According to an article published last week in the Medical Brief Newsletter (2016A), the Commission on Ending Childhood Obesity (ECHO) of the World Health Organisation (WHO) has recently issued its final report on the staggering levels of childhood overweight and obesity throughout the world.
Scary global statistics
Between 1990 and 2014, the incidence of global childhood obesity increased from 4.8% to 6.1%, which adds up to an additional 10 million children under the age of 5 years – from 31 million to 41 million in approximately half a century.
The statistics for the increase in overweight in this age group are even more troubling as the figures have doubled over the period – from 7.5 million to 15.5 million, particularly in the developing world. South Africa is no exception, and our statistics are just as bad.
Read: Childhood obesity brings future health problems
Scary SA statistics
The obesity and overweight figures revealed by the first SA National Health & Nutrition Examination Survey (SANHANES-1) (2013), showed that in children from 2-14 years the incidence of obesity for girls and boys was 7.1% and 4.7% respectively, while 16.5% of girls and 11.5% of boys were overweight.
This study also indicated that average overweight for both sexes in the age group of about 2-5 years, had risen from 10.6% in 2005 to 18.2% in 2013. Obesity in this young age group had remained static at about 4.7%.
The world is therefore facing an unprecedented childhood obesity and overweight pandemic. In response to these alarming findings, the WHO’s Commission on Ending Childhood Obesity has come up with the suggestion that governments should promote healthy diets through “effective taxation of sugar-sweetened beverages and curbing the marketing of unhealthy food”. The idea of a “sugar-tax” has been around for more than 30 years, but so far it has not been implemented.
Read: Why a 20% sugar tax would be devastating for South Africans
The South African Department of Health (DoH) has responded to the challenges posed by childhood obesity and overweight by publishing a strategy document focusing on 6 broad goals to address this problem. Basically the goals of the strategy are to emphasise communication, education and mobilisation of communities. These undertakings are indeed praiseworthy, but the sudden and unexpected appearance of the Zika virus on the international scene may divert resources and manpower away from childhood obesity prevention.
Acute versus chronic diseases
It has often been the case that an acute, devastating disease such as smallpox, polio and now Zika virus infection has focused the attention of global efforts to contain the spread of such diseases and consequently diverted attention away from more chronic diseases that develop over years rather than weeks.
We must hope that the broad, intensive interventions to prevent childhood obesity and overweight will continue despite the sudden appearance of a virus that also impacts infant health and well-being.
Physical activity and healthy diets
The mainstays of preventing obesity in any age group are a balanced, healthy diet that does not provide the user with excess energy and daily physical activity that helps to use up any surplus energy that may be available.
a) Physical activity
Research at McMaster University in Canada has found that a physically active lifestyle can decrease the effects of obesity genes that are inherited from one generation to the next. In other words, all is not lost for populations that have a tendency to gain weight because of genetic factors. The most important obesity gene is called the FTO gene and many population groups are prone to obesity because of it and other genetic factors.
A comprehensive study under the leadership of McMaster’s David Meyre of 17,400 subjects from 6 ethnic groups (South Asian, East Asian, European, African, Latin American, and Native North American) from 17 countries for more than 3 years, produced results showing that by being physically active, one can counteract the obesity gene’s effect.
Read: Every bit of physical activity counts
The finding that physical activity can “blunt the genetic effect of FTO, the major contributor to common obesity by up to 75%” comes as good news during these challenging times.
b) Healthy diets
The basis of most healthy, non-obesogenic diets is to eat plenty of vegetables and fruit. There are many reasons why vegetables and fruit can reduce the tendency to gain weight. Most fresh plant foods have a very high water content of about 85% or more and are good sources of dietary fibre. Both these factors reduce the energy content of fresh plant foods. In addition, fruits and vegetables are rich in protective nutrients such as vitamins, minerals and phytochemicals (i.e. flavonoids).
A recent study conducted in the USA of more than 124,000 men and women over 24 years compared flavonoid intake with weight gain, and found that eating fruits and vegetables rich in flavonoids, such as apples, pears and berries may help prevent weight increases.
Read: Flavonoids - powerful antioxidants
The highest effect on reducing weight gain was exerted by the anthocyanins, the flavonoid polymers and flavonoids. Anthocyanins are mainly found in blueberries and strawberries, flavan-3-ols originate from tea and apples, while orange juice and oranges were the main sources of flavanone and flavones, and tea and onions provided flavonols. So although these compounds may have confusing names and their contribution to reducing weight gain may not be dramatic on a yearly basis (between 0,07 - 0,10 kg less weight gained per year), over time such a reduction can become significant.
Currently most Americans consume less than 1 cup of fruit and less than 2 cups of vegetables a day. In South Africa, the majority of food intake studies over the years have repeatedly emphasised that the intake of vegetables and fruit by South Africans is far too low. One of the main barriers to an increase in the consumption of fruits and vegetables is their price.
Most people in this country regard fresh plant foods as expensive luxuries. It is important to emphasise that growing vegetable gardens at schools, in public areas and even on high-rise buildings could make more vegetables available to many people in South Africa. In the first half of the last century, most houses had at least 1 or 2 fruit trees providing shade and some fruit for the diet. Once again planting fruit trees in living areas could help combat the lack of fruit in our diet and help our children to escape the problems of obesity and overweight.
Combat childhood obesity
Breastfeeding may reduce childhood obesity
Childhood obesity starts at home
HSRC, 2013. Media release No. 2: Nutritional Status of Children, SANHANES-1. Published on 6 August 2013.
MedicalBrief, 2016A. WHO report on alarming levels of childhood obesity. Published on 26 January 2016.
MedicalBrief, 2016B. SA strategy on obesity prevention released. Published on 13 January 2016.
MedicalBrief, 2016C. Physical activity to blunt obesity genes. Published on 13 January 2016.
MedicalBrief, 2016D. Flavonoids help with weight maintenance. Published 27 January 2016.
Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Health24.com. Read more of her articles.