Obesity and overweight in children, a public health issue

Overweight and obesity in children are increasing. This is one of the biggest challenges for public health in the 21st century. The percentage of overweight children increased from 3% in 1965 to 16% in 2000 1.

THE MAIN CAUSES OF OBESITY AND OVERWEIGHT IN CHILDREN

The overweight and obesity of the child are mainly explained by an increase in food intake and a decrease in energy expenditure. The caloric intake by the food being superior to the caloric expenses, the body fat increases.

Our lifestyle is more and more sedentary and the diet is often unbalanced with intakes of added fat and sugars often exceeding the recommended values.

Metabolic, genetic, psychological and social factors can also add to this imbalance and promote weight gain.

HOW TO DETECT EXCESS WEIGHT?

Overweight and obesity are defined by the WHO (World Health Organization) as “an abnormal or excessive accumulation of fat that poses a health risk“.

In children, overweight can be difficult to detect. However, some tools such as body mass index (BMI) and corpulence curves are available to monitor the corpulence of an individual.

In children, baseline BMI values ​​vary physiologically according to age. Thus, it is not possible to refer, as in adults, to a single BMI reference value. The French corpulence curves, present in the health books, thus complement the BMI. Some websites include data such as the site www.imc.fr .

Regular follow-up by your health care professional is recommended, he / she will be able to analyze your child's overweight data and give you the appropriate advice.

1 INPES (National Institute of Prevention and Education for Health), Assessing and Monitoring the Corpulence of Children, 2011

Source: Lescuyer Laboratory

Snacks yes, but healthy for health

Tasting is important in children, it allows to meet their energy needs and to hold until dinner. It must be taken at a fixed time and respond as far as possible to a balanced diet. Alternatives to industrial products, often too rich in fats and added sugars, are possible to offer your children more healthy snacks.

FRUITS FOR VITAMINS, MINERALS AND FIBERS

Fruits are rich in nutrients, including vitamins and minerals, and provide fiber. Some fresh fruit ideas:

• Banana: it is rich in magnesium. It is also an ally of choice to provide energy to your children,
• The apple: rich in fiber and water, it represents an excellent appetite suppressant,
• Citrus fruits (orange, clementine...) and kiwi: these are the kings of vitamin c which helps reduce fatigue and helps the immune system function properly.

Think also of dried fruits (apricots, prunes, dates...) which have a high energy content (3 or 4 are enough to taste).

Dried fruits are often forgotten, yet these oilseeds (nuts, hazelnuts, almonds...) are an excellent source of protein, minerals, and good fatty acids.

CEREAL PRODUCTS, RICH IN COMPLEX CARBOHYDRATES

Cereal products such as whole meal bread, rusks, gingerbread, are rich in complex carbohydrates, offer healthy energy and are low in fat.

The association bread and chocolate bar will certainly remind you of some memories. Chocolate is an excellent source of magnesium. Bet on cereal bread or whole bread, it will bring additional fiber, and on dark chocolate, less rich in sugar.

Practical, cereal bars are easy to carry and represents a quick snack.

DAIRY PRODUCTS FOR CALCIUM

A yogurt, a white cheese, or a glass of milk, bring calcium to the body that participates in the formation of bone. So you can incorporate them into the snack! Think of a vitamin D supplementation that participates in the absorption of calcium by the body.

GOURMET HOMEMADE RECIPES

From time to time, you can also offer homemade cakes, such as a slice of four-quarters with a fruit salad.

If your kids are crazy about spread, why not make one yourself? You control their composition and can vary the pleasures: chocolate, hazelnut, caramel, pistachio and even pineapple, there is something for everyone!

DO NOT FORGET HYDRATION!

Avoid giving your children sodas or sugary drinks, which must be consumed in an exceptional way. Prefer water or a juice pressed.

Source: Lescuyer Laboratory

Tips for children to eat vegetables

BET ON SOFTNESS AND COLORS!

Some vegetables have a softer taste in the mouth while being colored like carrot, peas, tomato or pumpkin. Both characteristics appeal to children. Note that fresh vegetables often have brighter colors and are richer in nutrients.

