Daniella Ineza, a pupil at King David School, is nine years old and weighs 50 kilograms. Her mother says she had a normal birth weight but at the age of five, she started getting worryingly heavier. Ineza’s mother says that though she tries to help her daughter control her weight, as advised by physicians, it’s not easy and requires determination. Health experts say childhood obesity is a growing concern worldwide. WHAT HAPPENS? Rachna Pande, a specialist in internal medicine, says child obesity is mainly due to consumption of high fat and carbohydrate meals like junk food, cakes, chocolates and soda. All these, she says, cause obesity. She says that another reason as to why the situation is getting worse is because children these days are hooked to gadgets and are not as physically active as they should be. “The result is increase in weight and BMI (body mass index), which is an indicator of obesity,” she says. Pande adds that genetic factors are also important. If one or both parents, or any blood relative is obese, chances are the children may also become obese in their childhood or later in life. Besides, she notes that at times, there may be underlying medical problems like uncontrolled type 1 Diabetes or hypothyroidism. Private Kamanzi, a nutritionist at Amazon Clinic in Kigali, says if there is nothing done for child obesity, the population could likely experience a future generation with health problems. The challenge, he says, is that there is no research that has been done on obesity — in children or adults. He says that it’s only through observations — whenever they have nutrition outreach programmes in schools, or with the youth in Kigali and other areas. “Obesity has not been realised as a health problem yet, this is probably because there are other childhood issues that are still being handled and prioritised, such as stunting,” he says. Kamanzi says child obesity is the situation where a child does not have the normal body mass for his or her age. FACTORS BEHIND OBESITY IN CHILDREN Kamanzi says that most of the factors that bring about the condition are poor nutrition, or an unhealthy diet. He explains that these are factors that expose the child to obesity, albeit they are not the ‘worrying factors’. “Worrying factors include little knowledge on good nutrition among parents and guardians,” he says. He explains people tend to change their lifestyle based on the environment, which exposes them to unhealthy foods and poor nutrition. Rene Tabaro, a nutritionist at Oshen King Faisal Hospital in Kigali, says eating junk or processed foods exposes children to obesity, at that time or later in life. He says that due to some parents’ insufficient knowledge, they tend to expose their children to unhealthy diets, and such children continue with that lifestyle even as adults. “Since the children don’t have enough knowledge on good nutrition either, even at school, they prefer buying snacks at the canteen which in most cases is junk,” he says. He explains that this is because such children are brought up knowing that processed and junk foods are okay. COMPLICATIONS Prof Joseph Mucumbisti, a paediatrician at Oshen King Faisal Hospital, Kigali, and president of Rwanda Heart Federation, says an obese child suffers from mental and physical problems and often has a low self-esteem. He says this can affect their growth and overall performance and may lead to depression. As an adult, he says, such a child is prone to suffer from chronic diseases like diabetes, high blood pressure and heart problems. He says that when obese in childhood, when they reach the adolescent stage, it can be carried on even up to adulthood, especially if nothing is done to rectify the condition. “Something needs to be done immediately so that the population, especially the future generation, is protected from obesity and non-communicable diseases,” he says. WHAT IS ABNORMAL WEIGHT? To detect the normal weight for the child, Mucumbisti says they normally take anthropometric measurements; these are the height and weight measurements. He says the number acquired is called body mass index, same for adults, but the only difference is that when it comes to children, they take body mass index for age. “When we talk of a child, it means that this is from the age of six to 12,” he says. He says that the normal weight of a child in that age bracket should be between 18 to 24.9 kilograms, above 25 kilograms, the child is considered obese. When a child is found to be obese, he says the situation can be reversible and what is needed is to start influencing and facilitating them to change their behaviour on nutrition. He adds that such children should as well be encouraged to increase their physical activity levels. When children are obese, he says, they risk suffering cardiovascular diseases. WHAT SHOULD BE DONE? Pande says prevention lies in encouraging a child to have a healthy diet and lots of physical exercise. She says focus should be on freshly cooked food with vegetables, fruits and less sugary and fatty foods. Sodas can be replaced by fresh fruit juices. “Since children mostly copy adults, it is useful for elders to have the same kind of healthy, non-fattening diet that they desire for their kids. Physical activity should be arranged for the whole family so that children feel enthusiastic about it and are motivated for doing so,” she says. Pande adds that the whole family can indulge in running, swimming or long walks. The child should feel supported by the family and never ridiculed or rebuked for obesity. As he/she grows older, Pande says the risks of obesity should be explained, and children should be encouraged to maintain a normal body weight. OTHER PRACTICES Kamanzi says charity begins at home, therefore, it’s the role of parents to start improving the child’s feeding practices, so that they grow while consuming a healthy diet. Apart from just encouraging a healthy diet, he says it’s the parents’ role to inform and educate youngsters on what is good and what is not. “This is because the childhood stage is where food habits are affected, if one is brought up in a family with little to no knowledge on nutrition, unhealthy food consumption will influence the child throughout life,” he says. Kamanzi adds that good nutrition habits influence children to stick to a healthy diet regardless of where they are —home, school or any other place. He says this can be observed in schools and higher institutions when learners refuse to eat food prepared by the school and instead go for fast food in eateries. Also, Kamanzi says, you can notice it in restaurants when children order for unhealthy food while they are with their parents, meaning that their dietary behaviour was not influenced early. Tabaro says parents should learn to give their children a balanced diet, this is normal and local food prepared at home. “Women should ensure that their families consume a healthy diet, because most times, they are the ones who prepare it,” he says. Tabaro adds that sensitisation is needed for parents on how to keep their families out of danger as far as good nutrition is concerned. Experts share their views Ensuring that children are not fed on sugary foods is important, this is because it can expose them to dental problems, which has now been linked to non-communicable diseases. Pacific Nkusi, Dentist - Making sure children get enough sleep is important as its part of being healthy. Parents at home and teachers at school should encourage children to drink a lot of water and engage in physical activities. Joseph Mucumbisti, Paediatrician - For children who are suffering from malnutrition, parents should be sensitised on how to feed them. Just like obesity, undernutrition is a problem when it comes to a child’s health. Claudine Uwajeneza, Nurse - Parents who have a problem with their own weight should adopt habits that help them maintain good and normal weight. By doing this, children will emulate if and when faced with the same problem. Joseph Uwiragiye, Nutritionist - editorial@newtimes.co.rw
