A growing problem

And if you thought the school was shut on Saturday, think again. That8217;s when they all work out at the NCC ground.

From special exercises to 8220;climbing a hill8221;, playtime activity stretches to two hours. No, the school authorities are not eccentric. The programme is meant to check the increasing incidence of childhood obesity in India. And while the situation here is not as bad as the US, for the urban children, it is a very real threat.

Already, India has the largest number of diabetic patients and the figure is likely to rise to 57 million by 2025. It is also estimated that heart disease will soon be responsible for the death of many young adults in India, says Dr Rajeev Yeravdekar, honorary director of Symbiosis Centre for Health Care SCHC.

Under the circumstances, it is high time we changed our age-old idea that a fat baby is a healthy baby, says Dr Sheela Bhave, consultant pediatrician, KEM hospital.

The adverse and serious consequences of childhood obesity are now proven beyond a doubt, says Bhave. Already, Type 2 diabetes is beginning to emerge among children in India.

As of now, it is estimated that at least 10 per cent of schoolchildren in India are overweight or obese. Eighty per cent of them will end up as obese adults, with consequent adverse effects like diabetes, high blood pressure and heart diseases.

Bhave and Yeravdekar are a part of the team from SCHC and pediatricians from the KEM Hospital who have taken the initiative to arrest this unhealthy development among children.

A study has been undertaken at Symbiosis school to assess the baseline prevalence of obesity in the children and a programme has been crafted to prevent lifestyle-related disorders among them.

Apart from the questionnaire to parents and the Saturday exercise regimen, the annual school health check-up programme has been altered to include anthropometric measurements8212; height, weight, waist circumference and questions on diet.

Overweight and obese children are identified as per NCHS centiles and Cole8217;s cut-offs. Sixteen per cent of the children at Symbiosis school have been identified as overweight, admits Yeravdekar, and now counselling of over/underweight children is a priority.

An ongoing study undertaken over a decade ago by KEM doctors and the UK Medical Research Centre8212;have demonstrated the 8220;thin fat Indian phenotype8221; where the level of body fat is high despite low weight with evidence of hyperinsulinemia even at birth.

The study, published in the journal Diabetes six years ago, pointed out the deleterious effect of accelerated weight gain in childhood, especially in low birth weight babies. It found that indices of insulin resistance and cardiovascular risk factors were highest in those that were born 8220;small8221; but were overweight by the age of eight8212;even though they were not obese in absolute terms.

Apart from the Symbiosis initiative, the Indian Academy of Pediatrics8217; National Task Force for childhood prevention of adult diseases, too, advises special strategies for specific target groups.

It could include opening school playgrounds on holidays, avoiding teasing obese children, introducing nutrition and physical education in school curriculum or Body Mass Index BMI check-ups.

Obesity has not spared developing countries like Thailand, Iran, Nigeria and Brazil, where the reported levels are increasing every year.

The global prevalence of obesity in children between 5-17 years is approximately 10 per cent, as estimated by the International Obesity Task Force, but this is 8220;unequally distributed8221; with the prevalence ranging from over 30 per cent in the US to less than 2 per cent in sub-Saharan Africa.

Do8217;s and Don8217;ts

For kids between 5-10 years:

8226; Exercise/play for at least an hour daily

8226; No TV, computers or tuitions for over 2 hours

8226; Eat sensibly, cut down on fat food, colas and oily food

8226; Eat plenty of vegetables, fresh fruits and salads

8226; Keep stress to a minimum