On the texture side, children also enjoy sweetness like purees, soups or smoothies to drink with a straw!

PLAY ON THE CREATIVITY AND PLEASURE OF THE EYES!

Because you also eat with your eyes, beautiful creative plates will stimulate your children's appetite. Decorate your dishes in a playful way to create a face, an animal, a flower, an object. Mice in the form of radishes, ladybugs with cherry tomatoes and black olives, sailboats in zucchinis or peppers ... ideas are not lacking!

MASTER THE ART OF CAMOUFLAGE!

Why not make use of dishes known and appreciated by revisiting them? Do not hesitate to put some zucchini or sweet potato fries, vegetable tagliatelle or endives mini-burgers!

Conceal vegetables in quiche or soufflé recipes (e.g., carrot souffle). Breadcrumbs is also an effective technique for disguising vegetables. Kids love kibble and bread.

TRAIN YOUR APPRENTICE COOKS!

The ideal is to involve your children in the harvesting of vegetables from the vegetable garden, or to make them walk through the market stalls to arouse their curiosity.

In the kitchen, if the children get involved, they will be eager to taste the dishes they will have participated in.

Source: Lescuyer Laboratory

Omega 3, essential fatty acids!

The brain of children is extremely demanding because it is at the crossroads of all learning (walking, language, manual skill, relationships with others, self-awareness and others ...). The development of the brain is characterized by its long duration: about 15 years are necessary for the brain to reach its adult size.

Omega 3 fatty acids are polyunsaturated fatty acids, the most important being DHA 1 and EPA 2. These lipids are the main constituents of cell membranes and as such play an important role in the brain: the composition of the membranes of the neurons (brain cells) allows synapses to function properly, zones of information exchange.

Thus, omega 3, possess many benefits. In children, DHA plays a key role. It contributes to the normal functioning of the brain and thus participates:

• To the formation of neurons,
• Learning mechanisms,
• To maintaining normal vision.

1 DHA: docosahexaenoic acid

2 EPA: eicosapentaenoic acid

Source: Lescuyer Laboratory

The lactic ferments, good bacteria

The intestinal flora of children is a source of balance, to build and to preserve. This is a major element of children's well-being:

At the digestive level: transit, digestive comfort,

At the level of the system of natural defenses.

Virtually non-existent at birth, the intestinal flora develops through the environment, the child's diet and can be altered by many factors such as taking medication.

It is therefore important:

For infants and young children: to help the intestinal flora to develop so that it is dense and diversified,

For older children: to ensure the preservation of the balance of this flora.

The lactic ferments associated with natural fibers are valuable assets to allow the flora to exercise its role within the organism.

Source: Lescuyer Laboratory

Children: specific needs in vitamins and minerals

Vitamins are essential nutrients for the growth and development of children and the proper functioning of their bodies.

VITAMINS AND GROWTH

Childhood is a period of high growth: between 4 and 10 years, children grow on average 5 to 6 cm per year!

To support this intense pace, their organization has special needs micronutrients and including B vitamins and vitamin D.

The vitamin D is vitamin reference regarding growth: it is necessary for growth and bone development in children. This vitamin is very often associated with calcium as it helps in the fixation of this mineral on the bones.

Vitamin D exists in nature mainly in 2 forms:

• Ergocalciferol or vitamin D2,
• Cholecalciferol or vitamin D3, the assimilation of which is greater than that of vitamin D2.

VITAMINS, MINERALS AND BRAIN DEVELOPMENT

In children, whose organism is still developing, many systems and functions are still immature. This is particularly the case for the immune system, the nervous system or even psychological functions.

The vitamin B1, also called thiamine, plays a key role in some of these systems contributes to the proper functioning of the nervous system as well as to the functions of normal psychological. In addition, vitamin B1 helps preserve their energy metabolism.

The iron facilitates cognitive development of children, and iodine also helps maintain cognitive function.

VITAMINS AND IMMUNE SYSTEM

Children have an immature immune system that makes them more vulnerable to external aggression . In addition, sometimes difficult climatic conditions and fatigue can further weaken their bodies. To help them and stimulate their natural defenses, nothing is worth the vitamins such as vitamins C, A or some of the group B.

