NEARLY a quarter of Cypriot children are obese or overweight, with indications the figure is increasing.
The number corresponds to international statistics regarding the increasing prevalence of obesity in developed countries, raising questions of how best to combat a problem that has emerged as the new challenge in public health.
The alarming figure was the conclusion of two national studies on the obesity in children and adolescents in Cyprus and the prevalence and socio-demographic associations of undernutrition and obesity among preschool children. The results were published in the International Journal of Obesity in 2002 and the European Journal of Clinical Nutrition in 2005 respectively.
The studies were carried out by the Research and Education Foundation of Child Health – a preventive foundation that screens children for chronic disease risk factors, and guides them and their families in correcting them by lifestyle modifications.
Speaking to the Sunday Mail, co-author of the studies Paediatrician Dr Savvas Savva, said childhood and adolescent obesity in Cyprus was comparable to and in certain instances greater than in other developed countries.
In order to combat the problem, Clinical Dietician and President of the Cyprus Dietetics Association (CyDA) Eleni Andreou suggested establishing good eating habits from a very young age as well as educating parents/carers, children and teachers on proper nutrition.
She said CyDA had long acknowledged the problem and had discussed the issue of allowing dieticians, nutritionists and clinical dieticians to work as nutrition advisors in schools with the Education and Health Ministers as well as the House Education Committee chairman. The Association was still waiting for an answer, she said.
She also said a scientific committee of which CyDA was a member had banned crisps, sweet drinks, chocolates and burgers from school canteens. Instead, a list of healthy options, including fruit, was now offered, she added.
But Savva said it was not only parents or schools that had a role to play in clamping down on obesity.
“If as a society we don’t take measures to make changes then the battle is lost. We can educate and raise awareness regarding healthy nutrition and exercise, but unless an environment is created that allows people to change their eating and physical activity habits it is pointless. How can a child ride its bicycle to school when there are no bicycle lanes? Health food also needs to be more readily available at supermarkets.”
Savva said the European Union’s introduction of an agriculture policy, food labelling system and subsidies for producing healthy foods were just the things that would help bring about change.
Andreou said bad eating habits, a lack of exercise and eating outside the home all contributed towards why so many children were overweight and obese in Cyprus.
“But the biggest reason is overeating,” she said.
Moreover, not only were 24 per cent of under 18s overweight and obese, but 20 per cent of children also suffered from high cholesterol and hypertension, she said.
Savva said sedentary activities such as watching TV, video games and computer time should be limited between one and two hours per day. By limiting their inactivity, children’s natural energy levels would make them physically active, he explained.
“There are many different types of exercise. It doesn’t necessarily have to be a gym.
Children can cycle, play in the park, swim, play football and so,” he said.
Savva said research showed children were often more willing to eat healthily and to engage in physical activity if their parents and other family members were doing the same. This was why parents should also limit their own time in front of the TV in order to set a good example for their children, he said.
Snacking or eating meals when watching TV should also be discouraged, he added.
“It’s a very bad habit and studies have showed that children who snack on popcorn and crisps have a greater risk of becoming obese.”
Savva said it was a myth that children could eat as much junk as they wanted as long as they exercised, because a healthy body needed a combination of healthy nutrition and exercise.
“It’s not just about calories. You are what you eat and people’s bodies need a variety of nutrients to function efficiently,” he said.
Andreou said eating junk food periodically – once or twice a week – was not detrimental to a child’s health. However, “too much junk food can promote obesity, no matter how much the exercise, and possibly increase cholesterol and triclyceride (blood lipid) levels”, she said.
“Also, during the ages of one to three, as well as nine to 11, junk food can increase the number of fat cells. Furthermore, kids fed with junk foods can establish unhealthy eating habits for the rest of their lives,” she said.
Savva said while a balanced diet was important, so was sitting down to eat meals as a family because it helped children develop healthy habits and tendencies toward food.
He said: “It’s a time family members can use to talk about their problems, thoughts, concerns, etc. (But) unfortunately modern society’s busy schedules do not always allow families to co-ordinate meal times.”
The paediatrician also called for a return to the Mediterranean diet our grandfathers had followed, which was rich in fruit and vegetables, contained plenty of fish and pulses, was limited in red meat and excluded desserts.
Although Andreou agreed with him, she said that due to a lack of time, parents opted for the easy option of fast food to feed both themselves and their children. She said if parents wanted to change their children’s eating habits they had to improve their own first.
Savva added: “Parents can serve as role models in ensuring that children eat nutritious foods and can introduce their family to new, healthier ways of eating… If a child sees its parents eating healthily, then it will want to do the same. This must be cultivated when they’re toddlers.”
Savva said good eating habits had to be instilled early, as the problem of obesity started as young as pre-schoolers between the ages of four and six.
“This is largely due to nutrition. A toddler must learn to eat what everyone else is eating. This tendency to feed children pork chops when the adults are eating pulses, for example, must stop, because it teaches children they do not need to eat pulses and they carry this philosophy into adulthood. It then becomes more difficult to learn good eating habits.”
He added: “Also children should not be forced to eat up when they say they are full, as they have an in-built mechanism telling them when they’ve had enough. Forcing them to eat even just three extra mouthfuls per meal not only destroys this mechanism but adds up to a lot of mouthfuls over time, which equates to calories and subsequently the addition of extra kilos.”
Andreou said children who were overweight or obese between the ages of two and seven were kept on a maintenance diet until their height caught up with their weight. In cases where an obese child suffered health complications it was put on a weight loss regime. Obese children over seven were put on weight loss programmes, as were overweight children with health complications, she said.
The weight loss in each case was no more than one kilo a month so as not to stunt growth, she added.
The clinical dietician said child obesity was a worrying and increasing phenomenon all over the world. Worse still, more than one third of obese children grew into obese adults, she said.
Savva pointed out American scientists had concluded if present trends continued, this generation could be the first to have shorter expected life
spans than their parents.
This was because the health effects of child obesity increased the risk of developing cardiovascular disease, diabetes, high blood pressure, high cholesterol and cancer in adulthood, he said.
And over and above the health effects, Andreou said obese children suffered psychological effects including becoming a loner, low self-esteem, compulsive eating and depression.
