CHENNAI: Earlier this month, Prime Minister Narendra Modi declared that September will be celebrated as ‘Rashtriya Poshan Maah’ (National Nutrition Month). In line with the announcement, several private and government-run organisations have been curating awareness campaigns to improve the nutritional state of children, pregnant women and lactating mothers.
According to an article published by Lancet Global Health, one in nine schoolchildren suffer from overnutrition in India. ‘This is a concern as the country suffers a dual burden of undernutrition and overnutrition, representing the inequitable distribution of health’, reads the article.
Dr Reshma Aleem RD, nutritionist, Rainbow Children’s Hospital, discusses about interventions to reduce overnutrition burden and ways to monitor obesity in children.
Nip it in the bud
In 2018, WHO projected that childhood obesity is one of the most serious public health challenges affecting people in every country. “Overnutrition is a form of malnutrition which eventually manifests into obesity. When the bodyweight is more than the desired body weight, it is classified as obese. This ‘desired bodyweight’ differs from person to person depending on the age group, sex, genetics and also cultural background which plays an important role in our dietary habits,” she says.
She adds that in the pre-school and school-going age, children become exposed to the world of snacks. “Potato chips, cream biscuits, chocolate bars and wafers replace their regular meals. All these products are high fat, sugar and salt (HFSS) foods that are bad for children,” she says.
Quoting a report by the Indian Journal of Paediatrics, which noted a high prevalence of obesity among children in Chennai, she says, “They studied around 18,000 children between age groups 13-17. In the study, it was revealed that the prevalence was high in private schools than in government schools, and that more girls were obese than boys.”
Obese children are prone to hypertension, diabetes, PCOS, cancer, hyperlipidemia, gall bladder stone and osteoarthritis.
Early intervention
The change should start in the womb. “What the mother eats during pregnancy has a larger impact. Proteins, iron and folic acid are a must. The child should be breast-fed for six months before starting with complementary feeding. These foods should also be given in an adequate amount in proper consistency. They should contain balanced amounts of all food groups and should preferably be home-made. Doing this can tackle overnutrition at an early stage,” she shares.
Children should be introduced to all kinds of fruits and vegetables from as early as two years. “When they start going to school, healthy snacks like puffed rice, fruits, nuts, dry fruits, boiled corn, groundnuts, sprouts, chana or salad can be given. Parents should ensure that the child doesn’t miss out on his/her breakfast,” she says.
Support them
More often than not, people don’t read the nutrition label published in the food packages. “By reading the label, parents will know how much fat, sugar, additives and preservatives are in it. All the junk items have trans fat and it affects the arteries,” says Dr Reshma.
“Be patient with the child. Involve them while planning the food menu. If they refuse to have green vegetables, don’t force them. Instead, try integrating it in dal, parathas, gravy or kofta. Fruits can be introduced in the form of a fruit custard, whole fruit juices (without sugar or artificial essence), vegetables in raita,” she says, adding that parents should not give chocolates and snacks as rewards.
As children spend majority of time in school, institutions should step up and ensure that unhealthy snacks aren’t sold in their respective canteens.
Double burden of malnutrition?
It is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases, within individuals, households and populations, and across the life course.