Source: Lescuyer Laboratory

Cambodia - In Cambodia, bringing essential care to children and mothers in remote communities

© UNICEF Cambodia/2016/Kieng

Midwife Chhim Ren performs an antenatal check-up on Min Phath at the Tmat Peoy village community centre. Ren is part of a mobile outreach team from the Takoeung Health Centre that travels to remote villages to provide care.

For women in the remote Cambodian village of Tmat Peoy, getting pre- and postnatal care is neither common nor easy. The journey to the nearest health centre can take over an hour, and many women cannot afford the cost of transportation. Learn how mobile health teams are reaching these communities to provide much-needed maternal and child health services.

PREAH VIHEAR PROVINCE, Cambodia, 24 October 2016 – Min Phath, 27, lies down on a colourful mattress under the thatched roof of Tmat Peoy’s community centre in Preah Vihear Province, northern Cambodia. Chhim Ren, a trained health midwife from the Takoeung Health Centre, gently examines her belly.

Phath is six months pregnant with her second child, but this is the first antenatal check-up she’s ever had. The World Health Organization recommends a minimum of four antenatal care appointments to protect both the mother and child.

“Because of poverty, I have to work every day and have no time to go to the health centre,” she says. “It is too far.”

The Takoeung Health Centre is located 17 kms away, but in Preah Vihear Province a journey this distance can easily take an hour. Women like Phath would need to walk to the main road and wait for a shared taxi or motorbike taxi to navigate the dirt roads and rugged terrain. During the rainy season, travel time to the health centre is even longer.

Another issue is cost: the journey costs about 15,000 riels (US$3.75), a steep sum for a family like Phath’s.

That’s why today’s visit by Takoeung Health Centre’s mobile health outreach team is so important. The Provincial Health Department, with support from UNICEF, has been sending teams like these to remote communities at least once a quarter for the last five years. The teams educate mothers and pregnant women about safe pregnancy and the importance of vaccines, and provide direct services like immunization, antenatal and postnatal care, vitamin A supplements, deworming and iron folate tablets.

© UNICEF Cambodia/2016/Kieng

Members of the mobile health care team offer check­ups and other services to villagers, including vaccinations. They also conduct education sessions focusing on the vaccine schedule for children and women, the benefits of antenatal care, danger signs during and post pregnancy, and proper nutrition for expecting mothers and children.

Spreading the word

Tmat Peoy is home to about 338 families, with a population of 1,282 people. Of those, 121 are younger than age 5, including 24 children who are under 1 year old.

Antenatal care and delivery coverage are very low compared to other villages in the health centre’s catchment area: in the first six months of 2016, only five women received prenatal care and just two babies were delivered at the centre.

This is due in part to Tmat Peoy’s remote location – low education levels and limited access to mass media (TV/radio) mean that many villagers are unaware of the importance of appropriate care. Most villagers also eke out a daily existence through agricultural activities, and during the annual rice harvest families can spend as long as two months in the fields. Mothers, children and pregnant women miss important check-ups in this period.

The health centre staff now has a clear outreach communication plan, informing the village health support group one or two days before their visit, so villagers can plan to stay home for the treatment when possible.

The mobile teams also get a boost through word-of-mouth in the community.

Nout Noun, 27, has a five-month-old baby boy. While pregnant, she went to the health centre four times for antenatal care and vaccinations. She received information about healthy pregnancies at school, and after she got married, the village health support group and health staff told her about the benefits of prenatal care, nutrition and safe delivery at health facilities. “I know the frequency of tetanus toxoid vaccination and the number of vaccines my son needs,” she says.

Now, Noun is trying to motivate the pregnant women in her village to also receive antenatal care and deliver at the health centre for healthier, safer pregnancies and births.

© UNICEF Cambodia/2016/Kieng

Nout Noun sits with her five­month­old baby boy. After receiving antenatal care and vaccines for both herself and her son, she is now helping others in her village learn about the value of appropriate

health care.

A wide range of services

On health outreach days like today, the community centre is usually bustling with the large crowd of children and adults. The staff set up their work stations and the team divides the space into small sections, each offering a different service.

