With increasing evidence that childhood obesity is a “global epidemic”, affecting even the poorer nations, the World Health Organization (WHO) has released new guidelines on how trained professionals can better identify youngsters in need of help.
India has the second highest number of obese children in the world after China, according to a study published in The New England Journal of Medicine in June last.
Doctors say the identification of obesity in children is the main issue, as often parents think a chubby child is a healthy child.
The WHO guidelines, titled “Assessing and managing children at primary healthcare facilities to prevent overweight and obesity in the context of the double burden of malnutrition”, provides updates for the Integrated Management of Childhood Illness (IMCI). The guidelines include counselling, dieting and assessment of eating habits along with the usual weight and height measurements.
H.P. Sachdev, former national president of the Indian Academy of Paediatrics, who is part of the guideline development group, told The Hindu, “In 2016, one half of all children overweight or obese lived in Asia and one quarter lived in Africa. Paradoxically, overweight and obesity is found in populations where under-nutrition remains common — the term ‘double-burden of malnutrition’ is sometimes used to describe these settings.”
Dr. Sachdev said that routinely providing supplementary foods to stunted and moderately wasted infants and children in primary healthcare facilities was not recommended. “Early prevention is the need of the hour to avoid an entire generation from falling prey to heart ailments, hypertension and diabetic complications,” he said.
Sharing the message
The Indian Medical Association (IMA) is disseminating the guidelines to all its members. IMA national president K.K. Aggarwal said the prevalence of obesity in children reflected changing patterns towards unhealthy diets and physical inactivity.
A study published in Paediatric Obesity says India will have over 17 million children with excess weight by 2025. Quoting the WHO document, Dr. Aggarwal said that urbanisation, increased income, availability of fast foods, educational demands, television viewing and gaming have led to a rise in the consumption of foods high in fats, sugar and salt and low physical activity.
“While there have been major public health interventions to promote improved diet and patterns of physical activity in adults, the contribution of ante-natal and young-child interventions to reducing the risk of obesity in later life have not been significantly reviewed. We are writing to all our doctors explaining the guidelines,” he said.
Anjana Hulse, paediatric endocrinologist in Apollo Hospitals, Bengaluru, said ithe dentification of obesity in children was a major challenge. “Parents feel the necessity to see a doctor only when their children develop complications. Most obese children develop early puberty, joint pain and find it difficult to exercise. This in turn results in metabolic syndrome and they end up with Type 2 diabetes,” she said.