UAE: How to help a child shed those COVID-19 kilos

From a picky eater, to a food enthusiast with a tiny potbelly – remote learning changed my son’s food habits. I’m not sure about other parents, but I was relieved when schools closed in 2020. Not only did I get to spend time with my son finally (yes, working-mum guilt syndrome), it solved two big problems for me. He stopped falling sick constantly, and he finally started eating his meals on time.

My child, who was six when the schools closed, was lean and bony at the time – he would have a small breakfast, bring back most of the tiffin (lunch box) I sent him, and would reach home an hour after school closed due to a long bus route. By the time he had his lunch, it would be 4pm. On some days he would be tired and fall asleep before lunch was served. I would worry about his eating habits.

But that has changed. In fact, now, at the risk of sounding like a horrible mother, I try to discourage him from eating. Why? The lack of outdoor play, exercise, and staying at home for social distancing along with regular food and snacks meant my little pepperoni-pizza lover had put on weight. Struggling with being overweight myself, I do not want my child to head in the same direction.

Once, I told him he had been looking a bit round lately and lectured him about the need to eat healthy instead of too much bread or fried food, and he asked me: “I look cute and round, right?” I had to burst his little body-positive bubble and tell him that he doesn’t. Masks on, now we make it a point to play outdoors every evening, have swimming pool time on most weekends, and avoid ordering in food.

- Evangeline Jose, mum to an eight-year-old.

Jose's son is not alone. There’s a terrible formula at work here: it’s a lack of physical activity plus social isolation plus screen time plus access to an open kitchen. It all adds up to an unhealthy, bigger body. And unfortunately, the most affected people of all are the little ones.

When school decided on a blended – or remote – way of teaching owing to the fear of COVID-19 infections, it didn’t only mean a study-from-home experience; it meant that those breaks where they played with their friends, walked around and engaged with the world came to a sudden end. There was anxiety and fear of what was to come and a stagnant sort of stay order in place. “I could see heightened anxiety, social awkwardness and feelings of loss after a year of staying home. Their world was suddenly changed and kids were pushed into digital world from real world within minutes. And Ayaan found his comfort in food like many kids did,” explains UAE-based expat Komal Puri, who would go on to help her child – who had put on weight – to shed that burden later in the year.

“My kid's activity level changed drastically and suddenly his weight shot up. Having an access to open kitchen didn't help. He was eating whenever he wanted to,” she recalls of the time, adding that many people stocked up on junk food to keep the kids distracted or entertained.

“We didn't want her to feel bad about being staying locked in. I think it all started from there. There was easy access to food plus minimal activity,” says another UAE-based mum who spoke on condition of anonymity.

Earlier this year, the UAE’s Ministry of Health and Prevention (MoHAP), in collaboration with the Ministry of Education (MoE) and Abu Dhabi Public Health Centre (ADPHC), conducted a survey on the impact of the COVID-19 pandemic, distance learning, and social distancing on the physical activity, food habits, and quality of sleep among school students in the UAE.

About 27,754 parents took part in the survey. The study found that physical activity had declined by at least 46 per cent, especially among those who were active before the pandemic. And while the study delved into sleeping time and screen time, one of the most shocking observations was that there was a stark rise in obesity.

UAE is not alone in such a finding. Across the globe, parents are waking up to the parallel pandemic of the COVID curve.

According to a study published in the medical journal JAMA, “Youths gained more weight during the COVID-19 pandemic than before the pandemic. The greatest change in the distance from the median BMI for age occurred among 5- through 11-year-olds with an increased BMI [body mass index] of 1.57, compared with 0.91 among 12- through 15-year-olds and 0.48 among 16- through 17-year-olds. Adjusting for height, this translates to a mean gain among 5- through 11-year-olds of 2.30kg more during the pandemic than during the reference period (in 2019); 2.31kg more among 12- through 15-year-olds; and 1.03kg more among 16- through 17-year-olds. Overweight or obesity increased among 5- through 11-year-olds from 36.2 per cent to 45.7 per cent during the pandemic.”

Why is it so frightening?

Obesity is a scary disease, not least because it breeds COVID-19 complications besides an array of other conditions including diabetes and hypertension. It’s difficult once you put on the weight to shed it for good. And unfortunately there’s a clear connection between an overweight child and an obese adult.

