Obesity can be described as an imbalance between energy intake and expenditure such that excess energy is stored in fat cells, which enlarge or increase in number.

Childhood obesity has become a growing problem all around the world with a recorded 22 million children under the age of five being classified as overweight. This too has become increasingly evident in South Africa. The obesity levels of children have reached epidemic proportions and it can be estimated that 1 in 5 South African children are either overweight or obese, with 20% of that being under the age of six.

The National Household Food Consumption Survey reported that 17.1% of South African children between the ages of one and nine living in urban areas are overweight. The Primary Schools’ Anthropometric Survey and The Health of the Nation Study estimated an increase in overweight from 1.2% to 13% and in obesity from 0.2% to 3.3% over the period from 1994 to 2004.That number continues to increase during the past 10 years.

Although the country has moved into what they say is the final stage of nutrition transition, regarding the country’s decrease in the prevalence of undernutrition, the chronic overnourishment problem has now taken over and become a public health concern as stated by the 2012 South African National Health and Nutrition Examination Survey (NHANES-1).

The survey has documented a combined overweight and obesity prevalence of 13.5% for South African children aged 6-14 years. This is higher than the global prevalence of 10% in schoolchildren, but lower than current levels in the USA [18% for obesity and 32.6% for combined overweight and obesity in children aged 6-11 years (2009-2010)]

Obesity and overweight children are very prone to higher risks of fatal diseases and health problems that can have negative effects in the long run.

The physical effects:

Diabetes, coronary heart disease, hypertension, cancer, high cholesterol, sleep apnoea, sleeping problems, breathing problems, bone conditions such as weakening of the hips, gastro-intestinal diseases, and even the early onset of puberty.

The psychological implications:

Depression, eating disorders and poor self esteem resulting from poor body image issues.

So why are the country’s youth falling victim to the obesity epidemic?

South Africa has seen a great change in the past 20 years and has shifted the country into the modern era. These modern lifestyles, poor diets and lack of physical activity can be seen to contribute to the childhood problem of obesity and overweight. Yet these are just a few sides to the many on the obese coin being thrown into the air.

Safety has become a very noticeable problem as children are prevented from playing outside. They do not walk and cycle to school, relying on public transport and parents more. High-rise flats have become the standard in all major suburban areas that limit the space a child has to play and be active.

Regular physical activity has dwindled away and is viewed as a major contributing factor to obesity. Our modern children compared to their counterparts over 30 years ago have become lazy couch potatoes. By spending much less energy than ever before in front of TV, computer and cellphone screens instead of being outside playing. Countless hours spent in front of these screens allows their bodies to not be able to burn up as much energy as they should be doing.

What is more concerning is that schools used to be a place where children would be active through out the day but from the 2010 Healthy Active Kids South African (HAK) report card showed a decline in physical activity, physical education and an increase in sedentary time since the 2007 HAK report card. Less than 70 percent of high school pupils reported having regularly scheduled physical education and physical education classes. In disadvantaged primary schools this is even less. Physical education teachers and coaches in schools are not always adequately qualified for their roles, while others tend to focus on building winning teams and ignoring the children who are moderate achievers. In poorer schools, there is often a lack of sports infrastructure and resources.

So if children are not able to get the required physical activity at school they should be doing so at home but because this too is not happening children are falling victims to unhealthy and inactive lifestyles which breed the obese epidemic.

Diet goes hand in hand with exercise and physical activity. Research by UCT’s Medical Research Unit indicate that parents who are very strict when it comes to allowing children to make their own food choices is just as unproductive as being overly neglectful and allowing them to eat whatever they want. It boils down to parenting style and as parents they should make proper, informed and healthy decisions when it comes to balanced meals and diets for their children.

Many South African children are also consuming highly processed foods either out of convenience or simply because their parents don’t know any better. For disadvantaged families, the greatest challenge is how to get access to healthy food for their children with a limited budget. Therefore in many cases the cheaper option is the unhealthier option and processed foods end up in the shopping basket rather than fruit and vegetables.

Some parent’s work long hours in a week, don’t have much time to cook meals and this contributes to children opting for fast food and quick meals to eat instead of wholesome and healthy ones. South Africa has undergone increased urbanization and has now more association with the adoption of a more westernized diet, which is higher in fat and has less carbohydrate and fibre than a traditional diet. All of this contributes to the growing obesity epidemic.

Parents should also opt to make packed healthy lunches for school instead of just handing over a twenty-buck note and allowing their children to buy food from the tuck shop. According to the 2010 HAK report card nearly 45% of adolescents surveyed often buy from the school tuck shop, with more than one in five buying sweets, chocolates and crisps.

If parents and schools come together by enforcing rules at home for TV viewing and computer game playing, establishing more physical education programs at school, and incorporating healthy diets for their children the problem of obesity can be controlled. By developing the underlying foundations of a healthy lifestyle during childhood it will in turn reflect in adult health and quality of life. Parents should be implementing good ways to help their children fight the obese monster and give them a better quality of life.

Could it be in your genes?

Many researchers believe that most people have inherited genes that predispose them to storing fat and are what leads them to being obese. There are rare mutations in a gene that appear to have associations with slow metabolism and may explain why some young children become obese. Although this gene mutation only presents itself in about 2% of people with obesity but when it begins in early childhood, before ten years of age, its worth looking into potential genetic causes that play a role in some forms of obesity. A UCLA study also found that body-fat responses are determined largely by genetic factors and are linked to DNA.

During a two-year study, researchers measured obesity traits in response to a high-fat, high-sugar diet in more than 100 inbred strains of mice. They identified 11 genome-wide “regions” associated with obesity and fat gain due to high-fat, high-sugar intake. Several identified regions overlap with genes identified in human studies.The results are consistent with the inheritance of body mass index (BMI) and obesity in humans.