There is increasing concern over the problem of childhood obesity.
The 2017 National Health and Morbidity Survey (NHMS) found that the frequency of obesity among adolescents aged 13 to 17 was 13.3%, while 15.2% were overweight.
In 2013, the Nutrition Society of Malaysia (NSM) conducted the MyBreakfast study, which reported that around one in four primary school children were overweight or obese.
A 2019 local study found that overweight and obese children have a higher risk of depression, heart disease risk factors (such as high blood pressure and high triglycerides) and poorer cognitive function.
There is also evidence to show that overweight and obese children are more likely to become obese adults.
This increases their risk of developing chronic diseases such as heart disease, diabetes and cancer during their adult life.
Obesity is also known to affect work productivity.
Obese children may encounter social isolation, bullying and discrimination from their peers.
This can lead to low self-esteem, which in turn may lead to depression.
Another problem faced by obese children is the tendency to develop incorrect perceptions of body image, which can lead to poor dietary habits and/or the risk of eating disorders.
And the risk of developing obesity is higher if one or both parents (and/or siblings) are obese as most families share certain behaviours, such as unhealthy eating habits, a sedentary lifestyle, consumption of larger portion sizes, or the habit of constantly snacking, especially on foods high in sugar, salt, fat and calories.
The most common causes of obesity are lack of physical activity, unhealthy eating habits, genetic predisposition, or a combination of these factors.
Unfortunately, many children nowadays tend to lead sedentary lifestyles as they spend a lot of time being indoors and inactive.
On average, a child spends approximately four hours each day watching TV or playing games on computers or other digital devices.
In 2019, the World Health Organization (WHO) recommended that children below the age of two should not be allowed any screen time, while screen time should be limited to no more than two hours for older children.
We must be more proactive in adopting physical activity as a component of energy expenditure and help our children to balance their energy intake with their energy expenditure, following the energy balance concept.
This concept is simple enough: The energy we get from consuming foods and beverages (energy intake) should be balanced with the energy we use up in physical activity or for our bodies to grow/regenerate (energy expenditure).
Healthy eating habits
As a start, children should be provided with a variety of foods from different food groups every day:
Feed them with the recommended servings of rice, cereals or tubers, preferably from whole grains, to give them the energy they need.
Provide them with a combination of protein sources such as meat, poultry, fish or eggs, and also plant-based ones such as legumes and beans, for their growth and development.
Milk is very nutritious and good for building strong bone and teeth.
Provide them with adequate milk daily and encourage them to drink it in a variety of ways, e.g. milk shake or with cereals, pudding and custards.
Give them full cream milk, not low-fat milk, skimmed milk or sweetened condensed milk.
With fruits and vegetables, colours do matter in ensuring that children obtain the various vitamins and minerals that they need.
So do provide them with different-coloured fruits and vegetables, including dark leafy vegetables.
Fruits are also an excellent option for nutrient-dense snacks.
Another important point to note is to teach (and practise!) healthy eating habits.
This means that meals should be eaten according to a fixed schedule and never be skipped as this will eventually lead to eating a larger meal or snacking to make up for it.
If your child is hungry between main meals, do provide a healthy snack such as fruits, a glass of milk, steamed corn on the cob, steamed pau, kacang rebus or a wholegrain sandwich.
Do limit your child’s consumption of calorie-dense processed foods such as burgers, hot dogs, nuggets or sausages, and encourage him to drink water, instead of sugar-sweetened beverages.
Be physically active
On top of ensuring that your child eats healthily, you should also motivate her to be physically active.
That means that she needs at least 60 minutes of moderate-intensity activities every day.
You can achieve this by encouraging her to engage in activities such as riding a bicycle, rollerblading, playing badminton or football, or simply playing and using the swing, monkey bars and slide at the nearby playground.
Make time for the family to do more outdoor activities together and reduce the amount of time you and your family spend indoors with sedentary activities.
Take this as an opportunity to bond with your child by spending some quality time playing with her every day.
Another useful way to be more physically active is to get your child involved with household chores from a young age.
Helping out with chores teaches children the basic skills they need to know about caring for themselves and their home when they grow up.
There are also plenty of useful skills that will benefit them when they become adults, such as making their beds, cleaning their rooms and bathrooms, and preparing their own meals.
You should also encourage your child to be more active in school (e.g. joining extracurricular activities such as sports) or join after-school activities (e.g. martial arts or dancing), as these activities will also help develop confidence and self-esteem.
Lastly, you will find it easier to engage their interest if they have peers who are doing the same type of activity or if you can do it together with them.
A family affair
Make it a point to have home-cooked meals as often as possible.
You should also prioritise having family meals together.
To build on this, get your child to help out with meal preparation and clean-up duties after meals.
Spending more quality time together will certainly help to build your family bonds.
Try to limit eating out, especially at fast-food restaurants.
When you do eat out, make healthier choices from what’s available on the menu and teach your child to do the same.
Take the opportunity to also limit the intake of sugar-sweetened beverages by ordering plain water instead.
You should also encourage your child to drink more plain water by ensuring that there a plentiful supply of boiled water at home.
While it is important to teach your child how to lead a healthy lifestyle, nothing beats showing them how it’s done.
The simplest method is to walk the talk and be the role model to your child.
If your children observe that you are eating healthily and leading a physically active lifestyle, they are much more likely to do so as well.
This is important not just in the short term, but also in the long term, as achieving and maintaining a healthy weight will help prevent them from developing chronic diseases in later life.
Remember, preventing childhood obesity helps protect your child’s health now and in the future!
Professor Dr Norimah A Karim and Associate Professor Dr Chin Yit Siew are members of the Malaysian Association for the Study of Obesity (Maso). This article is contributed by Nutrition Month Malaysia (NMM) 2020, an annual community nutrition education initiative jointly organised by NSM, the Malaysian Dietitians’ Association and Maso. NMM’s first Virtual Nutrition Fair will be held on Dec 1-14. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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