Combatting childhood obesity

During the recent Healthcare 20/20 Conference one of the main talking points at the paediatric session was childhood obesity.

With a panel ranging from nutritionists to doctors and an informed audience, there were numerous suggestions in terms of how the crisis could be approached.

And a crisis it is, with a clear increase in the body mass index of children across all age groups, starting as early as the 3- to 6-year age group, where around 29 per cent of children are overweight or obese, with increasing blood pressure and cholesterol levels. This number rises more dramatically once the children reach primary school age, with some 34 per cent of children being overweight or obese.

According to Bethany Smith, Cayman Islands Health Services Authority community dietician, the numbers make for dire reading, especially when taking into account the link between obesity and chronic diseases.

“The blood pressure levels also were increasing, and that goes along with what we know about the correlations between BMI and how it affects chronic disease. We know that the younger children are when they are diagnosed as being overweight or obese, the more likely it is that they will get these chronic diseases at an earlier age,” she said.

She said that society sends mixed messages, with thinness being valued, while at the same time food plays a central role in gatherings and celebrations and the concept of what constitutes a normal portion having increased dramatically during the last 20 years.

“Food is integral to our social gatherings and social bonding,” she said.

However, eating too much is clearly only one part of the puzzle, with increased levels of activity also being important in managing this burgeoning problem, with government being in position to influence the level of activity of its citizens.

“Planning for sidewalks, bike lanes and more public open spaces all impacts on the levels of obesity, not just in children but in adults as well. So it’s not simply about sending an obese or overweight child to a dietician,” Ms Smith said.

The importance of activity, as well as the role government can play, was also a focus for another panel member, paediatrician Dr. James Robertson.

“I had a child that came in, he was about 7, and I was asked to see him because he had attention deficit hyperactivity disorder, allegedly. Whenever I have a child like this, my first question to the mother is ‘Does this happen every day?’ and the answer to that was ‘No, it doesn’t happen on Monday or Thursday’. Those are PE days,” Dr. Robertson said.

He said that children needed to get exercise every day and that at least some of this could be addressed through government legislation in terms of the number of physical education days at school.

“I asked my two older children why they were taking PE GCSE when I thought it was a Mickey Mouse subject, and they both replied to me, one a girl, one a boy, that was the only way they could do any exercise, and that’s why they were doing it,” he said.

However, Dr. Robertson was quick to point out that parents also need to take responsibility for the activity levels of their children.

“I have the pleasure, or sometimes not, of looking in a lot of kids’ ears, and I reckon somewhere between 10 and 20 per cent of them have sand in their ears. Why is it not 100 per cent? I go to the beach and it’s empty,” he said.

All the speakers pointed out that prevention of obesity has to start before birth, from as early as correct nutrition for pregnant mothers, as well as the promotion of breastfeeding.

Feedback from the audience on what government could do to help combat childhood obesity levels included extending the minimum mandated maternity leave to six months in order to allow mothers to breastfeed their children through one of the most critical phases of their development. With the current maternity leave allotment, it was suggested that many mothers rush to get their children on a bottle, while many workplaces were not supportive when it came to mothers using breast pumps during the day in order to keep from having to put their children onto formula.

Further education on using formula was also suggested as many parents do not level off a scoop of formula with a knife, thereby providing their babies with almost twice the number of calories per bottle and thereby setting children on a path toward obesity.

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