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The silence of epidemic of children obesity (overweight) in Gambia

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Preventing childhood obesity: things parents can do

What is child obesity (overweight)?

Childhood obesity is a complex disease that can occur when your child is above a healthy weight for their age and height, obesity rates are rapidly increasing in the African Region, as in most parts of the world. Overweight and obesity, particularly in urban settings, are major risk factors for type 2 diabetes, high blood pressure, heart attacks and a variety of cancers. There is a common misconception that obesity and other non-communicable diseases (NCDs) only occur among the wealthy. Poorer populations are experiencing high double-burdens of infectious and chronic diseases. Additionally, sub-Saharan women are far more likely to be obese than men affecting women’s health issues, pregnancy, maternal and infant health.

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Obesity is affected by many factors including food choices, sedentary lifestyles, genetics and cultural beliefs. Counterproductively, many countries in the region view obesity as a sign of prosperity. Sedentary lifestyles are affected by changing modes of transportation, types of work and increasing rates of urbanisation.

The upward shift in obesity is associated with, increased consumption of high-fat and high-sugar foods, increased consumption of highly-refined and processed foods, decreased consumption of fruits, vegetables, nuts and legumes; increased sedentary lifestyles.

Facts and figures on childhood obesity: Key facts, the number of overweight or obese infants and young children (aged 0 to 5 years) increased from 32 million globally in 1990 to 41 million in 2016. In the WHO African Region alone the number of overweight or obese children increased from 4 to 9 million over the same period. The vast majority of overweight or obese children live in developing countries, where the rate of increase has been more than 30% higher than that of developed countries.

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If current trends continue, the number of overweight or obese infants and young children globally will increase to 70 million by 2025.Without intervention, obese infants and young children will likely continue to be obese during childhood, adolescence and adulthood.

Obesity in childhood is associated with a wide range of serious health complications, an increased risk of premature onset of illnesses, including diabetes and heart disease. Exclusive breastfeeding from birth to 6 months of age is an important way to help prevent infants from becoming overweight or obese.

Consequences of obesity in childhood

Childhood obesity is a complicated disease that has many contributing factors. It’s not laziness or a lack of willpower. Your child needs a certain number of calories for growth and development. But when they take in more calories than they use, their body stores the extra calories as fat. Children gain excess weight for many of the same reasons adults do. Causes of childhood obesity include:

Behaviour

Shared family behaviours such as eating habits and being inactive can contribute to childhood obesity. The balance of calories consumed with calories burned plays a role in determining your child’s weight. Busy families are consuming more foods and beverages high in fat, sugar and calories. These foods and beverages tend to be low in vitamins, minerals and other vital nutrients. At the same time, many children are spending less time outdoors and more time indoors being inactive. As video games, tablets and smartphones continue to grow in popularity, the number of hours of inactivity may only increase.

Genetics

Genetic factors can increase the likelihood that a child will have obesity. Children whose parents or siblings have obesity may be at an increased risk of developing the condition themselves. Studies have shown various genes may contribute to weight gain. Although weight problems run in families, not all children with a family history of obesity will develop it.

Socioeconomics and community

Where your child lives can have a direct effect on their risk of developing obesity. The foods and drinks that schools and day care centers serve your child have a direct effect on their diet. They also contribute to the amount of physical activity your child gets every day. Other socioeconomic factors that contribute to childhood obesity

How can you help your child if they have obesity

The most important thing you can do to help your child is to focus on their health, not their weight. It’s very important that you support your child in their journey toward better health. Your child’s feelings about themselves are often based on your feelings about them. If you accept your child at any weight, they’ll be more likely to feel good about themselves. Avoid placing blame on your child, yourself or others.

It’s also important to talk to your child about their weight in a non-judgmental way. You should allow your child to share their concerns with you. You can help your child by gradually changing your family’s physical activity and eating habits. That way your entire family can benefit from new healthy behaviours.

There are many ways to involve the entire family, but increasing physical activity is especially important. Aim for your child to get at least one hour of regular physical activity each day.

How can you teach your child healthy eating habits

The eating habits your child picks up when they’re young will help them maintain a healthy lifestyle when they’re adults. If you’re unsure how to select and prepare a variety of foods for your family, ask your child’s healthcare provider. They can refer you to a registered dietitian for nutrition counselling. They can also point you in the direction of resources in your community that offer healthy food options.

Do not place your child on a restrictive diet to lose weight. You should only place your child on a diet if their healthcare provider supervises one for medical reasons. Restrictive diets are hard to stay on and can lead to eating disorders and disordered eating patterns., One way to begin teaching healthy eating habits is to serve a variety of fruits and vegetables to your family. Provide a “rainbow” of fruits and vegetables with every meal, including snacks. Avoid sugary drinks like soda, sweet tea, lemonade and sports drinks. The average child takes in more than 120 calories per day from these drinks alone.

Other approaches you can take to help your child include: Guide your family’s choices rather than dictate foods: Make sure a wide variety of healthy foods are available in your house. This practice will help your child learn how to make their own healthy food choices., Involve your child in food shopping and preparing meals: These activities can offer hints about your child’s food preferences. They can also help you teach your child about nutrition and provide your child with a feeling of accomplishment. In addition, your child may be more willing to eat or try foods that they help prepare., Encourage your child to eat slowly: Your child can detect hunger and fullness better when they eat slowly.

Eat meals together as a family as often as possible: Try to make mealtimes pleasant with conversation and sharing, not scolding or arguing. If mealtimes are unpleasant, your child may try to eat faster to leave the table as soon as possible. Then they may associate eating with stress.