What you need to know about fat cells

You see, fat cells, or adipose tissue,  are created quite easily in a body. In the March 2 issue of the journal 'Nature Cell Biology’, Yale researchers said they found that in mice, fat cell production starts within a day of starting a high-fat diet. These cells contract or expand depending on how much food we consume; however, they never really go away.

Dr Basim Alkhafaji, Head of Department and Obesity Surgeon at Canadian Specialist Hospital, and Academy Professor of Surgery, told Gulf News in an interview: “Fat cells are what reserves our energy. Every time our body is in need of energy, which is all the time, it is these fat cells that give them the required energy to do their tasks. What happens to the fat cells of an obese body is that they expand. When a person loses his weight these expanded fat cells shrink. It is impossible for a person to lose fat cells because that is needed for him to stay alive. Hence, no matter the size of his body the number of fat cells will remain the same. Which is why even people who lose weight can regain the lost weight. This would not be possible if you simply lost fat cells."

How do you calculate healthy body weight?

A body mass index, explains the US-based Centres for Disease Control and Prevention (CDC), has an easy formula, namely: person's weight in kilos divided by their height in metres squared.

However, it warns, BMI levels among children and teens are expressed relative to other children of the same sex and age. These percentiles are calculated from the CDC growth charts, which were based on national survey data collected from 1963-65 to 1988-94.

How you can help your child shed those niggling kilos

Weight loss is a simple equation of calories in minus calories lost, say experts. To lose weight either fewer calories must be consumed or more calories be burned through exercise. Cynthia Bou Khalil, Nutritional Consultant at healthcare firm Allurion, offers tips to help kids get to their goal weight. She tells Gulf News:

1. DON’T DO IT ALONE: Find your support team. Success in changing habits and behaviours is a team effort – from engaging well with your support team to enlisting support, and to sharing your achievements with your friends and family and school. Although sometimes even our nearest and dearest can sabotage our diet and lifestyle goals without even realising it, they can also be our most reliable support network. They will help you reach your goals if you talk to them and involve them on your journey.

2. BE CLEAR WITH YOUR GOALS: Mapping out exactly what you want to achieve and why helps you to stay focused. It might be getting into a favourite outfit, joining your school sports team or reducing the need for medications to manage conditions like Type 2 diabetes. I often work with patients at Allurion who are struggling to reach their goals, and need the extra support, more often than not in regards to portion control. Unfortunately, no weight-loss programme is a magic bullet neither will there be a one-size-fits-all approach. That being said, a combination of good science backed with the support of healthcare professionals will get you on your way. With this in mind, share your goals with your support network and hatch a plan for how you will get there. The more detailed and specific your action plan, the more likely it is you will do it and stick with it. For most people, reaching a goal is addictive as it provides you with an immense sense of achievement.

3. CHANGE YOUR HABITS: Habit-forming occurs when you repeat an action consistently over time. This helps something to become automatic or second nature, meaning it doesn’t feel hard to continue it over time. The simpler an action is, the more likely it will become a habit. Examples include always having a chopped apple on top of cereal or always ordering an additional side salad when eating out so you can fill up on this and eat less of the other options.

4. EAT HEALTHIER FOOD: You don’t need to make huge changes to eat healthier, nor do you have to change your habits all at the same time. It’s best to set small goals and change your habits a little bit at a time. For example, don’t eat in front of the TV and always try to sit at the table. Over time, small changes will make a big difference to your health and will help you maintain your weight loss.

5. PLAN AHEAD: Planning is a key part of staying on track. You can choose whether to do this each day or each week. Plan what meals you will have, what snacks and the timings and amounts - you can ask for your parent’s support (your support network). This will allow you to prepare some meals in advance to keep it easier. Make sure you have the foods or ingredients at home or you take the prepared meals to school that you’ll need for the day, making you less vulnerable to poorer choices if and when you get hungry.

6. SET BOTH SHORT-TERM AND LONGER-TERM GOALS: A short-term goal might be to swap your mid-afternoon snack for a piece of fruit each day this week, whereas your longer-term goal might be to lose 12 kilos over the next four months. This means that when you achieve your goal, you can then set further targets, helping you to constantly progress. Think of your goals as your destination, it’s where you want to be within a set timeframe.

