Welcome to Dr. Mike Clark's column

Dr. Mike Clark is a medical doctor and homeopath, has a practice based in Midrand, and is dad to Courtnee (16) and Glen (11). Dr. Clark has sent us articles that he has written for a print magazine in South Africa and given permission for the articles to be re-printed on our website for the benefit of parents globally.

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Homeopathy explained

Stressed out

Obesity in children

Obesity in children

by Dr. Mike Clark

The big fat problem :

The wealthy first world industrialized countries are experiencing an obesity epidemic: 60 % of American adults are overweight, half of them being obese, while 15 % of children are obese, this figure has doubled from 1980. Our entire western society is getting fatter, from babies to the elderly, even our pets have followed this trend !

South Africa follows this same pattern in the urbanized areas, and unfortunately the opposite in rural communities. A recent world health conference has recognized this crisis, and is now dedicating a task team to deal with this problem, a disease of abundance.

 

How to recognise if your child has a problem :

How do we differentiate between a cute chubby baby or youngster with puppy fat, and a child with a problem? A high index of suspicion in terms of your “gut feel” is needed.

If you are wondering if your child is overweight – this is the time to be medically assessed.

A child's height and weight are measured and put on to age/height and age/weight scales. You will recognize these graphs from your child's road to health vaccination charts. A newer follow on method has put the height and weight measurements into an age and sex related scale called the body mass index ( BMI ), and this is put onto a graph of its own. If your child falls above the 95 th .percentile, obesity is diagnosed, while figures between the 85-95 percentile, constitute being overweight.

 

The medical problem :

 

Obesity can manifest as both physical and medical symptoms.

 

a) Physical symptoms

- Breathing difficulties are found, with an increased link to developing asthma, sleep apnea (stopping breathing for several seconds while sleeping) and exercise intolerance.

- Orthopedic problems are more prevalent, with sprains and joint pains being more common – particularly nighttime “growing pains”. Movement is more difficult and a general stiffening and reduction of the supplety of youth occurs. An increase of the risk of fractures to the bones is also seen.

 

The main concern of obesity is the high relationship between this problem and adult diabetes and heart disease, the biggest killers in industrialized countries. Poor diet and lack of exercise, together with a genetic predisposition increase the development of hypertension, a high cholestrol and developing type 2 diabetes – previously called adult onset diabetes.

These conditions accelerate the narrowing of our body's arteries, affecting all of our organs including heart, lungs, kidneys, brain, retinas and placentas. Doctors have clumped these symptoms together and called it the metabolic syndrome – so much worsened by smoking ( hopefully passive smoking in children's cases )

The new buzz word among overweight adults is insulin resistance or glucose intolerance. Excess sugar ( refined simp-le sugars ) floats throughout our blood streams for too much of the day. Insulin is produced by our pancreas in response to blood sugar, which binds onto insulin receptors on most of our tissues. Insulin is the key which unlocks the receptor to sugar, now moving into the cells to be burned as fuel. Excessive insulin bombards these receptors, saturating them so that they stop working efficiently and insulin resistance, (or pre-diabetes), develops. This condition makes weight loss as an adult difficult. Lifestyle and diet make this an entirely preventable disease. Basic blood tests are done to exclude other pathology. Thyroid hormones, insulin, sugar, iron levels, electrolyte test should be performed, and an anaemia screen give a good baseline to move forward with.

 

b) Psychological symptoms

Children do take a knock with their peers regarding teasing and bullying. In addition their energy levels are reduced and they are inclined to participate less than their lighter peers. On a deeper level, children are designed for activity and play – and not honouring this aspect of themselves can lead to anxiety and isolation, which in turn affects self confidence and can lead to depression. Certain sensitive children respond with aggression and inattention with the peaking and troughing of blood sugar levels – how many of our ADHD diagnosed children match this eating style?

 

The reasons

 

- Genetics do play a role. Heavy families follow a pattern ( as height and body structure do too ). Some babies and children are preprogrammed overeaters and simply demand more sustinance from the minute they are born, than other children.

- Feeding babies bottlefed babies are more prone to being overfed than their breastfed colleagues, and children who are weaned to solids before five to six months are more at risk for being overweight for the same reasons.

- Diet - our modern diet is high in refined sugar, having a high concentration of simple carbohydrates. It is also rich in saturated animal fats and salt. These foods are tasty, cheap, easily available, over advertized, wirh a huge degree to choose from, making it suit our instant gratification, quick fix lifestyles. Up until recently, it has been difficult to buy convienience healthy food at garages, cafes and tuck shops.

