Fighting Childhood Obesity: Guide For Parents

Childhood obesity seems to be an oxymoron. Sadly, it’s a scary reality. India is the second most populous nation in the world with 27.05 per cent of our population in the 0-14 age range. We are notorious for the rate of child malnutrition in the country. However, it may come to you as a surprise that we are also the second country when it comes to the number of childhood obesity cases.

According to the latest National Family Health Survey (NFHS-5, conducted in 2019-21), the most comprehensive household survey of health and social indicators by the government, 3.4% of children under five are now overweight compared with 2.1% in 2015-16. On the face of it, the percentage may seem small but given the size of the Indian population, the number is horrifying.

According to Unicef’s World Obesity Atlas for 2022, India is predicted to have more than 27 million obese children by 2030. This means one in every ten obese children will be Indian. 

Given the data, it’s important for us to comprehend what childhood obesity is and how we can tackle this epidemic. 

Understanding Childhood Obesity

In medical terms, a child is considered obese when their body mass index (BMI) is at or above the 95th percentile on the Centers for Disease Control and Prevention’s (CDC) specific growth charts.

Childhood obesity, to put it easily, is a serious medical condition when the BMI of a child or adolescent is above 30. BMI is calculated using your height and weight. Your BMI percentile (where your BMI value falls in relation to other people) is then determined using your gender and age. 

Childhood obesity is an issue because an obese child grows into becoming an obese adult with a plethora of health complications ranging from type-2 diabetes, asthma, and sleep apnea to cancer, cardiovascular ailments and fatty liver to name a few. Obesity can also have devastating psychological effects on children and adults alike, including low confidence, social isolation, and depression.

The reasons leading to rising childhood obesity cases are multi-faceted. Let’s dig deeper to get to the roots and take preventive steps in order to work towards a better and healthier future. 

Symptoms of Childhood Obesity

1. Fatigue
2. Shortness of breath
3. Increased sweating 
4. Sleep apnea or snoring 
5. Flat feet and knock knees
6. Joint pain 
7. Skin rashes and irritation
8. Development of dark, velvety skin around the neck and neighbouring areas
9. Stretch marks on hips, abdomen and thighs
10. Early puberty in girls with irregular menstrual cycles
11. Late puberty in boys
12. Excessive fat deposition around the breast (both girls and boys)
13. Acid reflux
14. Chronic constipation
15. Eating disorder

Causes Of Childhood Obesity

1. Dietary Choices 

Junk foods were introduced as an easily accessible and convenient alternative to our staple diet. They’re surely tempting but by no means should fast foods completely replace or undermine the consumption of balanced diets. However, children, in recent years, have been observed to develop taste buds that prefer only fast foods. There are quite a few issues with this trend. 

Such foods are devoid of any micronutrients that our body requires for its functioning. They contain little to no health benefits. Most fast foods contain saturated fats, trans fats and high levels of sodium, sugar and artificial flavouring agents which affect us in more ways than one. 

To begin with, since these foods have very little to no nutritional value they fall short to provide the energy your child needs in her or his growing years. This can lead to health complications that range from physical such as stunted growth to mental issues such as lack of motivation to mingle with peers or participate in extracurricular activities. Furthermore, the lack of micronutrients makes the body crave them which your child is likely to misinterpret as hunger and overeat junk food.

Still further, the number of calories consumed should be proportionate to the calories burnt. In case of its disbalance, the body’s metabolism is hindered which leads to weight gain and other health problems. According to research, kids and teens who regularly eat fast food have a 27 per cent and 39 per cent increased risk of asthma, eczema and rhinitis respectively. 

Eating a lot of fast food in childhood makes it very hard to eat healthy in later life, even if related medical problems are already evident. The addictive taste of fast food makes it quite unlikely for your child’s palate to savour the less delectable flavours of ordinary food.

2. Sedentary Lifestyle 

The gradual disappearance of playgrounds from cities and towns has led to a drastic decline in children’s physical activities. Those few hours of running around with friends in the evening were not only refreshing for the mind and bodies of children but an absolute necessity. Its cut-down has a direct link to the rise in childhood obesity. 

