Sunday Reading

New Delhi, 21 December 2010

Obese Children

RISK TO NATION’S HEALTH

By Suraj Saraf

In the welter of debates about stream-lining the health of the nation, an important and basic problem is completely neglected. India has over 25 per cent obese children. Clearly, exposing the sorry mess in child healthcare. 

Importantly, so serious is the situation that unless drastic measures are taken immediately it could adversely affect all other measures. As obesity raises the risk for ‘type 2’ diabetes, hyper-tension, osteoarthritis, various type of cancer among women, menstrual disorder, infertility and many more diseases.

This is not all. According to a recent pan-Indian survey on physical fitness of urban school children, obesity is setting in earlier than adolescence. In fact, the most prone to obesity were children over eight years (25%), followed by 18 per cent below seven years and 23 per cent between five and fourteen years had a high body mass index. This abnormality also reflected in lower flexibility, muscle strength and endurance levels of the children.

The survey was undertaken to identify the overall fitness level of school children and to recognize the gaps in the children’s physical education. Especially as the education system favours academics over everything else, compromising the overall development of children.

The study encompassing the 2000-10 academic year was conducted among 4098 children in 21 schools across the National Capital Region, Mumbai, Bengaluru, Chennai, Mangalore, Lucknow, Indore, Raipur, Madurai, Mohali, Baroda, Amritsar, Panipat and Moga. Five factors were measured: body-mass index, aerobic capacities, muscle strength, endurance and flexibility.

The survey found that a significant improvement among children in three schools where a nine month physical education programme had been introduced. The endurance level went up by 17%, abdominal strength increased by 37.5%, flexibility shot up by 4% and children’s correct body-mass index increased to 67.72%.

Sadly, the survey noted that few schools pay any attention to physical fitness, a key for a child’s overall development. Whereby, sports needed to be made compulsory for children in schools. Excess weight at a young age could translate into serious diseases at a later stage. Imperiling the future of the country.

Worse, the excess weight epidemic has been spreading far and wide. Wherein obesity is treated as “normal and a sign of good health”. No matter that we are raising a generation which is handicapped in many ways from an early age.

Who is to blame? The Government, schools, parents and children in equal measure. The Government for not ensuring enough good schools and colleges for a burgeoning population. With kids scrambling to score 95% marks, physical activity is the last thing on a student’s mind. Schools think that their responsibility begins and ends with the study curriculum. Nobody cares two hoots for the child’s overall personality development.

Children are totally bowled over by advertisements and think the only food worth eating is junk food.  This situation is made worse by indulging parents. Arguably, what use a good education if a person is not in good health, physical, mental and emotional? 

Significantly, the Himachal Pradesh Government has introduced regular health check-ups of students to help detect and prevent diseases at the start along-with inculcating healthy habits among students. This programme, carried out with the help of the National Rural Health Mission intends providing nutritious mid-day meals to students. Moreover, mothers have been authorized to test the meals being served to the children.

But this might not be enough. India needs to take a leaf from how Britain has dealt with the problem of child obesity. Parents who fail to help an obese child eat and exercise properly and ignore expert advice and guidance, would be guilty of neglect. Stated a doctor, “the weight of a child itself is not a reason for child protection staff to get involved.”

In addition, a child protection register is maintained if the parents consistently fail to change the family’s lifestyle. Potential failure to provide their children with adequate treatment for a chronic illness (asthama, diabetes, epilepsy etc) is a well accepted reason for a child protection registration for neglect.

Pertinently, in UK childhood obesity becomes a child protection concern when parents behave in a way that actively promotes treatment failure in a child who is at serious risk from obesity. This might involve failure to keep appointments, get involved with healthcare staff who want to help the child or actively subvert the weight management initiatives. Parents are made to understand what is required, and are helped to engage with the treatment programme.

Undoubtedly, it is difficult to establish when obesity turns into neglect and becomes an issue for child protection, because the pressures on everyone to eat too much and exercise too little are powerful. These factors are so strong that for some parents, it is very difficult to stop their children gaining weight. There is a strong association between food, feeding, care and love. Eating is pleasure and you want to give your children pleasure.

Also, UK doctors have discovered increasing evidence linking adolescent and adult obesity with childhood sexual abuse, violence and neglect. But found no studies examining the relation between child protection actions and childhood obesity. Removing children from their parents may not help obesity.

 A recent study found that 37 per cent of children ‘in care’ were overweight or obese, but almost all of them had put on weight after they were put under care. However, before children suffering from high blood pressure or diabetes are put on the register, there should be clear objective evidence over a sustained period that the parents were not complying with the treatment plan.

In addition, obesity is only one of the factors causing concern, besides poor school attendance, exposure to violence, neglect, poor hygiene, mental health problems of the parents and emotional behavioural difficulties.

Further, a new global report, “Save the Children” by the International Child Rights Organisation has highlighted that children from poor communities in India are three times more likely to die before they reach the age of five than those from high income group. Of the 26 million children born every year in India, approximately 1.83 million children die before their fifth birthday. Half of these deaths occur within a month of the child being born, says the report.

In 2008, 5.3 lakh children died under five in the lowest income quintile compared to 1.78 lakhs among the highest wealth quintile. Recall, in 2000, world leaders had committed themselves to eight Millennium Development Goals, including MDG 4, which called for a two-third reduction in the under-five mortality between 1990 and 2015. India is signatory to this. Distressingly, however, despite progress India has fallen short of achieving the target. It needs to pull up its boot-straps! ----INFA

(Copyright, India News and Feature Alliance)