Health staff do their best to check each person’s registration card and identify those who aren’t present, so they too can be located and treated. Like in many rural Cambodian villages, Tmap Peoy’s population is scattered, so in addition to offering services at the community centre, health staff travel house to house to reach community members who haven’t made it to health centre.

Before immunizing pregnant women and infants younger than 1 year old, the health staff conducts an education session. It focuses on the vaccine schedule for children and women, the benefits of antenatal care, danger signs during and post pregnancy, and proper nutrition for expecting mothers and children.

“If the health staff wasn’t here, I would have had no antenatal care like during my first pregnancy,” Phath says. Her first child was delivered at home with a traditional birth attendant, putting herself and her baby at risk of infection or worse. “The health staff informed me that it is safer to give birth at a health facility with skilled midwives, so now I’m trying to save some money to do that.”

Phath’s midwife Chhim Ren is one of the many Takoeung Health Centre staff who travels village to village providing women and children with care. Though she says she sometimes struggles to explain and persuade people to use health services, she is starting to see some positive changes.

“More people get vaccinations now, including children. More pregnant women travel to the health centre for services. For this village, only 30 per cent of pregnant women received antenatal care, but compared to last year’s percentage, coverage is improving. Things are improving, one woman and baby at a time.”

Navy Kieng

unicef

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Philippines - A growing problem, child malnutrition costs Philippines $7 billion in a year -- Save the Children

Proper nutrition is crucial in a child’s first 1,000 days of life as lack of it leads to stunting and affects cognitive functioning. A global aid agency put the cost of child malnutrition at $7 billion in a year. -- AFP

Child malnutrition cost the Philippines $7 billion or nearly 3% of its GDP in one year in terms of education spending and lost productivity, while hunger-related stunting is on the rise among children, a global aid agency said.

A report by Save the Children found that the combined losses, calculated with data from 2013, are more than triple the cost of damage inflicted by 15 natural disasters that hit the Southeast Asian country last year.

“Stunting costs are a drag on the economy and impacts all of us, not just the child and the family. It keeps the Filipino economy poorer by 3%. If you add that up over time -- it’s an anchor to progress,” said Ned Olney, head of Save the Children in the Philippines, by Skype from Manila.

Stunting is defined as low height-for-age and is measured by comparing the height of a child against the international benchmark for a child of the same age.

Caused by a poor diet in a child’s first 1,000 days of life, stunting has severe, irreversible consequences on physical health and cognitive functioning.

The report, citing government data, said that after 25 years of steady improvement, the prevalence of stunting among Filipino children under five increased to 33% in 2015 from 30% in 2013.

“That’s a 10% increase in a two-year period, so that is devastating. We’re going in the wrong direction,” Mr. Olney said.

“Even though you have an economy that’s humming along at 6% to 7% a year, you have an increase in poverty from 24% to 25% of all families, and you haven’t addressed the issue of access to food.”

The report said of the estimated 49,000 students who had to repeat a grade level in school, 15% repeated as a result of under-five stunting. It estimated that $27 million was required to cover the costs of grade repetitions for these stunted children.

It calculated lost productivity at $7 billion based on reduced productivity among stunted workers and complete loss of productivity due to premature under-five child deaths linked to hunger.

Meanwhile, urban poverty and hunger are worsening, Mr. Olney said. In the past, Save the Children had focused feeding programmers on rural areas but this year started providing emergency food therapy for “starving, skeletal children” in urban areas.

Yet the hardest hit area remains the conflict-plagued island of Mindanao, where 40% of children are stunted -- an average seen in sub-Saharan Africa, he said.

Save the Children called for more investment in nutrition programs for pregnant and lactating mothers and babies in their first 1,000 days.

Mr. Olney also urged the government to address issues such as water and sanitation, agriculture, education and investment in overall productivity.

“Malnutrition is seen as disease burden to be handled by the department of health. We know that doesn’t work,” he said.

“That’s treating the sick child, rather than understanding why the child is malnourished. Countries that address poverty and access to food have made progress in reducing malnutrition.”

Reuters

bworldonline

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Cambodia - The Bite of Healthy Teeth

Callum Durward, the dean of Dental Health Sciences from the International University, Cambodia spoke to Khmer Times about children’s dental health in Cambodia.

