A structured daily plan for meals and snacks is required for each meal like filling half the plate with salad and vegetables, one-fourth with protein and one-fourth with carbohydrate. The protein content in the diet must be sufficient to prevent loss of muscle mass. Butter in the diet, processed foods and sugary beverages must be limited.
Healthier options and cooking methods (like steaming) is suggested for snacks, reduction in caloric intake by 30%–40% in usual intake of daily meal. One must remember that the recommended daily allowance (RDA) for calories should be based on active life style, lower food intake would be required for those with a more sedentary life style, including higher amounts of vegetables, fruits, whole grains, poultry, fish and nuts is associated with a decreased risk of developing obesity. Mindful eating is the healthy concept where one is consciously aware of what he/she is eating. There are many structured programs including anti-obesity drugs, recently approved by Food and Drug Administration (FDA) in USA, which are to be considered after proper medical advice especially in children. Since obesity is a serious concern because as it is linked with poorer health and reduced quality of life. If it goes untreated, people risk developing of other serious health problems like high blood pressure, raised cholesterol, diabetes, heart and gallbladder diseases, arthritis and digestive problems. Many patients accomplish weight loss with diet, exercise and lifestyle modifications, which remains the cornerstone of the treatment.
Obesity in Children-A Silent Epidemic. The paediatric obesity is assuming an epidemic proportions in the developing countries, especially more common(15-20%), in the privileged classes with higher socioeconomic status. The scientists are considering the possible effect of inheritance or lack of awareness as the main factor for adiposity. However, we should lay more attention towards their dietary issues and should not force a child to give up their favourite dishes altogether, rather eating in moderation. Additionally, we should stress more on the lifestyle modifications like exercise, sports, physical activity, reduce watching TV and playing computer games. Increased use of stairs, cycling or walking and running to be encouraged especially in sedentary children. They should begin with 20 min daily or at least thrice a week including enjoyable activities such as dancing, playing or joining a sports academy. School going children should sleep at least 8 hours a day as insufficient sleep affects dietary intake, leading to obesity, as insufficient sleep is associated with reduced glucose utilization and leading to weight gain. Spending long hours in front of the television, or computer promotes sedentary lifestyle associated with increased intake of snacks, junk foods and sweetened beverages. However, family involvement for all lifestyle modifications have a significant and lasting effect on health. Parents have to serve as a role model for healthy eating, regular activity and reduced screen time, which should motivate them instead of criticizing them. Younger children always rebel if sudden changes are introduced in the lives, as parents need a gradual approach. The active phase can last, initially, for 2–3 months duration, depending on the target of weight loss, at least-1 kg/week. The global prevalence of childhood obesity is increasing in the age groups of 2–4 years and 5–19 years. A balanced diet overweight breast feeding mothers is essentially important during the growing age of infants. According to WHO23% of children in Pakistan are obese, especially higher in urban population. In fact, it has become a health issue in economically rich families for the past few years due to fast urbanization, eating fast food high in fat and sugar. Globally, Pakistan is ranked 165thamongst 194th thickly populated countries above the age of 15 years, revealing one in four Pakistani children being overweight, as they are more exposed to the risks of obesity as compared to rural population, mainly due to sedentary lifestyle, excessive screen time and eating unbalanced diet rich in fat and sugar. The best course is to consult a child specialist if the blood sugar remains constantly above normal, In fact the child is not diabetic, as our children consume lot of sugary drinks, fast food, cookies, cakes, rapidly releasing sugar into the blood. We should not immediately resort to medication but to life style modifications. Moreover, one should not consider obesity as a disease but a lifestyle eating disorder. In fact, childhood obesity has become a common concern in the developing countries as researchers found in students from urban and non-urban areas of Pakistan to determine the style of dietary intake with physical activity. Since the prevalence of obesity is higher in boys and girls (12% and 8% respectively) especially in males. However, it is encouraging to note that the parents and school teachers are giving some attention to the problem. A 6-months study was carried out in 212 schools, designed to formulate recommendations in students of 6-10 grades, in Sindh under Aga Khan University. They found 12% in boys and 8% in girls were over-weight as most of them were eating fast food and less home-made diet. Similarly, the prevalence of obesity in another Turkish school (in Pakistan) was 13.1% and 10.7% amongst obese boys and girls respectively. Boys in Pakistan are likely to have more access to different types of foods, with restricted interest in sports and physical recreation, whereas the girls suffered more restrictions for social mobility due to family restrictions. Scientists have currently observed that the fruits protect against obesity, if used at least 4 time a week, they are less likely to gain weight.As far as the possibility of surgical treatment for obesity, Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery called bariatric surgery, reducing the size of stomach to a medium-sized pouch, the result shows durability of weight loss, with prevention of type 2 diabetes and hypertension with exercise are the most effective method of improving obesity.—Concluded
—Co-authors Dr Madiha Durrani and Dr Zainab Inam.