- Lifestyle – Our modern technological lifestyle with the hugely stimulating dreaded triangle of Channel TV, playstation and computer games, has an effect of allowing children to spend hours a day with this sensory overloaded entertainment, together with it's appealing advertizing of food. My son tells me that it is a known fact that we use more energy sleeping than we do watching TV! Food is often associated with this form of entertainment – not longer just nutritional.

As parents ( working or not working ), it is often easier to allow the electronic age to entertain – we are simply too busy, tired and responsibility filled to have energy to interact meaningfully with our gifts from heaven. Add to this the huge struggle and gnashing of teeth when as a parent one comes between the child and it's screen!

So changing to healthier lifestyle patterns is not for sissies.

Exercise has played less of a role than in previous years, with sport at many schools not being compulsory, and parents often not supporting the teachers in encouraging participation when it is available. In the South Africa scenario, security concerns have kept us prisoners in our own homes, behind electric fences, isolating ourselves and our children more than ever before. Interestingly enough, we have less involvement with our extended families and communities than before, as cultures have been broken down in this urban setting

 

So, is it all doom and gloom?

The purpose of writing this article is to create awareness of what is happening in the lives of our children and the society in which we live, and allow us to become proactive in making creative choices for our households. Obesity is merely a physical symptom of a deeper underlying problem – we can not one day say we did not know !

 

Education regarding food

 

This message is aimed at all consumers – both children and adults.

 

Children are fortunately becoming the targets of education. Fitness tests are being introduced several times a term at certain schools. Tuck shops are no longer stocking fizzy and energy drinks, and are selling healthy food other than sweets, chips and chocolates. Some enlightened headmasters have insisted on this. Pick & Pay are sending dieticians to selected schools to educate staff and pupils about responsible eating methods, a campaign matched by what Jamie Oliver's work internationally – creating an awareness. Children have the knowledge to chose what foods to eat, read the nutritional labels on the packets and are taking responsibility for their own health – an amazing concept of empowerment.

 

Parents

 

This same awareness of food groups and their calories and fat percentage is so important in buying the food, so that the availablefood at home is nutrional and healthy particularly snacks and drinks – fizzy and energy drinks and neat fruit juiceare the biggest offenders in the beverage line while attempts should be made to drink skimmed or low fat milk - especially when mixing it with flavoured powders.

 

Emphasis on having plates of food divided into 3 main food groups: a half of the plate being vegetable, and a quarter each protein and starch. Attempts should be made in always having some protein with a carbohydrate meal ( jam sandwich, pasta ) : add some cheese or peanut butter to this – it prevents sugar rushes and assists absorbtion through the intestines. As do the low glycemic index ( GE ) carbohydrates – ie complex sugars such as fruits, seed loaf, brown rice and pasta's.

 

Portion sizes should be kept smaller – bite size pieces of wrappers chocolate – not entire bars, cooldrink now available to 500 mls now 1000 mls instead of former 340 ml and 200 ml sizes.

 

The food industry should self regulate before it becomes law to do so as in the tobacco industry. Health risk warnings on consumables would be advisable. I heard an interesting debate on the radio about taxing unhealthy food as tobacco and alcohol is at present – the times they are a changin'.

 

Lifestyle education

 

The aim here is to break down the cycle of unhealthy living, and replace it with creative choices. These changes are difficult, but are possible limiting the “dreaded triangle” to no more than 1 hour per day below the age of 2 and to have no routine television for children under this age is advised to parent groups in America. This can be linked in with a reward system for positive behaviour. I do believe that children need tools to equip themselves for this era, and exposure is certainly needed to develop these skills – but a balance is required. Children should develop their hand motor coordination, learning depth perception, use their muscles – ride, climb, swim, fall, swing, walk the dogs, build, hit a ball, stroll in the park, get out a bit more, use their imagination to play without passively being entertained, - yes, get back to the old fashioned stuff, communicate with mom and dad, share ideas, spend a little time listening and talking to your children.I get the sense that society is moving to participating rather than spectating.

 

As parents, we are chiefly responsible for these lifestyle changes. This takes huge commitment as a family – reidentifying the family lifestyle we have. Steve Covey's book on effective families deals with this resetting of the course.it's all about creating a balance in life, work, play and sleep – with a bit of healthy eating in between.

 

Homeopathic constitutional prescribing can greatly assist these individuals prone to weight gain and assist many of the associated behavioural issues simultaneously.