The compulsory physical education periods in schools have also rendered themselves incapable of making children interested in physical fitness. Children have their days packed with extracurricular activities and tuition, leaving hardly any time and energy for them to have a relaxed evening where they play. 

COVID-19 further worsened the situation. Our lives became intertwined with electronics during the pandemic. No doubt this development has its pros and cons but this is not the article where we discuss that. The point that we’re making is that the digitalisation of our lives has made us all physically less active. Talking about children, we parents had no option but to let them use gadgets and maintain their sanity while all of us were locked inside our houses. From school lectures and assignments to online games and video calls with friends and family all hooked them to screens.

A recent study shows that about 70 percent of internet users, especially the young generation, were using their smartphones more as a direct result of the lockdown. This habit that gradually developed over the two years that the pandemic lasted is a hard one to die. It has made many children addicted to mobiles phones and laptops at the cost of their physical fitness.

Late sleeping habits are also a contributing factor to obesity. Your child is likely to get hungry while staying awake late at night and resort to ‘quick to prepare’ food options or order it from outside to satiate themselves. They hardly burn any calories consumed from the ‘late night snacking’ and thus it directly gets added to their body weight. 

3. Psychological Factors

Personal, parental or family issues can increase a child’s risk of obesity. Some children overeat to cope with problems or to deal with negative emotions, such as stress, anxiety, loneliness or to fight boredom. 

4. Genetic Issues 

If your child comes from a family of overweight people, he or she is likely to put on weight easily. This is especially true in an environment where unhealthy food options are easily available and physical activity isn’t encouraged enough. 

While we have discussed the causes of childhood obesity, preventive or curative measures should be taken keeping them in mind. Here are a few tips from our experts to help you keep your child healthy and happy. 

Tips To Tackle Childhood Obesity 

1. Encourage Physical Activities 

In addition to burning calories, physical activity strengthens your child’s bones and muscles, helps them get better quality sleep and can boost their mood and overall health. 20-45 mins of moderately intense physical activity daily is essential for your child to stay fit. Motivate them to go outdoors and play with children of their age.

This will also have a positive impact on their social and psychological being. In case that’s not possible, encourage them to go cycling or for a walk alone or with someone accompanying them. Occasionally, you can make their physical activities more fun by dancing with them or playing a sport like badminton or cricket. 

2. Make Healthy Food More Available 

Offer whole foods like fruits, vegetables, whole grains, seeds, nuts, and lean proteins to your child. Fresh seasonal fruits and vegetables should be encouraged in particular. Cut back on processed and convenience foods like cookies, biscuits, ready-to-eat snacks etc. all of which can be high in sugar, salt, fat, and calories. 

Make sure a wide variety of healthy foods are available in your house. Put healthy snacks and meal choices in the kitchen at eye level. This will teach your child to make their own healthy food choices.

3. Practice Mindful Eating 

Having a meal while watching a screen may lead to overeating. Thus, try to eat together as a family. This will not only help prevent binging but you will be able to keep a track of the nutritional value of your child’s plate and deal with any unsolicited fuss. You can also teach your child healthy eating habits like chewing slowly which will enhance their digestion and thus boost metabolism. 

One thing to keep in mind is to make mealtimes pleasant with conversations. If your child associates mealtimes will unpleasant talks or awkward silences they may try to eat faster in order to leave the table as soon as possible. This will make their brain link eating with stress. 

4. Have A Proper Sleep Schedule 

Not getting enough sleep can lead to weight gain by increasing levels of ghrelin, the hormone responsible for appetite. Too little sleep can also rob your child of the energy to exercise during the day and encourage cravings for sugary foods. To help your child get a good night’s sleep, serve their last meal at least two hours before bedtime, limit screen time in the evening and have a consistent nighttime routine.

5. Don’t Use One Food Against Another 

When you use foods such as sweets as a reward, your child may assume these foods are better than other foods. For example, telling your child they’ll get a dessert if they eat all their vegetables sends the wrong message about vegetables.

While these are a few basic tips, it’s important to remember that each child is unique and a parent knows the best on how to make the best decisions for their child’s health. We’ve prepared a sample diet plan for children of various age groups according to their nutritional needs. This may help you keep a tab on your child’s needs and wants. 