Plan for snacks: Continuous snacking may lead to overeating. But if you plan for snacks at specific times throughout the day, they can become part of a healthy diet. They won’t spoil your child’s appetite at mealtimes. Try making snacks as nutritious as possible. Discourage eating meals or snacks in front of the TV: try to eat only in designated areas of your home, such as the dining room or kitchen. If your child eats while watching TV, it may be harder to pay attention to feelings of fullness. It may also lead to overeating. They may also be exposed to ads for unhealthy foods.

Try not to use food to reward your child: When you use foods such as sweets as a reward, your child may assume these foods are better than other foods. For example, telling your child they’ll get a dessert if they eat all their vegetables sends the wrong message about vegetables.

Monitor your child’s meals outside your home: Find out if your child’s school lunch program provides a balanced meal. If you can, pack your child’s lunch to include a variety of foods. When dining out at restaurants, choose healthier items and think about portion sizes. Be a good example for your child and take half of the meal home for a second meal.

Every aspect of the environment in which children are conceived, born and raised can contribute to their risk of becoming overweight or obese. During pregnancy, gestational diabetes (a form of diabetes occurring during pregnancy) may result in increased birth weight and risk of obesity later in life.

Choosing healthy foods for infants and young children is critical because food preferences are established in early life. Feeding infants energy-dense, high-fat, high-sugar and high-salt foods is a key contributor to childhood obesity.

Lack of information about sound approaches to nutrition and poor availability and affordability of healthy foods contribute to the problem. The aggressive marketing of energy-dense foods and beverages to children and families further exacerbate it. In some societies, longstanding cultural norms (such as the widespread belief that a fat baby is a healthy baby) may encourage families to over-feed their children.

The increasingly urbanised and digitalized world offers fewer opportunities for physical activity through healthy play. Being overweight or obese further reduces children’s opportunities to participate in group physical activities. They then become even less physically active, which makes them likely to become more overweight over time.

Obesity prevention for kids

Parents and caregivers can help prevent childhood obesity by providing healthy meals and snacks, daily physical activity, and nutrition education. Healthy meals and snacks provide nutrition for growing bodies while modelling healthy eating behaviour and attitudes. Increased physical activity reduces health risks and helps weight management.

Healthy eating

Parents are the ones who buy groceries, cook meals and decide where the food is eaten. Even small changes can make a big difference in your child’s health. Prioritise fruits and vegetables. When food shopping, cut back on convenience foods — such as cookies, crackers and prepared meals — which are often high in sugar, fat and calories., Limit sweetened beverages. This includes beverages that contain fruit juice. These drinks provide little nutritional value in exchange for their high calories. They can also make your child feel too full to eat healthier foods. Avoid fast food. Most of the menu options are high in fat and calories. Sit down together for family meals. Make it an event — a time to share news and tell stories. Discourage eating in front of a TV, computer or video game screen, which can lead to fast eating and lowered awareness of the amount eaten.

Serve appropriate portion sizes. Children don’t need as much food as adults do. Start with a small portion and your child can ask for more if they’re still hungry. Allow your child to eat only until full, even if that means leaving food on the plate. And remember, when you eat out, restaurant portion sizes are often way too large.

How can you prevent childhood obesity?

There aren’t any simple solutions to tackle childhood obesity. But parents and caregivers can help with childhood obesity prevention in many ways. Ways you can prevent childhood obesity include:

Be a role model: Parents can affect childhood obesity by switching to healthy habits. Your child imitates what you do. If they see you eating healthy and being physically active, they’ll be more likely to change their habits too. Reduce sugar intake: If your child is older than two, sugar should make up less than 10% of their daily calories. Avoid sugar-filled drinks, and offer water or low-fat milk instead. Children younger than 2 years of age shouldn’t have any added sugar in their diet at all., Encourage better sleep: Children ages 6 to 12 need nine to 12 hours of sleep every night. Adolescents ages 13 to 18 need eight to 10 hours of sleep every night. Poor sleep can lead to obesity because it makes your child want to eat more and be less physically active.

Keep your child’s well-child appointments: Your child’s healthcare provider can support you and your child on their journey toward a healthy lifestyle. Your child is more likely to gain weight during periods of missed appointments. Make sure your child sees their healthcare provider every year.

A note from Dr Paolino senior paediatrician at Medicare Clinic: Childhood obesity is a complex disease that can lead to lifelong complications. Seeing your child deal with weight issues can feel heart breaking. It’s important to support your child no matter their weight. Focus on their health and encourage them by explaining why you want them to stay healthy. If you’re worried your child may have obesity, reach out to their healthcare provider. Their provider can help you determine if your child’s weight is something to worry about. They can help you develop a plan to get your family back on track with healthy eating habits and increased physical activity.

Get help

Losing weight is not easy and you may need to get extra help for your child. This will likely include your Paediatrician Dr specialized in children health, who can monitor your child’s weight gain and loss every few months, but it might also include a Registered Dietitian, who can help you come up with a healthier diet for your family. If being overweight is affecting your child’s mood or self-esteem, then a Child Psychologist might also be helpful.

For further information about paediatrics department of EFSTH, email; [email protected] or on WhatsApp at 2207774469/3063333 during working days from 3-6pm.

Dr Azadeh MD is a senior lecturer at the University of The Gambia, senior consultant in obstetrics and gynaecology, clinical director of Medicare Health Services.

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