India, a country that had long struggled with malnourishment, especially among children, is now witnessing a new and shocking trend. According to a recent study published by The Lancet, more than 12.5 million Indian children aged between 5 and 19 years were found to be obese. In 1990, the figure was just 0.4 million.
“The analysis underscores a concerning reality for India
This shift from childhood malnutrition to obesity can be attributed to various factors, according to the expert, such as “changes in dietary habits, increased consumption of processed foods high in sugar and fat, decreased physical activity and socioeconomic factors”.
As per the Harvard TH Chan School of Public Health, as poor nations witness a rise in income levels and switch from traditional to Western diets, obesity levels rise. Due to this “nutrition transition”, lower- and middle-income countries face a double whammy—the debilitating issues associated with obesity and Western lifestyles coupled with the infectious diseases, which accompany malnutrition.
However, doesn’t obesity solve the issue of malnourishment? “That’s not how it works,” says Dr Karunesh Kumar, senior consultant, paediatric gastroenterologist, Indraprastha Apollo Hospitals
Nutrition is key
Top food and drink companies, such as Nestle and Cadbury, have recently come under fire over high amounts of sugar in their foods, marketed for infants and kids. This includes Cadbury’s Bournvita and Nestle’s Cerelac baby cereals.
Such foods can be especially detrimental to the kids’ health, both immediately and in the long run, experts say. “Immediately, they can lead to dental problems, excessive weight gain, energy highs, and crashes, affecting mood and behaviour. And in the long-run, they increase the risk of chronic diseases such as diabetes, heart disease, and certain cancers, and may even impair cognitive development,” Dr Kumar says.
Parent’s role is crucial. “When buying packaged foods for kids, parents should read labels carefully, avoid products with high added sugars, and choose minimally processed, nutrient-dense foods,” the expert recommends, who goes on to endorse some form of sugar tax.
“To discourage excessive sugar addition, governments can implement a sugar tax on foods/beverages with high added sugars, making them more expensive to discourage consumption and incentivise reformulation by manufacturers,” he says. “While not a complete solution, sugar taxes combined with education, labelling, and promoting healthy lifestyles can help combat overconsumption of sugary products among children,” Dr Kumar adds.
Formula foods for babies need to be factored in too. While beneficial when breastfeeding is not an option or insufficient, “they should be chosen carefully,” says Dr Chauhan. “Some formula foods may contain added sugars or unnecessary additives, contributing to excessive calorie intake and potentially increasing the risk of obesity later in life
While nutrition has worsened, the level of physical activity has dipped too. “Several factors contribute to this, such as screen time due to the increased use of smartphones, tablets, computers, and video games, which has led to a rise in sedentary behaviour among children. Busy schedules, academic pressure, and urbanisation have also reduced opportunities for spontaneous outdoor play,” says Dr Chauhan. Safety is another factor. “Additionally, changes in urban planning and community design have made it less conducive for children to engage in active transportation or outdoor play safely,” says Dr Kumar.
Psychological factors
Apart from nourishment and physical activity, psychological factors, too, contribute to obesity among children. “It has been seen that many children resort to emotional eating when they are stressed. Eating chocolates or junk food provides them comfort at that moment. This can lead to overeating and weight gain in such children,” explains Dr Jyoti
While psychological factors contribute to obesity, the opposite is also true. “Children with obesity often experience low self-esteem, depression, anxiety, and eating disorders. They start to develop poor body image issues and that’s the reason they start to withdraw from social gatherings. Their distorted body image makes them unattractive compared to their peers. This also further leads to a feeling of loneliness and isolation in kids,” the psychiatrist explains.
Whatever the reason, the impact can be far-reaching both in the short and long term. “Immediately, it can lead to physical discomfort, low self-esteem, and social stigmatisation,” says Dr Chauhan. And in the long run, “childhood obesity can lead to a higher likelihood of obesity persisting into adulthood, along with an increased risk of developing chronic diseases like cardiovascular disease, stroke, certain types of cancer, and osteoarthritis. Obese adults may also experience reduced quality of life, stigmatisation, and discrimination in various aspects of life, such as education, employment, and social interactions. Furthermore, childhood obesity can contribute to the development of metabolic and endocrine disorders, which can have lasting impacts on overall health and well-being,” explains Dr Kumar.
A comprehensive approach
Since the reasons are multifold, addressing obesity among children requires a comprehensive approach involving dietary modifications, increased physical activity, and addressing underlying psychological and environmental factors to prevent long-term consequences, say experts.
Starting with nutrition, both parents can play a vital role in educating children about the importance of nutrition. “Involve children in meal planning, grocery shopping, and cooking, which can help them understand the components of a balanced diet. Also engage them in reading food labels, which would help them in identifying healthier options and portion sizes,” says Dr Kumar. “Additionally, exposing children to a variety of nutrient-dense foods from an early age can help them develop a taste for healthier choices. It’s also important to lead by example and model healthy eating habits yourself,” he adds.
Equally important is physical activity and parents have a crucial role to play here as well. Firstly, “limit screen time and enforce boundaries around the use of electronic devices. At the same time, encourage play, both indoors and outdoors, and make physical activity more enjoyable for children,” says Dr Kumar. At the same time, try incorporating activity into daily routine, says Dr Chauhan, such as “encourage walking or biking to school, taking the stairs instead of the elevator, or participating in active chores around the house,” the expert adds. Also, “enroll children in sports leagues, dance classes, or community recreation programs to provide structured opportunities for physical activity,” he adds. Remember, parents can be excellent role models for kids. Hence, “ Engage in physical activity as a family and make it a priority. Children are more likely to be active if they see their parents being active too,” the experts say.
Schools, too, have an active role to play here, which “ can incorporate more physical education classes, recess periods, and active learning approaches into the curriculum,” says Dr Kumar. At the same time, “community efforts to create safe spaces for outdoor play, such as parks, playgrounds, and bike trails, can also promote increased physical activity among kids,” he adds.
Childhood obesity levels in India follow global trends, which, as per The Lancet study, quadrupled from 1990 to 2022, with a rise seen in almost all countries. “This new study highlights the importance of preventing and managing obesity from early life to adulthood, through diet, physical activity, and adequate care, as needed,” the World Health Organisation’s director-general Tedros Adhanom Ghebreyesus had said then. He highlighted the role governments and communities need to play, he also stressed the role of private players. “Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies. Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products,” he had said in a statement.
Make healthy choices
- Make healthy options readily available and accessible to encourage kids to make better food choices. Limit access to unhealthy items
- In order to make healthy food items more appealing to kids, present them in more interesting ways, such as using fun shapes
- Also, involve kids in growing their own fruits and vegetables, which can foster a deeper appreciation for fresh produce
- Use positive reinforcement, not negative, such as praising the child for trying new foods or making healthy choices
- It’s important to be patient and consistent, as developing healthy eating habits takes time and requires a supportive environment
Start early in life
- Start with breastfeeding as it can provide optimal nutrition and help regulate appetite that reduces the risk of obesity later in life
- Promote healthy eating by introducing a variety of nutritious foods early on and encouraging healthy eating behaviours
- Encourage active play involving several activities, both indoors and outdoors, and limitsedentary time from an early age
- Teaching children about nutrition and physical activity is important; it can go a long way in ensuring a healthy lifestyle
- Limit unhealthy foods. Instead, offer water or milk as the main beverage and limit sugary drinks like soda and fruit juice
