Phillip Karera (not real name), 11, opens the kitchen cabinet and is greeted by bags of chips, candy bars and microwave pizza. This is the life the boy, who weighs 60 kilograms, has known since he was a toddler. 

"I have tried before to replace my son’s menu with tasty cut-up fruits and vegetables, low-fat yogurt and higher-fiber foods, but I get strong opposition (from him)” says the mother of two who is also a resident of Kimironko, a Kigali City suburb. She added: "I don’t want my son to consider me as one of those people making his life miserable.”

While malnutrition in Rwanda is still largely associated with children who don’t get enough food, improved living standards mean there is a growing risk of children becoming overweight or even obese due to poor parental knowledge vis-à-vis nutrition or simple negligence.

"The DHS 2010 shows that 7 per cent of under-five children country wide are overweight, and the problem is common with financially stable families,” says Alexis Mucumbitsi, a nutrition expert at Ministry of Health (MOH). "Children from well-off families are likely to spend less time exercising and more time in front of the TV, computer, or video-games. And today’s busy family heads have little time to prepare nutritious meals, preferring fast foods which are readily available but unhealthy,” he adds.

Mucumbitsi remarks that research conducted by his ministry shows that 52.6 per cent of children between the age of 6 and 12 consume a lot of sugar, and 53 per cent of households in Kigali feed their children on a food cooked with a lot of oil.

According to MOH, children who are overweight or obese can develop health problems during childhood because of their weight. Such diseases include Type II diabetes, high blood pressure, high cholesterol levels, fatty liver disease, gallstones and risk factors for heart disease.

"Being overweight or obese as a child or teenager can also have psychological effects for some, as it can lead to low self-esteem and a lack of confidence due to bullying. Such children may become withdrawn and avoid social contact, and this may lead to low moods and, in severe cases, depression,” says Daffin Akimanzi, a psychologist with Dex Poly-clinic, Gikondo.

Fortunately, if obesity is treated at childhood, these health problems can be reversed or prevented.

Diagnosis of obesity

As a parent, it can sometimes be difficult to tell that your child is overweight, as they may not look particularly heavy. For kids younger than two, doctors use weight-for-length charts to determine how a baby’s weight compares with his length. Any child who falls at or above the 85th percentile may be considered overweight.

Depending on your child’s BMI (or weight-for-length measurement), a doctor may refer you to a registered dietitian for additional advice and, possibly, might recommend a comprehensive weight management programme.

"One of the best ways to instill good habits in your child is to be a good role model. Children learn by example. Any changes you make to your child’s diet and lifestyle are much more likely to be accepted if the changes are small and involve the whole family,” says Francine Mukankubito, a physician with Medplus Clinic, Remera.

She adds that all children need about 60 minutes of physical activity per day for good health, but it doesn’t mean they do it all at once. Several 10-minute or even 5-minute bursts of activity can be just as good as an hour-long stretch.

Medics also warn that parents should limit the time children spend on inactive pastimes like watching TV, emphasising that this kind of activity should not take more than two hours each day.

These health experts note that apart from physical activity, diet is also important. Children, just like adults, should aim to eat five or more portions of fruit and vegetables every day since they are a great source of vitamins, minerals and fiber.

"Discourage your child from having too many sugary or high-fat foods like sweets, cake, biscuits, and soft drinks,” Mucumbitsi advises. "These foods and drinks tend to be high in calories and low in nutrients. Ensure your child gets most of their calories from healthier foods such as fruits, vegetables, and starchy food such as bread, potatoes, pasta and rice,” he concludes.