7. KEEP TRACK OF YOUR FOOD CHOICES: Keep track of your food choices, activity levels, weight and body fat on a frequent basis. This will help you to see your changes over time and understand if and where things feel harder, so you can problem-solve them with your support team. There are also several tools to help you track your progress.

8. TRACK YOUR EMOTIONS: This is important and can help you identify reasons other than hunger that lead to eating. This might be boredom, sadness or stress, especially during exams or from all the uncertainty COVID has created with at-home learning for example. Understanding your triggers can help you put plans in place for managing these emotions in a healthier way. Make a list of distraction techniques for when boredom strikes and also soothing activities that you can do when you feel a craving coming on.

9. DON'T FORGET TO REWARD AND CELEBRATE YOURSELF: We all need treats and rewards, or else we end up feeling deprived and neglected, making us want to give up. Many of us use food and drink for these rewards, which can slow down our weight-loss progress. Make a list of non-food rewards you can use for each victory and milestone reached. This can be as simple as a magazine you love.

10. KEEP IT SIMPLE: The simpler the plan, the higher the likelihood of success. Nothing is written in stone. Individualise and simplify what works best for you. As I said, no weight-loss programme is a magic bullet, but through consistency, planning, support and simplicity, you can achieve your goals. Just take it one step at a time.

Kill those COVID kilos

Parents have a bit of a long road ahead of them as they navigate the road to better health for their young ones. Farah Hillou, Licensed Nutritionist (DHA) and Registered Dietitian (Canada, USA), explains that a guardian can help their child though emotional as well as physical support. She offers the following tips:

1. Encouraging kids to eat the rainbow. Parents should aim to offer colorful vegetables and fruits at each meal. In addition to important vitamins and minerals, the different colors contain a range of phytonutrients and bioactive components with many health benefits and which can help maintain a healthy, balanced weight.

2. Limiting the amount of sugar and processed foods that kids eat by choosing homemade foods instead of pre-packaged foods; using healthier cooking methods like grilling, steaming, or sautéing instead of frying; and using healthier ingredients such as avocado oil instead of canola/sunflower/corn oil, and natural maple syrup or pure honey instead of white sugar.

3. Encouraging daily movement and less time spent on sedentary activities. The benefits of exercise include stress reduction, better mood, enhanced learning, a healthier weight, stronger bones, and improved sleep. Pre-schoolers need at least 120 minutes of active play daily, while kids and teens need 60 minutes or more of moderate-vigorous physical activity daily. Encourage kids to play sports which they enjoy, cycle around the neighbourhood, jump on a trampoline, or dance to their favourite song.

4. Improving sleep habits and promoting a healthy circadian rhythm. Disrupted sleep patterns impact kids’ hormones and appetite levels thus increasing risk of weight gain. Kids aged 3-5 years need 10-13 hours of sleep, while kids aged 6-12 years need 9-12 hours of sleep every night. Have a consistent bedtime routine schedule. Moreover, avoid screen time at least an hour before bed and instead, encourage kids to read a book or practice some deep breathing. Finally, ensure the room is completely dark to support restorative sleep.

5. Promoting stress reduction. The pandemic has affected kids’ mental and emotional health, and has increased feelings of anxiety, fear, isolation and withdrawal. In turn, this has increased emotional eating and made many resort to food as a source of “happiness” or “reward”. To help support kids’ mental wellbeing, parents can encourage their kid’s to speak about their feelings without passing any judgments, encourage journaling, teach deep breathing, and practice mindfulness as a family.

Portion control is key

While there are plenty of diet plans going around, experts generally agree that a balancing act - i.e. when all the food groups are on your plate - are best.

The founder of It’s SO Simple, a 12-week fitness programme, Rachael Sacerdoti recommends the hand measure method for a balanced meal. “We don’t add fats into our meals as we already get natural fats from protein and vegetables such as meat, eggs and avocado. It’s SO Simple very much goes by the percentage of 40 per cent, protein, 40 per cent vegetables and 20 per cent of carbs, which can also be compared by hand.”

As schools reopen and children head back to school and afterschool activities, parents heave a sigh of relief; and hope they will shed those COVID curves. Step by step and play by play.

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