Fast food promotes childhood obesity
By Wasundara Rathnaweera
According to the Sri Lanka Demographic and Health Survey (SLDHS)
2006/07, obesity and over-weight prevalence among children under five
years was 1.6 percent, with the highest prevalence in urban and estate
sectors. Though recent data covering the whole country is not available
since 2007, many studies support the fact that the incidence rate is
increasing at an alarming rate.
World Health Organisation (WHO) has revealed the globally estimated
number of overweight children under the age of five in 2010 is more than
What is childhood obesity?
Truly, obesity is one kind of malnutrition. Malnutrition is simply
the improper nutrition and refers to under and over nutrition. WHO
defines overweight and obesity as "abnormal or excessive fat
accumulation in the body that adds a health risk", which can merely be
identified as over-nutrition. However, determination of child and
adolescent obesity is not that simple as in adults due to number of
physiological changes and continuous growth of their bodies.
Biologically, a child is a human between the stages of birth and
puberty. WHO Child Growth Standard Charts, CDC Growth Reference Charts
are some widely used methods to assess their nutritional status.
They are either population based Z-score or percentile charts, which
have been specifically developed with specific indicators in assessing
Weight-for-age, Height-for-age, Weight-for-height and BMI (Body Mass
Index)-for-age are the basic indicators used in assessing child
nutritional status. Cut-off value greater than +1SD (+1 Standard
Deviation from the mean value of the population)of BMI-for-agein both
sexes classifies as over-weight and cut-off value greater than +2SD of
BMI-for-age classifies as obese in children.
"At least 2.6 million people across the world die each year, as a
result of being overweight or obese". This statement stresses the danger
of obesity. Therefore, the consequences of childhood obesity are not
simple, as it is linked with a greater risk of early death and many
serious disabilities or diseases in adulthood.
Overweight and obese children are more likely to step in to their
adulthood as obese and there is a high possibility of developing some
life threatening non communicable diseases (NCDs) such as diabetes and
cardiovascular diseases at a younger age.
The age of onset and the duration of obesity are two major factors
which determine the risk of NCDs. Therefore it is obvious that obese
individuals who have continued their obesity from childhood are at a
higher risk than those who develop obesity in late life.
WHO states that the most significant health related bad outcomes of
childhood overweight and obesity are cardiovascular diseases (mainly
heart disease and stroke), type 2 diabetes mellitus (T2DM),
musculoskeletal disorders, especially osteoarthritis, and certain types
of cancer (endometrial, breast and colon).
Due to obesity condition, body cells lose the sensitivity to insulin
hormone, which is responsible for maintenance of blood glucose, hence
develop insulin resistance. As a result of this, body cells fail to
uptake glucose from blood stream leading to elevated blood glucose
levels. This can ultimately lead to many serious NCDs such as type 2
diabetes, cardiovascular diseases and cancer.
What are the causes?
The prime cause of overweight and obesity is the positive energy
balance,which occurs as a result of excessive calorie (energy) intake
than calorie expenditure. Two major factors can be identified as reasons
attributable to global increases in childhood overweight and obesity.
Unhealthy diets: Increased consumption of energy-dense foods which
are high in fats and sugars but low in vital micro nutrients (vitamins
and minerals). These foods are known as "Empty Calorie" foods.
Physical inactivity: Decreased physical activity levels due to busy
lifestyles, sedentary nature of recreational activities, increasing
facilities in transportation and urbanisation.
What is the role of "Fast Foods" in obesity?
"Fast food" is the term given to food that can be prepared and served
quickly. Pizza, burgers, French fries and other short-eats like
pastries, roles, and buns are some common examples for fast foods. These
foods are also known as "Junk foods". Fast foods were first popularised
in the 1950s in the United States and are now spread all over the world.
They are popular among children due to many reasons. The notable reason
for being popular among children is that the taste of these fast foods.
Furthermore, they are instant and economical in most restaurants. When
considering the nutritional content of these fast foods, they are
reported to be energy dense up to 65% more than an average diet. Though
these foods are high in calorie content, they are not rich sources of
vital nutrients; specially in vitamins and minerals, and also poor
sources of dietary fiber. High amounts of salt, sugar, and fat;
particularly saturated fats in these food items are also being widely
Unhealthy 'Industrially Produced Trans Fatty Acids' (IPTFAs) are
found in many varieties of food from fast food outlets and takeaways;
mostly occur as a result of the food frying in hydrogenated vegetable
oils such as margarine.
The repeated reheating and cooling process of frying oils result in
chemical changes within the oil increasing the levels of trans fats, and
it is proven that some amount of fat can be converted into trans fatty
acids through the deep frying process over longer periods with initially
IPTFA-free vegetable oils.
