More screen time, less outdoor play over lockdown may have exacerbated childhood obesity epidemic

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In light of upcoming World Obesity Day on 4 March, Laager Tea4Kidz partner dietician, Mbali Mapholi, weighs in on what is behind this global epidemic, and practical ways it can be addressed.

Obesity is a severe health crisis in many countries, including South Africa, affecting people of all ages – children among them.

Following two years of restricted movement, which saw a massive rise in screen-time for children and less outdoor activity (including less schools sports), there is a concern that this already problematic issue may have been exacerbated.

Currently, 1 in 8 children are obese in South Africa which is a marked increase from the past decade where 1 in 20 children were obese. The World Health Organization (WHO) estimates that over a quarter billion of children in the world will be obese by 2030.

This makes childhood obesity a rapidly growing health concern in South Africa, and the world. 

Why is this such a major problem, especially for children?

Being overweight or obese increases one’s risk for having a heart attack or stroke. It is also linked to the increased risk of developing chronic diseases, such as Type 2 diabetes, high blood pressure and some cancers for both children and adults.  

Childhood obesity has been reported to be higher among South African children and adolescents (17.1% to 22.8%). This is particularly concerning considering studies have shown that 7 out of 10 overweight adolescents grow up to become obese adults.

What are the main contributing factors to childhood obesity?

The truth is that obesity and body weight are very complex – and even more complex and sensitive when it comes to children.

Poor dietary habits and a sedentary lifestyle – more screen time, less outdoor play for children as seen in lockdown – are two of the major contributing factors of childhood obesity.

What are poor dietary habits?

A poor diet is one that is characterised by food and drinks which are high in added sugar, low in nutrients and contain what we call ‘empty calories’. Examples of poor dietary habits include infrequent home-cooked family meals, a high intake of fast foods, and a high intake of sugar-sweetened beverages. Among infants, complementary foods with added sugar and fats, as well as sugar-sweetened drinks, contribute to excessive weight gain. 

All of this is fuelled by commercial marketing and advertisements of food and drinks with poor nutritional value targeted at children and adolescents. The consumption of energy-dense school tuck shop items also contributes greatly to childhood obesity.  Research shows that in South Africa, 50% of school-going children do not carry a lunchbox to school, making many of them reliant on tuck shop food.

Moreover, there are many other factors that contribute to childhood obesity such as genetics, age, hormonal changes, environmental factors and metabolism, to name a few. However, what children eat and drink on a daily basis contributes hugely to their health, irrespective of these other factors.

What can be done today?

1.     Wholesome | Fun | Nourishing lunchboxes

Children should be encouraged to carry lunchboxes. What makes a healthy lunchbox?

  • Carbohydrate rich food: brown bread, rice, potatoes, pasta, wraps, rolls, popcorn.
  • Lean protein source: tuna, boiled eggs, cold meat, or chicken can make for great sandwich fillers.
  • Dairy products: yoghurt, cheese, milk, or any plant-based dairy alternatives, Maas.
  • Fruit and vegetables: apple slices, grapes, carrot sticks or cherry tomatoes.
  • Healthy fats: Peanut butter, mayonnaise, margarine, nuts.
  • Beverage: Homemade Rooibos iced teas, water, milk.

2.     Reduce sugary drinks intake

  • Make homemade Rooibos iced teas – Laager Tea4Kidz flavoured Rooibos teas offer a variety of delicious flavours to choose from which are naturally sweet, but sugar free. Rooibos tea is a great option for kids as it is naturally caffeine free, packed with health benefits, and affordable for the whole family.
  • Make water easily accessible for kids in the house and at school.
  • Offer kids fruit over fruit juice.
  • Soft drinks should not be made available on a daily basis but can be included in moderation (occasionally with a meal) as part of a healthy diet.
  • Milk and plant-milk alternatives can be offered to children as nutrient-dense beverages, but choose unsweetened versions.

3.     Treats vs snacks

The word snack is often used interchangeably with the word treat, when the truth is that treats and snacks are completely different.

A snack is a mini meal or a nutritious smaller version of a big meal which can be eaten in between large meals; while a treat is often a nutrient-poor item that should be eaten only occasionally with meals.

In the market these days, healthy snacks can be difficult to find as many delicious food items are high in added sugar.  

Ways to reduce intake of treats:

  • Explore fun but healthy snack recipes with children.
  • Go for non-food and drinks-based party pack ideas such as games, puzzles, Lego pieces, craft items.
  • Kids should eat at home before a party so that they are not too hungry upon arrival.
  • Fruit should be visible and not tucked away in the fridge somewhere as it’s an easy, healthy snack.
  • Treats can be enjoyed in moderation with meals.

4.     Cook more at home

Eating out with kids can be counterproductive when trying to instil good dietary habits. To help combat this, it helps to cook more at home and involve kids in cooking or meal preparation.

  • Use fun ingredients in cooking that will excite kids such as Rooibos as a healthy cooking ingredient. Laager Rooibos shares great recipes to try at  www.joekels.co.za.
  • Cut up vegetables and store well in advance to reduce preparation time, and do not fear frozen and canned vegetables and legumes.
  • Create ‘fake takeaways’ at home such as homemade burgers and pizzas.
  • Every now and then, take kids to the shops or market to buy fresh produce so they get to see, feel, and explore fresh produce before it gets home.

What do you do if your child is obese or overweight?

It can be scary and overwhelming for a parent or caregiver when they learn that their child has a higher body weight compared to their peers.

Here is how to navigate this:

  • Be a good role model. Do not shame or speak negatively about your own weight or your child’s weight.
  • Encourage physical activities with the kids.
  • Involve kids in buying or preparation of meals and drinks such as homemade iced teas and fun meals using vegetables.
  • Watch the language you use around kids regarding food and body weight.
  • Consider consulting with a dietitian for further weight management guidance.

My takeaway message

Childhood obesity is a serious problem in South Africa, more worrying since childhood obesity is linked to an increased risk of chronic diseases as adults.

Over a quarter of a billion children are expected to be obese in the next decade. We may not be able to alter our children’s DNA, age, socio-economic and environmental factors, but we can foster good eating habits and physical activity. It starts with making small purposeful changes each day.