataset. National Income Dynamic Study. URL: http://www.nids.uct.ac.za/publications/discussion-papers/wave-1-papers)

 

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