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Updated: November 11, 2012 01:58 IST

A fat child is not a healthy child!

Dr. R. Prem Sekar
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In the absence of a medical cause, childhood obesity can be managed only by a strict diet and exercise regimen. File photo
The Hindu In the absence of a medical cause, childhood obesity can be managed only by a strict diet and exercise regimen. File photo

The theme of this year’s World Heart Day, ‘Cardiovascular disease prevention among women and children,’ indicates a paradigm shift in the focus from adults to children. This is a result of the global realisation that the war against the leading killer, atherosclerosis and coronary artery disease, can be won only if remedial measures are initiated from childhood.

Obesity is a result of energy intake exceeding energy expenditure, leading to excessive fat deposition in the body. The excess fat and cholesterol commonly get deposited inside the arteries, resulting in a hardening of the arterial vessel wall. This is called atherosclerosis. The fat deposits inside the vessel are called plaques and the increase in size over a period of time, causing a progressive blockage to blood flow. When the blockage is significant, it will lead to a heart attack.

Recent data from the Centers for Disease Control and Prevention in the United States of America have established that 35.7% of adults and 16.9% of children are obese. Other studies show that at least 70% of these obese adolescents grow up to be obese adults. Once obesity is established in adulthood, it will be extremely difficult to reverse it. This is the rationale for shifting the focus on controlling obesity in children as well as inculcating lifestyle modifications, which in turn will produce a generation of adults free of the early onset of cardiovascular disease and contribute to a healthy society.

Childhood obesity is caused by multiple factors. The predominant cause is an unhealthy dietary habit compounded by a sedentary lifestyle. Other causes include intake of medications such as steroids, some medical conditions such as hypothyroidism and genetic factors. It has been found that if one parent is obese, the chances of obesity in the child are 50%, whereas if both parents are obese, it is nearly 80%. Children whose family members are overweight or have hypercholesterolaemia or a history of cardiovascular disease under 55 years are considered high risk for the early onset of coronary artery disease and should be screened periodically beyond two years of age with a fasting lipid profile. The lipid profile values for children are:

  • Total Cholesterol >170mg/dl (Borderline), >200mg/dl (Elevated)
  • LDL >110 mg/dl (Borderline), >130 mg/dl (Elevated)
  • HDL <35 mg/d
  • TGL >150 mg/dl (Elevated)

If the average results of three lipid profile results are above the cut-off values, then intervention will be required in the form of dietary and lifestyle modifications. Medications to reduce cholesterol is indicated when the LDL exceeds 160mg/dl with associated high risks or when it is > 190mg/dl.

In the absence of a medical cause, childhood obesity can be managed only by a strict diet and exercise regimen. This includes avoiding fatty foods and snacks, binge eating, watching television while eating; eating slowly, increasing outdoor physical activities and, if necessary, taking the help of a dietician or psychiatric counsellor.

(The writer is Interventional Paediatric Cardiologist, Frontier Lifeline Hospital, Chennai. Email is premsekar@yahoo.com)

The origin of the word `obesity` is from the Latin `obedere` that means `over eat`[ob=over and edere=eat]which symbolises fatness.In
fact,obesity is not caused by devouring as believed and the cases
arising out of excessive consumption of food,are minimal percentage
wise.Even if one eats less quantity of food of fat contents,one is
sure to add to his body-weight.Fat banded with cholesterol,the waxy
insoluble substances, are deposited inside the arteries,block the free flow of blood due to the hardened blood veins and thereby
drawing to obesity that,in turn,causes numerous diseases like
type 2 diabetes and heart diseases.The only way to treat obesity is
for the patient to diet and exercise to lose the excessive weight.
Awareness campaigns are organised world wide to impart knowledge
about obesity and its influences over incited diseases particularly
heart-attack.Regrettably,scientists and medicos fail to present a
clear,solid solution to fight the harmful fattiness.

from:  R.Gopalakrishnan.
Posted on: Nov 13, 2012 at 07:26 IST

Good to see journalism selling out along with the profession of doctors.
Now that you have figured out the science behind it, pay attention also to
the trauma that this article would cause to the many "overweight" children
that see this. Your laurel-hardy photos are most insensitive to the doubts
that many have about themselves, and I hope they don't help reaffirm the
low morale that's a gift of this wretched entertainment/advertisement
industry!

from:  Pratik Ali
Posted on: Nov 12, 2012 at 13:52 IST
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