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Published on October 10, 2007

But how do parents know that they are not unintentionally hurting their kids by feeding them the wrong foods?

 According to the World Health Organisation (WHO), while the rate of childhood obesity is not as alarmingly high as it is in adults, it is already at epidemic levels in some areas and on the rise in others.

 Globally, in 2003, 17.6 million children under five were estimated to be overweight. This problem is increasingly spreading to developing countries, borne out by a study of Bangkok primary-school students, which showed how a 16-per-cent prevalence of obesity among Grade I students has jumped to 31 per cent in just six years. In England, childhood obesity has doubled in 10 years.

 Dr Jeerunda Santiprabhob, a paediatric endocrinologist at Siriraj Hospital, says the increase in childhood obesity is caused mainly by changes in lifestyles and diet. While genes play a role in determining susceptibility to weight gain, diets high in carbohydrates, saturated fat and sugar combined with inactive lifestyles that see youngsters playing computer games instead of field sports, are the main culprits of childhood obesity.

 Being overweight and obesity are easily assessed by the body mass index (BMI), which uses a mathematical formula based upon a person's height and weight. BMI equals weight in kilograms divided by the square of the height in metres (kg/m2). For an adult, a BMI over 25 kg/m2 is considered overweight, and a BMI of over 30 kg/m2 is obese. A normal BMI should be within the range of 19 to 24 kg/m2.

 In children it's a little bit more complicated - there are two ways of calculating. The first uses a growth chart and translates a BMI number into a percentile for age and gender. A child equal to or greater than the 95th percentile is considered obese. The second, which uses the per-cent weight for height, calculates an actual weight by dividing by ideal weight for height and multiplying by 100. A per-cent weight for height of 120 or above is considered obese.

 Obesity and overweight pose a major risk for many chronic diseases including high blood pressure and diabetes mellitus type 2, a cause of premature death in children. A Siriraj Hospital study of 125 obese children aged six to 18 years old with a mean BMI of 33.5kg/m2 revealed that 21.6 per cent had pre-diabetes (high blood sugar but not yet critical) and 13.2 per cent were already suffering from diabetes.

 Dr Jeerunda points out that children with diabetics mellitus will often not present any symptoms and may only come to hospital after developing serious complications. Overweight youngsters are at risk of developing diabetes if they do not shed the extra kilos. Dark and thicker skin around the neck and armpits in obese children are signs of insulin resistance and parents noticing these symptoms should bring their children to the hospital for an immediate check-up.

 High blood pressure is another important consequence of obesity. The same study showed that 27 per cent of obese children already suffered from hypertension.

 Other health concerns caused by obesity include obstructive sleep apnoea (obstruction of airway during sleep), a fatty liver, early puberty, and poor self-esteem and depression.

 Childhood obesity is now a national problem and it is one of which we all must be aware. Children are the future of this nation so childhood obesity is a public-health time bomb. Not only is the cost of treatment high, but the long-term complications and related consequences are a very real threat.

 The whole family must be involved when treating obesity in children. If we want to preserve the health of the next generation, we have to encourage every member of the family to lead a healthy life. Let's stop hurting kids by constantly feeding them.

Dr Poramaporn Prasarttong-Osoth, MD

Department of Surgery, Faculty of Medicine Siriraj Hospital