Dietary Guidelines

Toddlers and Preschoolers (2 – 5 yr olds)

From 2 years of age, your child should be eating almost all dishes made for the family. However, taking into consideration that seasoning/ spice level needs to be moderated for their palate. 

1. Grains (at least 2-3 small servings per day)

Whole grains are a good source of energy for the child and provide key vitamins required for various bodily functions.

Options to include in their diet can be (1 serving)

• Red rice flake  poha/ upma – 1/3 a cup
• Raagi Malt – 1/2 a glass
• Home-made dosa/ idli with 1 scoop of Raagi – 1 or 2
• Paneer stuffed Roti – 1 or 2 
• Vegetable Khichdi – 1 bowl

2. Proteins (at least 1-2 servings per day)

Proteins are the key building blocks for the growing child. They are also essential for body repair and rejuvenation.

Options to include in their diet can be (1 serving)

• Boiled/ grilled chicken (1 drumstick or 2 small pieces)

–         Steamed fish (1 filet deboned)

–         Prawns (2- 4 in number)

–         Mutton (1 small piece)

–         Dal (1/3 of a cup)

–         Chickpeas (1 or 2 Tbsp – boiled and mashed or in form of Hummus)

–         Rajma (1 or 2 Tbsp – boiled and mashed or added to a Tikki)

–         Sprouts (1 or 2 Tbsp- boiled and mashed)

3. Dairy Products (at least 2 small serves per day)

Dairy and its products are essential as they provide protein, calcium and Vitamin D.

Options to include in their diet can be (1 serving)

–         Regular milk (1/2 to 1 cup)

–         Home-made yoghurt (1/2 to 1 cup)

–         Cheese (1-2 cubes)

–         Cottage Cheese (4-5 medium cubes)

4. Fruits and Vegetables

This food group is extremely important for the growing child as they impart key vitamins and minerals along with keeping them hydrated.  

So ensure you are giving 5 plus a day to your little one! These include all seasonal Fruits and Vegetables. 

Ideally, there should be 3 servings of vegetables comprising: 

–         Leafy green vegetable (1/2 to 1 bowl – boiled and blended or added to a khichdi)

–         Root vegetable (1/2 to 1 bowl- boiled and mashed carrot/ potato/ radish)

– Non-starchy vegetable (2 serves per day e.g 1/3 bowl of sautéed broccoli/ 1/2 bowl of cauliflower/ 1/2 bowl of sautéed cabbage and peas)

2 servings of fruits should be included daily, preferably seasonal ones. Please avoid juicing them as the child will get pure sugar and no fibre.

5. Fats

Good quality fats are important for the growing child as the fat-soluble vitamins (A, D, E. K) are better absorbed by the body in their presence. Good quality fats are important for the growing child’s overall body and brain development. Vitamins (A, D, E. K) are best absorbed by our bodies in the presence of fat. So do ensure you are adding 1 to 2 tablespoons of ghee or coconut oil to your child’s daily meals.

6. Water: (3-5 glasses daily depending on activity levels) 

Do ensure you are providing your pre-schooler with sufficient water to ensure the prevention of dehydration and smooth flow of bodily functions. You can also offer them coconut water (1 yield coconut) or fresh lemon/ lime water along with regular water. 

Some Food Options:

• Mini Bajra and Oats Uttapams
• Multigrain Palak Paneer Roti
• Rajma Salad for Toddlers
• Moong Sprouts Dosa
• Sprouts Khichdi
• Mini Mixed Moong Dal Chilla – Paneer Vegetable Paratha – Carrot Beetroot Raita for Toddlers.

School Going Children (6 years to 12 years)

From 6 years of age, your child is in a fast-growing phase where there will be key growth spurts. So, to support these phases of growth the household nutrition should match the biological expectations.

Grains (at least 2-3 small servings per day)

Whole grains are a good source of energy for the child and provide key B Vitamins required for various bodily functions.

