Expert Speak: Obese kids are at a 4 times higher risk of developing type 2 diabetes

Treatment of childhood obesity depends on the child's age and existing medical conditions. Treatment includes changes in the diet and regular exercise. ©Shutterstock

Unhealthy body weight is the culprit behind a host of health conditions, diabetes being one of the most prominent among them. In this exclusive article penned by Dr. Ravi Gaur, MD (Pathology), COO, Oncquest Laboratories Limited, sheds light on the growing rate of childhood obesity, the blood sugar impact it has on kids and ways to manage the condition.

Childhood obesity is a complex health issue and its leads to several critical health problems. Children with obesity face four times the risk of developing type 2 diabetes compared to children with normal weight. Other Obesity-related health risks include metabolic syndrome, hypertension, coronary heart disease, bone problems, deranged lipid profile and obstructive sleep apnoea. Obesity has its adverse effects on health as well as the psychology of children. Moreover, it has certain long- term health effects.

Childhood obesity: The current scenario

Children and adolescents who are obese in their childhood are most likely to be obese as adults. As in India, it is one of the fastest growing problems; prevention for it must be taken before hand for the children. The causes of excess weight gain in children are similar to those in adults, including factors such as a person's behaviour and genetic makeup. Childhood obesity is a condition in which a child is significantly overweight for his or her age and height.

According to the Indian Journal of Endocrinology and Metabolism, nearly 20 % school children in India are obese. Methods to determine body fat directly are difficult. the diagnosis of obesity is often based on BMI. For children and adolescents, overweight and obesity are defined using age and sex specific normograms for body mass index (BMI). Children with BMI equal to or exceeding the age-gender-specific 95th percentile are defined obese.

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In 2016, World Health Organisation's (WHO) commission termed childhood obesity 'an exploding nightmare' as it finds 41 million under-fives overweight or obese. Many children are growing up in environments encouraging weight gain and obesity. According to the WHO Commission, the number of children under five who are overweight or obese has risen to 41 million, from 31 million in 1990. The statistics mean that 6.1% of under-fives were overweight or obese in 2014, compared with 4.8% in 1990. The number of overweight children in lower middle-income countries like India more than doubled over the same period, from 7.5 million to 15.5 million. Nearly 48% of all overweight and obese children aged under five lived in Asia, and 25% in Africa.

Obesity and type 2 diabetes in children

There is an alarming rate of increase in the incidence of type 2 diabetes among children with obesity and those with a family history of the condition. Lower income and ethnic minority status are associated with both obesity and type 2 diabetes in children.

Children with type 2 diabetes do not achieve optimal glycaemic control, and are at high risk for later health complications. Obesity and type 2 diabetes represent significant public health issues. They impose a heavy burden on society because the condition is common and costly to treat. Studies indicate that children with type 2 diabetes are prone to develop serious diabetes-related health complications relatively early in adulthood, contributing to decreased life expectancy.

It is clearly recognized that type 2 diabetes is a progressive disease and the duration of the disease predicts complications and mortality. As such, it is reasonable to conclude that children with type 2 diabetes may be facing a grim future unless they seek comprehensive treatment for diabetes and obesity. Preventing our children and youth from getting diabetes and treating it aggressively once diagnosed should be a public health priority.

Screening is important

Overweight children who have a body weight greater than 120% of the ideal for height, and anyone who has family history of type 2 diabetes, hypertension or polycystic ovarian syndrome shouold be screened. Screening should begin at age 10 or at the onset of puberty whichever comes first. Screening should be done every other year. Childhood obesity, also known as paediatric obesity usually is self- diagnosable, as the weight of the child increases abnormally. Lab tests or imaging are often required for tracking the condition medically. Maintaining a healthy diet and physical activity levels are important for preventing obesity and consequent diseases.

Managing childhood obesity

Schools can play an important role in establishing an environment that supports healthful lifestyle habits to encourage healthy eating and regular physical activity. Schools have the opportunity to both educate students about these behaviours and provide opportunities for them to be practised. An effort should be made to increase the number of fruits and vegetables served during break time in schools.

Treatment of childhood obesity depends on the child's age and existing medical conditions. Treatment includes changes in the diet and regular exercise. The goal for obesity treatment is to maintain healthy weight. Depending on a child's existing health complications, treatment may involve a multidisciplinary team. The team will include the family physician, dietitian, counsellor or physical therapist and in some extensive or refractory cases bariatric surgery/ weight loss surgery can be considered.

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