Experts raise alarm over rising number of fat children in towns

Saturday April 5 2014

The prevalence of overweight and obese children is increasing, and health officials are worried that many parents think obese children are healthy. PHOTO/FILE

The prevalence of overweight and obese children is increasing, and health officials are worried that many parents think obese children are healthy. PHOTO/FILE 

By JOY WANJA MURAYA
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It’s a sunny Sunday afternoon at one of Nairobi’s up-market malls and the perfect day to catch up with the children over snacks, lunch and probably dinner on the family’s day out.

As one family drives into an almost full parking lot, the youngsters in the back of the car crane their necks in anticipation at the fast-food feast that awaits.

The doors are flung open and out jumps a seven-year-old boy and his sister, who is a year or two younger. The pair barely pauses to listen as their mother issues instructions.

“No fighting today, Tracy and Jayden. Otherwise we will leave for home with no lunch! Okay?”

“Sawa basi,” the children respond, almost in unison, the more common way of saying “that’s fine” in urban society.

This family of four makes its way to the food counter where the children eloquently read out their favourite food on the overhead menu as if they are reading from a school chart.

“Today, I will have a medium Hawaiian pizza with extra topping and a big soda,” Jayden says.

Tracy quickly places her order. “I will have two pieces of chicken and chips. Oh! And vanilla ice cream with chocolate topping.”

The orders are served, and the siblings sit at a nearby table and tuck into the food as their parents make their order and pay the bill. An hour later, the family is done with lunch but not before the two children order take-away French fries and kebabs for dinner.

Welcome to the urban middle-class and rich society where health experts are raising the alarm over the increasing number of inactive children who eat poorly, are physically inactive and spend more time watching TV or before the computer compared to their peers a decade ago.

In a report released on Friday, Kenyatta University researchers presented findings showing that urban children are growing fatter than their counterparts in rural areas, exposing themselves to lifestyle diseases like diabetes and hypertension at an early age.

Kenya’s 2014 Report Card on the Physical Activity and Body Weight of Children and Youth” was prepared with the help of three Canadian organisations in collaboration with the university.

It is based on analyses of data on Kenyan children and youth since 1986 and the recently concluded International Study of Childhood Obesity, Lifestyle and Environment (ISOCLE-Kenya).

“The aim of the study was to determine the relationships between lifestyle behaviours and obesity in a multi-national study of children in order to inform policy and practice,” said lead researcher Vincent Onywera, a senior lecturer at the university’s Department of Recreation Management and Exercise Science.

The researchers are worried that energy-saving devices are turning children into junkies and dummies before puberty, putting their future health at risk.

Among the factors considered for the survey were children’s waist circumference and body mass index (BMI), which measures fatness in proportion to one’s height, age and gender. Dr Onywera attributes the trends in towns to a shift from active traditional lifestyles to the sedentary behaviour such as watching TV instead of playing outside.

According to the study, rural children were more physically active than their urban counterparts largely because they engaged more frequently in household chores, walk to school and play more often in open spaces.

The 2014 Report Card is the second assessment completed in Kenya after the first study on the lifestyle habits of children and youth was conducted and released in 2011 by the same researcher. It also shows that boys are more active than girls because of what the researchers attributed to role-modelling.

“Parents tend to assign boys masculine tasks, for example, sending them on errands, while girls are discouraged from venturing out,” Dr Onywera notes.

The study of 1,479 pupils in Nairobi found that 23.6 per cent were overweight or obese, with more children from private than public schools and more female than male pupils in this category.

Dr Onywera also blames the problem on parents’ predilection for gadgets, which means that children spend little energy on domestic chores and entertainment. “The paradox is that children born to highly educated parents are fatter than those whose parents have less education. The reverse is the case in more developed countries,” Dr Onywera says.

The study sampled 6,000 10-year-old children from 12 countries in Europe, Africa, the Americas, South-East Asia, and the Western Pacific.

Collaborating researchers were Dr Stella Muthuri, Dr Lucy-Joy Wachira, Dr Mark Tremblay, Dr Florence Kyallo, Dr Robert Ojiambo, Dr Joseph Kibachio, Dr Muthoni Gichu, and Dr Peter Bukhala.

“Rural youth spend part of their leisure time engaged in physically-active household chores, while their urban peers reported pursuing largely sedentary activities such as studying, watching television, and listening to the radio,” the researchers found out.

But it is not all rosy in rural areas where children face malnutrition and were more likely to be underweight. Dr Onywera notes that today more children take either the school bus or are driven to and from school compared to their parents who walked, rode a bicycle or ran to their institutions of learning as they grew up within the same age brackets.

“Ninety-nine per cent of rural parents and 89 per cent of urban parents reported walking, running or cycling to and from school when they were young,” Dr Onywera said, calling for policy makers and implementers to roll out road safety measures that encourage walking to school.

Consultant paediatrician Mary Limbe agrees there is a greater number of overweight and obese children today than there was two decades ago due to a shift from active to sedentary lifestyles.

“There is a false notion that being fat is healthy. On the contrary, growing fat is the uncontrolled increase in weight,” Dr Limbe warns, adding that Kenya is heading in the direction of countries where fast food and soft drinks adverts proliferate.

“Our media is awash with all types of promotions, and cities are ‘littered’ with competing billboards,” adds Dr Limbe, also a senior lecturer at Aga Khan University Hospital.

She calls for the revision of the school curriculum which she describes as “choked” because it encourages theory subjects and rote learning.

“For sustainability, the activity should be one that the child enjoys or family can participate in together, like swimming.”

Nutritionist Gladys Mugambi, who works at the Ministry of Health, told the Sunday Nation that the onset of unhealthy eating begins when women are pregnant and this carries over to infancy, to toddlers and to children as they enrol in schools.

Mrs Mugambi said children not exclusively breast-fed for the first six months drink and eat things not appropriate for their age, mainly starchy foods and sugary drinks, progressing towards being overweight.

“At school-going age, these children carry snacks purchased at the kiosk that contain a lot of fats and sugars accompanied by carbonated soft drinks,” she said, adding that this rooted the culture of unhealthy eating.

She urges parents to introduce healthier foods at an early age so that children do not form poor eating habits, adding that as they grow older, health education is critical. “Parents should also avoid stocking high-fat and high-sugar foods in the house and introduce physically engaging activities,” Mrs Mugambi adds.

“Children usually learn from their parents, who should be active too. There should be a timetable for children to help them not to spend most of the time inactive or watching TV.”

Psychologically bullied

In addtion to disease risks, Mrs Mugambi warns that obesity in children exposes them to psychological problems from constant teasing and bullying by their peers.

“Obese children are not able to play like other children, making them develop low self-esteem. At times they avoid being with other children because they do not feel comfortable. Many of them may be lonely,” she says.

The government has released guidelines on infant and young child feeding, and there exists a guideline for school health in which nutrition is part of the school health policy.

Dr Onywera recommends the development of national sedentary behaviour guidelines for Kenya. He further proposes continuous monitoring of physical activity patterns and emphasises the need for more education and advocacy on the health benefits of physical activity and exercise.