Lockdowns implemented across the world due to the COVID-19 pandemic have negatively impacted diet, sleep and physical activity among children, according to new research. Improper nutrition, prolonged screen time and lack of regular exercise have increased the frequency of obesity in children.
Body mass index (BMI) is a measure that uses height and weight to work out if the person is healthy or obese. An ideal BMI is in the 18.5 to 24.9 range and more than 30 is defined as obesity.
Malnutrition is a major public health problem and a complex issue to solve. Both under-nutrition and obesity are high risks for premature death and disability. On one hand as the levels of under-nutrition have fallen by 10 percent as per National Family Health Survey 2016 NFHS, there is marked rise in frequency of obesity on other side of spectrum , which is an independent risk factor for various non-communicable diseases including hypertension, diabetes mellitus and subsequent heart attacks and brain strokes.
The worrisome situation is that Covid lockdowns have resulted in an increase in various disorders in children including obesity, increased screen time and it's adverse consequences and behavioural changes. The increased screen time has resulted in eye strain, behavioural changes, sleep disorders and increased weight in children.
Due to lockdowns children remain confined to their home and their only recreation comes from watching videos on mobile phones and or other gadgets. On the other hand , people in general don't have knowledge about the balanced diet and daily requirements for energy, carbohydrates, fat protein, macro and micronutrients. They eat whatever they can afford and is pleasurable to their taste buds. People eat as much as they can afford without giving a single thought to calories excess or deficiencies.
Research finds obese kids under lockdown in Italy ate more junk food, watched more TV at expense of physical activities.
“First things first, online classes have increased stress and a sedentary lifestyle in children. On average lockdown has increased screen time in children by as much as three times as compared to pre-Covid times.”
This study, published in April on Obesity, examined 41 overweight children under confinement throughout March and April in Verona, Italy.
Compared to behaviour recorded a year prior, the children ate an additional meal per day; slept an extra half hour per day; added nearly five hours per day in front of phone, computer and television screens; and dramatically increased their consumption of red meat, sugary drinks and junk foods.
Physical activity, on the other hand, decreased by more than two hours per week, and the amount of vegetables consumed remained unchanged.
"The tragic COVID-19 pandemic has collateral effects extending beyond direct viral infection," says Myles Faith, PhD, UB childhood obesity expert and co-author on the study. "Children and teens struggling with obesity are placed in an unfortunate position of isolation that appears to create an unfavorable environment for maintaining healthy lifestyle behaviours."
"Recognising these adverse collateral effects of the COVID-19 pandemic lockdown is critical in avoiding the depreciation of hard-fought weight control efforts among youths afflicted with excess weight," says Faith, chair and professor of counseling, school and educational psychology in the UB Graduate School of Education.
The study was led by Steven Heymsfield, MD, professor at the Louisiana State University Pennington Biomedical Research Center; and Angelo Pietrobelli, MD, professor at the University of Verona in Italy.
It is high time to educate and ensure people eat the right foods in the right quantities and start regular exercise programs for their kids.
The major causes of obesity are excessive eating of fat, oils, animal fat, junk foods and invisible fat present in cereals, pulses, legumes, meat and nuts. In most children with obesity, environmental and hereditary factors play a major role. Only less than 1% of kids with obesity do have underlying pathology for childhood obesity.
Childhood obesity is associated with significant complications. The obesity is responsible for development of insulin resistance due to fat deposition in skeletal muscles and liver. Insulin resistance predisposes a person to develop type 2 diabetes mellitus, polycystic ovarian syndrome, metabolic syndrome, and non-alcoholic fatty liver.
The cardiovascular effects of obesity in children are due to higher prevalence of dyslipedemia, hypertension and consequent atherosclerosis particularly in coronary arteries supplying blood supply to heart muscle and tissues. Childhood obesity is one of major risk factors for premature coronary artery atherosclerosis and heart attacks at a young age.
Further obesity is a risk factor for many orthopedic ailments like flat foot, genu valgum and osteoarthritis. The most debilitating complication of obesity is slipped capital femoral epiphysis which results in pain in the groin and abnormal gait.
Obesity is associated with frequent gastrointestinal complications including gastroesophageal reflux disease and non-alcoholic fatty liver. Fatty liver is present in 40 percent of children with obesity . Around 2 percent of children with obesity develop gallstones and can result in life threatening complications like pancreatitis in them.
This higher incidence of obesity and associated complications calls for mass level awareness programs.
Malnutrition is the main cause of death and disease in the world. Developmental, economic, social and medical impacts of malnutrition are serious and lasting.
Balanced diet is defined as a nutritionally adequate and appropriate intake of food items that provide all macro and micro nutrients in desirable quantities. Cheap food tends not to be healthy food; we need government policies that make healthy food more available and affordable. We need to see changes in the public sector so that government organisations will ban all unhealthy food particularly outside or inside schools.
Health education and investment in food research will be crucial over the next five years. “One of the biggest barriers is availability of the right food, which is still dictated by the large producers. We need to find a way of engaging with the food industry to change the content of food products. In some countries, a desire to eat the right food cannot be met because of the choice of food available at the supermarket and its price.”
It is high time to have a major review into food and technology and people must know how food is produced, how many calories it contains, and what percentage of carbohydrates, fats and proteins in particular food. It is time to educate people about what are advantages of polyunsaturated fatty acids and the disadvantages of saturated fats.
The three major reasons for young heart attacks are obesity, smoking and drug addiction and it is time to address all of them holistically in the shortest possible time frame so that many young lives can be saved.
Depending on the duration of the lockdown, the excess weight gained may not be easily reversible and might contribute to obesity during adulthood if healthier behaviours are not re-established. "This is because childhood and adolescent obesity tend to track over time and predict weight status as adults."
Generally speaking, people in Kashmir have good affordability and accessibility to food. The erratic food habits in Kashmir is a major reason for increased obesity in general masses and children. People in Kashmir are voracious meat eaters and high consumption butter, ghee, poultry and its products has increased the soaring levels of obesity and it's subsequent metabolic complications.
There is also a need to establish and evaluate telemedicine programs that encourage families to maintain healthy lifestyle choices during periods of lockdown.
Dr Suhail Naik
GB Pant Children Hospital