What are the dental health statistics for children in Cambodia?

Close to 100 percent of children that have dental decay develop it by the age of six – the average child in Cambodia has nine decayed teeth. So it starts at a very young age and of all these children, 95 percent do not get treatment. When children lose their baby teeth early, the permanent teeth will grow in closer together so they end up with orthodontic problems as well.

often experience toothaches, infections and have difficulty eating food that needs to be chewed, such as vegetables and meat, which can affect their general health. Some studies have shown that the body weight of children with decay is lower than other children with healthy teeth.

Why do you think so many children have dental problems here?

Firstly the early introduction of tooth brushing with fluoride toothpaste is vital for children and unfortunately in Cambodia many children do not start brushing their teeth until they get to school. Brushing should actually start as soon as the teeth come up with a small soft brush and just a smear of toothpaste.

The second one is related to diet. The weaning foods here often contain a lot of sugar, so from a very young age many children have a lot of sugar in their diet. That sugar, combined with plaque on the teeth, turns into acid and they get caries (dental decay).

Then we have the bottle feeding. Of course now everybody promotes breast feeding, which is very important, but in Cambodia there are still quite a number of mothers who are bottle feeding.

This isn’t so bad if they stop bottle feeding at one year of age. Studies in Cambodia and internationally show that children who go to bed with a bottle, especially if it is continuing over a few years, will get dental decay.

This is called early childhood caries (ECC). It starts with the upper front teeth and then spreads to the back teeth. Many children in Cambodia have this condition.

What is the key takeaway for parents?

Brush children’s teeth at least twice a day with fluoride toothpaste.

In Cambodia, we recommend adult toothpaste as it has a higher level of fluoride. There is no fluoride in the water in Phnom Penh and most of Cambodia so having that additional fluoride is very helpful considering the high decay rate. For a preschool child, just a little paste on the toothbrush is sufficient.

Try not to give young children a lot of sweet snacks and drinks especially between meals. If they are having something sweet, it is better to have it at a meal time.

If a child has decay, sugar-free chewing gum especially Xylitol gum helps prevent against caries.

Mouthwashes that contain chlorhexidine are also regarded as better for helping to remove decay.

Lastly parents should help to brush their children’s teeth up till five years of age, to ensure the teeth are thoroughly cleaned.

Karen Owens, R.N.

khmertimes

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Cambodia - Youth Leaders Are Helping Cambodian Children Grow Up Healthy

As a child advocate, I recently had the opportunity to travel to Cambodia to see some of the work World Vision is doing to make a difference. It was also the first time I took my sons to see how many people in developing countries live. I tracked my experience in this travel journal.

Day 4: Youth Leaders Provide Hope

I am so excited to tell you about the youth leaders that I met in rural Cambodia! They are young people between the ages of about 14 to 30 years old. Sure, they get together to socialize like any youth group, but the focus of their group is more important than any other youth group I have ever heard of.

These young people are the front line of the Starting Strong program that my family helps support through World Vision for all of Cambodia.

This dynamic group is the core to teaching women, mothers and caregivers in rural areas about their options and choices, and how to raise their babies with the best-possible care.

This group of young leaders is an important support for expecting and new mothers. Photo: World Vision

Starting Strong measures and tracks the progress of pregnant mothers, babies and children up to the age of five. It is difficult to believe how little education most of the women in Cambodia have here about care for themselves during pregnancy, breastfeeding and caring for their children.

Malnutrition is also prevalent, even in families that are not considered poor. It is not an economic thing; it is an educational thing.

The focus of Starting Strong is to educate and support mothers to learn how to use local, readily available ingredients to make sure that their families have all the nutrients they need. The primary goal is to prevent stunting in children, which has a very high incidence rate. (Stunting means they don't develop and grow properly because of poor nutrition.)

If addressed before a child is two years old, the long-term physical and mental effects of stunting can be reversed.

The leaders invite the mothers to join groups that teach them about food preparation. They also have regular weighing of mothers and babies using the same growth chart that my doctor used for my kids when they were born in Canada.

