chibet Cricket How the pandemic is making children obese

The pandemic is weighing down urban children’s health. No running through corridors, no after-school football and no structured diet times — anchored to their desks before screens that have turned into classrooms, four out of 10 children in Indian cities are dealing with obesity-linked problems since the Covid-19 outbreak. The year is ending on an unhealthy note for Prantik Panja, a 19-year-old college student in Bengaluru. Already battling obesity, Panja piled on more than 10kg. “College is shut and classes are all online,” said Panja. He has been dealing with low immunity, high blood pressure and back pain — all related to obesity. “And, of course, people tease me about my weight,” he added. medium79639606Doctors that TOI spoke to said they have observed an increase in the number of children coming in with diseases related to obesity this year. “In India, the prevalence of childhood obesity is 8-10%. In urban areas, it is 15-20%. It’s normal for children between the ages of 3 and 8 to put on up to 2kg a year. This year, we have seen kids gain about double that,” said Dr Ganesh Jevlikar, consultant paediatric endocrinologist at Max Super Speciality Hospital in Delhi. “Most of my patients have put on weight. Those who were healthy have become obese and those who were obese, are now getting signs of pre-diabetes,” said Dr Tushar Parikh, paediatrician, Motherhood hospital, Pune. It’s not just clinic-based evidence. medium79640610Mid-year, endocrinologist Dr Anoop Misra and his colleagues did a cohort analysis on the impact of Covid-19 on diabetes and found 40% were vulnerable to weight gain. In the study, published in an Elsevier journal, 16% of the cohort gained between 2 and 5 kg. While the analysis was based on a study of adults, Misra, chairperson of Fortis C-Doc Hospital’s centre of excellence for diabetes, metabolic diseases and endocrinology, said, “The same would apply to children, along with the risk of metabolic syndrome.” medium79638492And that would be a huge spike. As baseline data, the Comprehensive National Nutrition Survey by the Union health ministry last year had found about 5% children in the country were overweight and 1% were obese. It had also noted the much stronger association between body mass index and diabetes risk among Indians than in other parts of the world. So, the heightened obesity problem is also paving the way for more cases of diabetes in children. Misra had observed the same pattern in his analysis — there was a 7% increase in diabetes risk score during the lockdown. “Most children coming to the hospital for obesity treatment have developed insulin resistance. They are between 10 and 17 years old,” said Dr Pavithra Nagaraj, consultant paediatric endocrinologist at Narayana Health City in Bengaluru. “Insulin resistance leads to other problems, like PCOD (polycystic ovarian disease) in girls, high cholesterol and high blood pressure. It’s a spectrum of problems known as metabolic syndrome.” medium79638731But it looks like the pandemic is here for a while. What can children and parents do then? “I make my eight-year-old run 2km every day. She also attends ballet classes thrice a week. We have to act early before the problems catch up,” said Indira Hora from Pune, a mother of two. Dr Randeep Wadhawan, a bariatric surgeon at Delhi’s Manipal Hospital, said he has been referring children to dieticians. “Restricting intake to 1200-1500 calories a day helps. So does 300 or more minutes of cardio a week,” he told TOI. Panja, meanwhile, has been asked to cut carbs, junk food and sweets. “But college is shut. I don’t know how long I’ll be able to sustain this diet.” boxcontent medium79637967Childhood obesity on the rise in India* From 1990-2017, there has been an annual rise of 4.98% in the prevalence of obesity in Indian children* By 2030, the projected prevalence of obesity is estimated to be 17.5% * 23 states have child overweight prevalence higher than the national prevalence, with Telangana and Delhi having prevalence as high as 23.2% and 23.1% respectively. At least 6 states have child overweight prevalence of more than 20% *According to a study, 14.4 million kids in India have excess weightSource: The Global Burden of Disease Study 1990–2017