It is all very well to talk from a pedestal on how it is essential to eat healthy and have a decent level of exercise. But how do you convince children to actually fashion their lifestyle to facilitate a healthy life, tortured as they are by choices and temptations.
“It is very difficult to do,” admits Anoop Mishra, Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Group of Hospitals, in Delhi. He leads the DISHAA programme to sensitise schoolchildren, their parents, teachers, and general public to healthy living. It also focussed on primary prevention of obesity and inculcation of healthy diet and lifestyle practices.
“In a six-month study we did, we could show that intervening among children has the desired effect, of lowering weight, blood sugar levels and other factors,” Dr. Mishra explains. “But, for that we need dedicated counsellors working with the children every week. To find that dedication is difficult, also parents, and teachers do not consider this a priority issue.” It can be done, he assures, but one needs to find the dedication, the time, and people with the requisite skills. Lecturing to children will scarcely have any effect, according to him.
Since then, the DISHAA project has been launching interventions countrywide. Over 70 cities and over 80 diabetologists and physicians have been instructed to intervene in various schools. “It is true, not all have succeeded, but about half of them have been working in schools. And we do have a clear idea as to how the programme must be taken ahead to bring a true change,” he adds .
Closer home, in Chennai, another pilot effort has been ongoing to try and change the behaviour of children again in schools. The M.V. Hospital for Diabetes, as a follow up to a study to measure obesity and the impact of socio economic factors, has taken up intervention in schools, its managing director, Vijay Viswanathan says.
The study examined the weight of over 1,100 children between grades four and 10, to estimate whether they were obese, overweight, or normal. It showed that 12.1 per cent among the children were overweight and the same figure for adolescents was 15.5 per cent. The intervention programme was rolled out about six months ago, and tried to look at whether implementing the Central Board of Secondary Education's health manual in schools will have a beneficial effect. “The manual is very, very comprehensive, was developed by the CBSE along with a team of medical, nutrition, and education experts. If all schools follow this and implement it, it will definitely result in bringing down the obesity rates,” Dr. Viswanathan states. It covers everything, including provisions for preventing obesity and improving lifestyle, monitoring what must be served in the canteen, what children bring for lunch and snacks, he explains.
However, the manual, drawn up in collaboration with the WHO, a few years ago, was implemented by very few schools. Three manuals are available for different grades. “We found that schools needed a little more inputs on the subject and a little help with implementation,” he said. That is how 10 CBSE schools in the city came to be involved in the intervention programme, each sending teachers for training in implementing the manual for children of different ages.
At the end of an initial evaluation in two schools where the project was implemented, there were definite pluses, Dr. Viswanathan adds, indicating satisfactory implementation. The kids' knowledge on lifestyle factors and health, their height, weight, waist and hip circumference have been measured initially and will be contrasted after implementation of the programme. A control group of 10 schools without as much intensive intervention would also be measured in comparison.
“If we can show that this manual works, then it would be perfect to be adapted to the other boards of education, across the States. Thereby, we will go a long way in influencing the lifestyle choices of the future generations,” he says.