It’s a story as old as the hills. Mum goes to the doctor, says the child is not eating enough. The doctor examines the child; everything seems fine. “But doctor,” the mum frets, “he only eats half-an-idli for breakfast and a tiny cup of curd rice for lunch. He simply hates fruits and vegetables.” Does he eat anything in-between? “Oh, he munches on a packet of chips, nibbles on some chocolate and washes it down with a soft-drink.” And that, in case you were wondering, is how today’s picky and poor eater becomes tomorrow’s obese adult.
Thoughts of tomorrow, however, do not enter a mum’s head, certainly not when she’s waging a battle with her little one to eat up what’s on the plate. “Parents complaining that their child isn’t eating well is extremely common,” says Dr. Bhaskar Raju, paediatric gastroenterologist. “But in reality, they’re unhappy because the consumption of home-cooked food drops, not packaged foods.” And given that pre-processed foods are high on empty carbohydrates, and that a majority of the kids are couch potatoes, expanding waistlines and weight-watchers subscriptions are, in the future, near certainties.
“A lot of these problems typically surface when the child starts school,” says Dr.Sujatha Sridharan, paediatrician. “When children wake up late on school mornings, they might not have time to eat a good breakfast.
They might bring back unfinished lunch boxes. And some kids won’t touch anything beyond potato/ ladies finger.” All this, naturally stresses out parents, who’re then happy to indulge their children with whatever takes their fancy. Just as long as they eat something…
Obesity, the outcome
Besides obviously eating the wrong food-stuffs, very thin children also become very fat adults thanks to overanxious parenting. “Today's theory is, when a child is born small, allow it to grow at its own rate,” says Dr. Raju, adding that if food is forcefully pumped into such children, it will only end up as abdominal or visceral fat. “The internal organs don't get any bigger; the muscles don't increase in size. The extra baggage places undue stress on the body, leading to long-term health issues,” he says.
“Babies grow rapidly in the first six months after birth’, says Dr. Dharini Krishnan, consultant nutritionist, “and gain weight the next 6 months too. Since the weight gain isn’t as substantial after one year, parents tend to get anxious. It’s only when you plot their weight on a growth chart that you can prove they’re growing normally.” Children are naturally curious about different foods from 9 months to age 2, says Dr.Raju. “If at this time you do not introduce them to a wide variety of foods, there is a high chance they will become picky eaters.”
The simplest advice is, after one year of age, the child must eat whatever the family eats, says Dr.Dharini. “Traditional home-cooked food is well-balanced, so all you would need to do is tweak a child’s palate.” “Kids ask for chips or chocolate, as advertisements repeatedly reinforce the images,” says Dr. Sujatha. “But no child is going to stay off chocolate because you say so. What helps is asking them to cut down the frequency of these treats.” And it will really be helpful if fruits — say a beautifully cut pomegranate — or vegetables were similarly advertised, says Dr. Dharini.
No need for anxiety
But most important, all the doctors advise, don’t panic that your child is small/ eating too little. “When a child is born, it has a layer of subcutaneous fat. This stored fat — chiefly the omega 3 and 6 — is used up in the first few years of its life to develop the brain (which, at birth, is not fully developed). So, by the time a child is 4 or 5 years old, he/she is quite skinny. This is normal,” says Dr. Raju. If the child's weight falls above the 10th percentile (on the growth chart), if he/ she is active, cheerful, not falling ill frequently, if there are no vitamin/ iron deficiencies or sleep disturbances, and if the child on examination shows no abnormality or weight loss over a period of time, then the slow-growth/ low appetite can be ignored, he concludes.
Symposium
Heinz Nutrition Foundation India recently conducted a symposium on Child Obesity in the city. Dr. A. Laxmaiah, Dr. Y. K. Amdekar, Dr. Dharini Krishnan and Dr. Bhaskar Raju spoke on various subjects, including the magnitude of childhood obesity, its effect on various organs, parental attitudes, besides management of the problem and preventive strategies. Dr. P. Jagannivas, Director, Heinz Nutrition Foundation India and Ms Seema Modi, trustee designate and MD, Heinz India Pvt Ltd also spoke.
Dr. Dharini Krishnan’s tips to handle picky eaters:
* If kids don’t take to any particular food, reintroduce it later; they might take to it.
* By 8 months, kids can handle soft-cooked foods. Don’t pulverise all that they eat; it’s important for them to try different textures.
* Discourage them from eating in front of the television.
* Never prolong mealtimes.
* At age 4, a healthy child needs half a cup of vegetables twice a day, and half a fruit.