It's wonderful to see how stunting can be reversed with this team approach!

There's nothing more beautiful than a healthy mom and baby! Here, I was speaking with moms at a rural health clinic. Photo: World Vision

At a rural health care facility about an hour outside of Siem Reap, Cambodia, I was able to meet mothers and babies who came for their regular weigh-ins.

This is important because it shows the mothers that their participation in the Starting Strong program is working. It's also an opportunity to identify mothers and babies who need additional support.

There were many mothers attending the weigh-in. Some of the babies were in the danger zone of the growth chart, meaning the babies had malnutrition and were at risk of stunting. Left untreated, stunted babies could have physical and mental problems for life.

Embracing education

One mother I met was new to the program and she had no prior knowledge of breast feeding. She did not know that what she ate affected the quality of her breast milk, or that a diet consisting mainly of rice, or crackers was not sufficient to prevent stunting. Her baby was underweight and malnourished. The mother was anemic and lethargic.

She very relieved though that her baby had been identified as being underweight. And this mother was very motivated to follow the food regimen that was suggested. Mostly, she was thankful for having heard about the Starting Strong program from a youth leader.

She looked forward to learning about nutrition, being taught how to cook with local, readily available ingredients to make proper nutritious food for her and her family. Without it, she feared for the quality of life her baby would have.

It brought tears to my eyes to feel her struggle. It made me thank God for the good work World Vision is doing in the Starting Strong program.

I am humbled that my family and I support this program throughout Cambodia

Day 5: How Nutrition Changes Lives

Today I got to prepare nutritious food with a women's gathering in a rural area, outside of Siem Reap, Cambodia. This is a learning and sharing opportunity for all of us.

The focus of the day is a big pot cooking over an open flame. Inside the pot is rice, meat, fish, egg, oil, clean water, peanuts, iodized salt, local pepper, herbs and lots of green leafy vegetables from local trees and shrubs. The people cook this into what they call "porridge."

This is the front line to ensure proper nutrition for mothers and their children! It tastes more like lunch to me, not breakfast porridge. The babies and young ones can't get enough of it and I get a great deal of satisfaction feeding babies!

I love to hold the babies! And to talk with the mothers who are keen to learn about what it's like to raise children in Canada. I also love to be a part of this Starting Strong program that we are partnering with World Vision Canada on to support Cambodian families and communities.

One of the mothers said to me, "As a mother of a malnourished baby, I am so thankful to be learning how to make this porridge!" She was not embarrassed, nor was there stigma, rather, she was thankful that World Vision was there to help.

Joan Kelley Weisshaar Walker

huffingtonpost

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Brunei - Brunei faces serious children overweight problem

'This means that obesity rises by one percent every year. If this issue is unresolved, every single child in Brunei could potentially be obese in the near future'

Brunei is facing serious children overweight problem, because one in every two children from the age of five is either overweight or obese in the sultanate, Hj Zulkarnain, Brunei's Minister of Health said in a message to mark the World Obesity Day 2016.

Hj Zulkarnain said being overweight and obese have "seemingly become the new normal" among children, and obesity among schoolchildren in Brunei increased to 18 percent in 2014 from 12 percent in 2008, according to a local media report on Saturday.

"This means that obesity rises by one percent every year. If this issue is unresolved, every single child in Brunei could potentially be obese in the near future", the minister said. "As a result of obesity, it is entirely possible that our children may have a shorter life span than their parents."

He said obese children in Brunei are increasingly being diagnosed with a range of health conditions that are mostly seen only in adults. Some examples include Type 2 diabetes, high blood pressure and sleep disorders such as having breathing difficulty during sleep, known as sleep apnoea.

"It is also worrying that some children have even died at a very young age from heart attacks," the minister added.

With 62 percent of adults in Brunei overweight and obese, the minister said it is a problem that cannot be ignored.

Speaking on the World Obesity Day 2016 theme of "Ending Childhood Obesity", the minister said obesity prevention and treatment require a "whole-of-nation approach" in which policies across all sectors take health into account.

The minister advised members of the public to take action to improve the health of their family and themselves through physical activities or reducing their intake of unhealthy food and drinks.

xinhua

dailytimes

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