Options to include in their diet can be

– Whole wheat or multigrain chapatis (2-3)

– Red rice flake  poha/ upma (1 cup)

– Home-made dosa/ idli with 1 scoop of Raagi (2-3)

– Paneer stuffed Roti (2-3)

– Raagi Malt (1 tall glass)

– Vegetable Khichdi (1 bowl)

2. Proteins (at least 2-3 servings per day)

Proteins are the key building blocks for the fast-growing 6 yr old and even more important for their body repair and rejuvenation; so do ensure they get good quality ones (with all the 9 essential Amino acids in them)

Options to include in their diet can be

–         Boiled/ grilled chicken (2 drumsticks or 2-3 medium pieces)

–         Steamed fish (1 full fish- deboned)

–         Prawns (5-7 in number)

–         Mutton (2 medium pieces)

–         Dal (1 cup)

–      Chickpeas (1/2 – 1 cup boiled and mashed or in form of Tikki OR 1-2 Tbsp in form of hummus)

–         Rajma (1/2 -1 cup or 2-3 Tbsp- boiled and mashed or added to a Tikki)

–         Sprouts (1/2 cup or 2-3 Tbsp – boiled and mashed or added to Tikki)

3. Dairy Products (at least 3 medium-sized serves per day)

Dairy and its products are essential as they provide protein, calcium and Vitamin D for the growing bones of the 6-12 yr olds.

Options to include in their diet can be

–         Low-fat milk (1- 2 cups)

–         Home-made yoghurt (1 cup)

–         Cheese (2-4 cubes)

–         Cottage Cheese (5-7 medium cubes)

4. Fruits and Vegetables

This food group is extremely important for the growing child as they impart key Vitamins, Minerals and Water. 

So ensure you are giving 5-7 plus a day to your school goers! These include all seasonal Fruits and Vegetables. 

Ideally, there should be 3 servings of vegetables comprising: 

–  Leafy green vegetable (1/2 to 1 bowl – boiled and blended or added to a khichdi)

–  Root vegetable (1/2 to 1 bowl- boiled and mashed carrot/ potato/ radish)

–  Non-starchy vegetable (2 serves per day e.g 1/3 bowl of sautéed broccoli/ 1/2 bowl of cauliflower/ 1/2 bowl of sautéed cabbage and peas)

2 servings of fruits should be included daily, preferably seasonal ones. Please avoid juicing them as the child will get pure sugar and no fibre.

5.  Fats

Good quality fats are important for the growing child’s overall body and brain development. Vitamins (A, D, E. K) are best absorbed by our bodies in the presence of fat. So do ensure you are adding 1 to 2 tablespoons of ghee or coconut oil to your child’s daily meals.

6. Water (4-6 glasses daily)

Do ensure you are providing your School goer with enough and more water to replenish lost fluids while sweating (during play), prevent dehydration and help with smooth organ functioning. 

You can also offer them coconut water (1 yield coconut) or fresh lemon/ lime water along with regular water. 

Adolescents (13 years to 18 years)

Teenagers need to be properly nourished at this stage, as it’s their last chance to catch up and get to their optimum height and weight. Due to their rapid growth rate, teenagers’ energy, protein and micronutrient requirements are much more than any other age group.

Improper nutrition at this stage can delay linear growth, compromise peak bone mass and make them susceptible to micronutrient deficiencies (in particular iron, calcium, zinc and vitamin D) ultimately hindering their overall growth potential.

The latest Pan India survey, data shows that >50% of adolescents are either wasted, stunted, obese or overweight. Thus, do ensure your teenager is consuming a varied diet inclusive of all 5 food groups; cereals, pulses, vegetables, fruits, and dairy/meat. Carbohydrates should make up 50–65% of energy intake; protein 10–30%; and fat 25–35%. They should eat three meals (breakfast, lunch, dinner) and 2–3 snacks/day. 

Final Words 

As parents, we have to be really careful about what and how we communicate with children. Do not fixate on numbers and scales but instead focus on health, healthy behaviours and lifestyle.

To support your child, avoid commenting on your child’s body, appearance, or weight. Do not encourage your child to diet, skip meals, or go hungry. Growing children need solid nutrition. Focus on affirmative behaviours rather than deprivation.