15 January 2007

Kids and health risks: take action

Our children have never before been exposed to more diet- and exercise-related health risks than right now. Parents, caregivers, teachers and doctors need to take action.

A number of articles in the January 2007 edition of PEDMED, a paediatric medical journal, stress that our children have never before been exposed to more diet- and exercise-related health risks than right now.

A recent report published in the Mayo Clinic Proceedings, emphasises that even young children are increasingly being diagnosed with diseases and conditions that were previously only seen in older adults.

In addition, speakers at the 19th World Diabetes Congress, which was held in Cape Town in December 2006, reported that metabolic syndrome and types 1 and 2 diabetes in children are increasing "at an alarming rate".

Increasing prevalence
The incidence of diabetes (both type 1 or insulin-dependent, and type 2, or non-insulin-dependent diabetes mellitus) in children increases by 3% per annum and is found in up to 5% of pre-school children.

One out of three children in the USA with metabolic syndrome will develop diabetes as they get older and there is no proof that this situation is any different in South Africa. These statistics make chilling reading. The impact of diabetes on daily life in children is also greater than in adults.

Increasing risk factors
Risk factors for the development of the metabolic syndrome and/or diabetes include overweight or obesity, and lack of physical activity.

Diets that are loaded with fat and highly processed carbohydrates with a high glycaemic index (GI) and an increasing tendency for children to spend hours every day in front of computers, the TV and playing video games instead of participating in healthy physical activity, predispose children to gain weight and develop other symptoms of the metabolic syndrome.

The metabolic syndrome is a cluster of conditions such as overweight, diabetes, high blood pressure and increased blood fat levels, among others.

The fact that children as young as three years are already being diagnosed as pre-diabetic or as suffering from the metabolic syndrome should make alarm bells ring. Not only health practitioners, but also all parents need to be aware of these serious threats to the health of our children.

What can we do?
The question as to what can be done to halt the metabolic syndrome and diabetes epidemics in our children, needs a multifaceted approach.

a) Awareness
As a parent, it is important to be aware of these trends in child health and not to wear blinkers when it comes to assessing your own child's weight and activity levels. Don't make excuses about your child's weight or physical activity, such as 'Mary has a healthy appetite!' or 'John has a big build!' or 'It's just puppy fat and Natalie will grow out of it!'

When it comes to making excuses about why your child is not physically active, parents often cite amazing reasons. In some cases because of constraints of parental time or safety in the living environment, it is difficult to ensure that your child gets daily exercise.

However, human beings have always been inventive and I firmly believe that if you put your mind to it, you can come up with a solution to ensure that your child can get more active.

b) Get help
If you are honest, you will realise when your child is overweight. If you are in doubt, then have your child assessed at your local clinic, or by your doctor, by a paediatrician or a clinical dietician.

If your child is diagnosed as overweight or obese, take him or her to a clinical dietician so that the dietician can work out a diet prescription for your child. The diet prescription will be based on low-fat foods with a low glycaemic index (GI). This is a relatively tricky diet to apply, but with the guidance of your dietician you will soon get used to providing the correct foods and portions for your child.

By the way, you may find that the entire family will benefit from using a low-fat, low-GI diet so that it is not necessary to put your child on a diet that differs from what the rest of the family eats. This will prevent conflict and prevent your child from feeling that he/she is somehow "different".

To contact a dietician, visit the Association for Dietetics in SA website at and click on "Find a Dietician".

To learn more about the GI, click on "Diet" at the top of this page and then on "Nutrition basics" and "Glycaemic Index" and read the articles on the GI. Also click on "Food as Medicine" on the Diet Site and then on "Type 2 diabetes".

You can also access the website of the Glycaemic Index Foundation at

c) Get active
Another article published in PEDMED indicates that a study conducted with 1732 children in three different countries (Denmark, Estonia and Portugal), found that the optimum period of physical activity required to keep symptoms of the metabolic syndrome and diabetes under control, is 90 minutes a day.

This is sobering news and may present problems to most parents in the modern world. In contrast, the Guidelines for Physical Activity compiled by the American College of Sports Medicine and the Health Education Authority in the UK, recommend that children and teenagers should do 20 to 30 minutes of vigorous exercise, or one hour of moderate-intensity exercise on a daily basis.

As a pragmatist, I believe that it is important to ensure that your child gets active and that you make an attempt to ensure that he or she does at least 30 minutes of vigorous activity every day.

There are many options: if you have the financial means, enrol your child in exercise classes at a local gym or swimming pool; if you have some spare time, take your child for brisk walks or swimming or cycling every day for at least 30 minutes; if you are not able to afford such activities, because of limited funds or lack of time (working parents), then buy your child a skipping rope or a hoola hoop and monitor that he or she does this exercise every day for half an hour.

d) Start early
Be vigilant about your child's weight and physical activity from an early age. Young children are very receptive to learning good eating habits and doing exercise. Healthy lifestyle habits learnt at a parent's knee will equip your child to lead a healthy lifestyle for the rest of his or her life and prevent overweight, metabolic syndrome and diabetes.

Let's make 2007 the year when we do something proactive for our children's health!

Text copyright: Dr I V van Heerden, DietDoc
15 January 2007

(Metabolic Syndrome Strikes Children Too; Alarming Increase in Type 1 and 2 Diabetes in Children - PEDMED, January 2006, p 7; Children May Need 90 Minutes of Physical Activity A Day, PEDMED, January 2006, p 8)


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