Stop right there!

Farid A. (not his real name) is a 10-year-old boy with lovely hazel eyes that reflect the embarrassment and pain he has to suffer every single day.

At school, he is the butt of cruel jokes and is constantly bullied and harassed by other kids. He rarely scores high marks because he is frequently unwell.

At the school canteen, other kids stare in mock horror when he piles his plate with fried chicken legs, cake slices, packets of chips and fried goodies ... He has been told by his mother that the foods are full of empty calories and won't do him any good. But how can a 10-year-old, who is perpetually hungry and always tired, even think of resisting them?

And so he keeps eating and the taunts keep coming – even outside school. And woe befall him if he attempts to swim. The minute he splashes into the pool, every other child turns to stare at him, as though saying, what's that that just dropped into the pool?

You see, Farid A. weighs in at 80 kg.

On the one hand we see a stream of images, on TV, in documentaries, in the print media, of starved, malnourished children, with bloated bellies and diminishing day by day in stick-figured misery. The pleas to donate, to get these children to eat a handful of rice, to put a shirt on their backs and some life-saving vitamins in their bellies ... to make this planet rid itself of the scourge of starvation ...

On the other hand, we see photographs of children who are anything but malnourished, but these pictures also make us feel very sad. You see, these are the pictures of overweight children carrying way too many extra pounds on their bodies that squeeze their internal organs to malfunction and the joy out of their living.

Which crisis is more symptomatic of a world going wrong, terribly? Starving children or needlessly overweight ones? As alarming as the starvation crisis is, it is the new pandemic (of overweight kids) that is making policy makers, medical experts, food scientists and social analysts sit up and reveal the worry in their eyes. You can catch this worried look in the developing world as well as in the developed world.

Even the International Obesity Task Force (IOTF) that has been set up to monitor this development worldwide, considers obesity a ‘crisis in public health'.

A prosperous and post-industrial society coming to terms with big technological revolutions has changed the parameters of comfort and luxury. What was till recently in short supply is now in abundance, at least in some parts of the world. Food.

Thanks also to aggressive marketing, no longer can you afford to negotiate your way through a supermarket aisle without being bombarded by promotions and sales of food items, many of which you don't really need.

Here, children seem to be the target as almost all fast-food and junk food items lure them with eye-catching ads and absolutely not-to-be-missed prizes. The result: whether we like to admit it or not, we are raising a generation of kids whose propensity to turn obese is more likely than not. And it follows that if obesity strikes in childhood and is allowed to grow unimpeded, the consequences for the child in adulthood can be potentially dangerous, to put it mildly.

Take a look at the statistics in Dubai. A study carried out by the Department of Health and Medical Services (DOHMS) in the UAE indicates that at least 40 per cent of the adolescents and as much as 25 per cent of primary school children are obese. The report also indicates a new trend of medical problem – the onset of Type II diabetes in adolescents.

When diabetes strikes children, it is routinely of the Type I diabetes or juvenile diabetes. However, Type II diabetes, which usually has its roots in genetic and lifestyle factors, is being seen as a result of unchecked obesity in children. Of a random group of children tested by DOHMS last year, about 304 in the age group of 4-19 were found to have Type II diabetes, of which 229 (75.3 per cent) were UAE nationals. Among Emaratis, females accounted for 46.7 per cent of the sample.

The DOHMS report cautions that Type II diabetes mellitus is a new morbidity in children and adolescents, and heralds the earlier onset of cardio vascular disease, retinopathy (blindness due to diabetes), nephropathy (kidney failure triggered by diabetes) and neuropathy (loss of sensation in the legs owing to prolonged diabetic condition) with the risk of impaired quality of life and premature death.

Quite a few paediatricians admit that they are finding an unusually large number of overweight and obese children visiting their clinics routinely. It appears that in our efforts to provide all comforts to our children, we are quite literally killing them with kindness, condemning them to a life of ill-health.

Dr Delia Fayyad, general practitioner and pediatrician at Jebel Ali Hospital, Dubai, was alarmed to see the increase in the number of obese children in her daily consultations. "I saw that more and more of my patients were routinely overweight and had such low basal metabolic rates that I felt it was important for me to caution them and correct their lifestyles," she says.

Dr Fayyad rules out hormonal or genetic defects as the main causes of childhood medical conditions. "Most of the children who were overweight had obese parents. While this may not exactly be a genetic problem, it had more to do with the dietary habits of the family. In other words, most children put on excess weight because of their lifestyles that include unhealthy diets and a lack of physical activity."

Dr Fayyad cautions about the far-reaching health consequences for these children: "Obesity often persists into adulthood and obese teenagers are 15 times more likely to become obese adults. In adulthood, obesity can lead to heart disease, diabetes, cancer, arthritis and other serious conditions. Even while they are young, obese children face medical problems like glucose intolerance, high blood pressure, bone structure problems, asthma and sleeping disorders."

Dr Fayyad feels not enough is being done by society to create awareness about the dangers of obesity. "The family, as a whole, has to make a serious attempt to educate their child [of the dangers of obesity] and make sure that correct dietary goals are achieved. They must ensure a normal growth pattern for their children."

The reasons for obesity

One of the most common reasons for obesity is our lifestyle, say doctors. Children are becoming couch potatoes relying on the plethora of remote controls that technology offers them to while their time away, thus making them loath to carry out even the simplest of physical tasks at home.

But are children completely responsible for their love of inactivity? How about checking out a few other factors that could have helped but don't. Like the availability of more playgrounds near to where children live? Like weather conditions that practically force them to stay indoors for many months of the year?

Add to this the latch-key lifestyle where children come home to an empty house (because both parents are out working to keep the hearth from going cold) and end up hunting for the can opener or push buttons on a microwave to feed themselves and you begin to see how dietary missteps make them lose the healthy rhythm.

Poor nutrition, coupled with foods that cause instant insulin spikes and dips, take the children on a roller coaster dietary ride where they are hooked on to fast foods and sugar for their daily fix of energy. Quite clearly, it is a vicious circle.
Parents need to be aware of what groups of food items their children must eat, how much and how often, says expert.
Lovely. R. Deep, dietician and nutritionist at Al Zahra Hospital, Sharjah, thinks it is time parents and society took a serious look at this issue and initiated concerted efforts to address a problem that has achievable goals.

"There are many causes of obesity,'' she says. "Genes alone can't account for the huge increase in [obesity] rates over the past few decades. The main culprits are the same as those for adult obesity: eating too much and exercising too little. The risk of becoming obese is greatest among children who have obese parents. This may be due to powerful genetic factors or due to parental modelling of both eating and exercise behaviours, which indirectly affect the child's energy balance.
"Highly processed, high-calorie meals and fast foods have become staples. Eating habits have also changed drastically. Family meals today are often replaced by all-day snacking. [There is no dearth of variety] in cookies, chips and other high-calorie snack foods which are readily available for children to fill up on."

Also, children's leisure time has become increasingly sedentary. Television, video games and computers take up nearly all of their free time at the expense of physical activity, says Deep. "Kids who watch the most hours of television have the highest incidence of obesity. The fact that kids usually snack while watching TV simply adds to the problem."

Deep thinks a multi-pronged strategy must be put into effect which not only corrects eating habits in children but also tackles behavioural issues.

Diet management: Rarely does any treatment focus on weight loss. Instead, the primary aim is to slow or stop weight gain so that a child can settle into his or her ideal weight category.

Fasting or extreme caloric restriction is not advisable for children. Not only is this approach psychologically stressful, it may adversely affect a child's growth and his perception of "normal" eating. Balanced diets with moderate caloric restriction, especially reduced dietary fat, have been used successfully in treating obesity.

Behavioural strategies used with adults – such as self-monitoring, recording food intake, physical activity logs, slowing down the pace of eating, limiting the time and place of eating – have been successfully applied to children and adolescents as well. What has been found to be particularly effective for children are treatments based on behavioural patterns based on parental lifestyle.

Prevention is the best treatment

As always, the oldest and the most severely, tried-and-tested belief is what works, irrespective of the era. Creating an awareness about this issue is as crucial as it is controlling it, perhaps even preventing the condition in the first place.
It is idiot-proof logic that it is easier to prevent obesity than to control it. Or to indulge in a prolonged and stressful battle to treat it. Prevention to a large measure depends on parental guidance.

From a child's infancy, parental education should centre on encouraging breastfeeding, recognising signals of satiety, and a delayed introduction of solid foods. In early childhood, emphasis should be on teaching the child the merits of proper nutrition, selection of low-fat snacks, the importance of good exercise/activity, and creating an awareness of the dangers of turning into a couch potato.

In cases where preventive measures cannot totally overcome the force of hereditary factors, parents should focus on building the child's self-esteem and address his psychological issues (if any).

What you as a parent can do:

If a family eats healthy from the early days in a child's life, it is more likely the child will adapt to healthy eating patterns faster. Eating patterns in a family are a crucial predictor of which way a child will go regarding his dietary preferences.

It is every family's duty to emphasise the importance of eating healthy. But, please don't treat the dining table as a podium and drone on and on. You might just kill the bud of interest that is ready to bloom.

Make talking about healthy food a fun subject. Don't lean on it so hard it breaks. Food is fun and eating healthy food is more fun. As parents, it is important for you to deal with the subject in a way that is enjoyable for the child to listen to.
And, if for some reason, your child has already begun to tip the scales to the right, a heavy-handed approach won't work. Gentle encouragement, non-judgmental disciplinary measures and loving enthusiasm should bring him back from the brink.

Some basic eating patterns for families to adopt:

Remember, if you have not been following a healthy eating pattern, bringing about these changes over the course of the next meal is ... well, impractical. Even impossible.

It is best to focus on small, gradual changes; replace fried potato wedges with baked jackets topped with a dash of spice, some hot pepper sauce or even a touch of flavoured salt. You can love flavours in a jiffy but the flavours are attached to a habit, so take it easy but don't let go of your goal.

Introduce new healthy foods slowly, but remain unyielding under the barrage of Yucks and Nos. Remember, all food is tasty; it's the mind that is biased. As a parent, it's your duty to tackle the bias, slowly, lovingly, calmly.

The following tips will help the child make the transition to healthy eating:

Exercise

The best way you to ensure that your child gets plenty of aerobic playtime is to lead the way. Hopscotch and jump rope are great cardiovascular activities.

Even busy parents can teach their children the importance of staying physically active by parking farther away than necessary and walking to your destination, or taking the stairs instead of the elevator [provided you are medically fit].
Make household chores a family affair. Don't make exercise seem a punishment. Forcing your child to go out and play may breed resentment and resistance. Try using physical activity to counter something your child does not want to do. For instance, make it a routine that your child can ride a bike for 30 minutes before getting down to complete his homework. Your child will beg for 20 more minutes outside just to put off doing homework!

Television

Limiting television time leads directly to more calorie-burning moves. Plan TV hours in advance. Pick the shows you want to watch and when they are over, TURN OFF THE TV! There is no excuse for channel surfing now.

Take control of portion sizes

Size matters. Portion size has a lot to do with why kids are getting chubbier. To master the art of portion control, you need to know how big a portion size really is.
One portion =

Trim the helpings; waistlines will follow.