These fast food products give less feeling of satiate due to low
amounts of dietary fiber, inspiring the consumer to eat more(Dietary
fiber adds bulk to the foods and gives the feeling of fullness or
satiety very quickly. Therefore, fiber rich foods can limit the food
intake, hence calorie intake). Furthermore, their high salt content
makes children thirsty, resulting in consuming more sweetened soft
Due to the increased trend of consuming fast food items by children,
numerous health impacts have been raised. High amounts of calories, fat
and sugar in these food items are directly linked with obesity.
Obesity can be identified as the preliminary step of a series of
dangerous health defects which are linked together. Owing to high
amounts of fats and sugar, and low amounts of dietary fiber, these foods
have become calorie dense foods.
Excessive intake of calories can be deposited in the body as fat, if
they are not expended via physical activity. This scenario is known as
the positive energy balance, which ultimately results obesity
conditions. The danger is that children tend to eat more, due to their
less satiety feeling and also the taste of these foods are preferred by
children. On the other hand modern children spend a very sedentary life
with no or less time spending for sports or any physical exercises. Due
to high consumption of fast foods and less physical activity, they are
unable to spend the ingested energy, thus it is more likely to
accumulate energy in their bodies, resulting over-weight or obesity.
Abnormal lipid profiles, high blood glucose levels and elevated blood
pressure are obvious but unfavourable conditions in obesity.
Furthermore, fast foods are rich in saturated fats plus cholesterol,
which are unhealthy in excessive amounts.
They tend to be deposited in blood vessels and obstruct the vessels,
which ultimately results in cardiovascular diseases, leading to heart
attacks or stroke. Trans fatty acids are extremely dangerous in elevated
amounts as they can cause many types of cancers.
High content of sugar and insulin resistance of body cells due to
obesity conditions may lead to type 2 diabetes mellitus in later life.
High salt content of these food items leads children to be
hypertensive (High blood pressure). The most dangerous consequence is
that these non-communicable diseases are long-lasting and life
What can be done to avoid obesity?
Since childhood obesity is becoming an epidemic, immediate action
should be taken to defeat it. Parents are the key persons in the battle
against child obesity. Really it is not a difficult task if you are
willing to take the challenge.
Parents should promote healthy eating patterns within the family and
encourage children to engage in regular, adequate physical activity.
Children can be given home-made healthy and well-balanced meals which
contain all the food groups adequately.
For instance, child's diet can include cereal or cereal based
products (rice, bread, roti), vegetables, fruits, legumes (dhal, chick
pea), source of protein like fish, meat or eggs (vegetarian children can
be given legumes like soy, dhal as their protein source, but best is
animal proteins), and dairy products like milk, yoghurt adequately,
while they can be given sweets and fats sparingly.
It is not necessary to give these all food groups within one meal,
but you should be able to balance all the food groups adequately in your
child's meals within a day. You can easily go for home prepared healthy
snacks like sandwich with omelet and vegetables or pancakes with fried
vegetable mix which are prepared in an acceptable way by the child,
instead of going for fast food snacks.
Consumption of fruits and vegetables can be promoted within your
family and better to try various preparation methods to avoid rejection
by the children.
Same time energy dense, high fat, salty and sugary food items (fast
foods, sweetened beverages) can be restricted in your child's diet.
Minimise saturated fats which are abundant mostly in animal meats. It is
better to go for white colour meats like poultry (mostly chicken) after
removing fat rich skin, instead of eating red colour meats like beef.
You can reduce fat intake by removing skin of chicken. But in red meats,
fat is not concentrated to skin or any specific organ which can be
removed; consequently you will eat high amount of saturated fat with red
meat. But fish would be a more healthy choice as a protein source,
particularly fatty fish like salmon, tuna, trout and herrings as they
are also rich sources of healthy fatty acids like omega 3fatty acids.
Moreover it is important to emphasize drinking adequate amount of water
to be healthy.
Apart from the dietary alterations, you can encourage your child to
do physical activity; either they can engage in sports in their school
or parents can give them opportunity to do safe cycling, walking or any
other play events at their home.
It is important to reduce inactive time of the children, specially
the time they spend in front of the television or computer.
More importantly, your child can be educated on importance of proper
nutrition and selecting healthy food choices as they grow.
These are some easy tips to keep your child healthy. Though the fast
foods have negative effects on your child's health, those can not be
totally banned or avoided as sometimes these foods are really beneficial
to busy lifestyles.
However, the Government can introduce some rules and regulations to
make available healthy foods which are low in fat, salt and sugar,
instead of currently available fast foods.
Still your child can enjoy these food items occasionally if your
choice is wise and smart. It is all our responsibility to protect our
children as they are the future of our country and its work force.
(The writer is a final year undergraduate at the Department of
Applied Nutrition, Faculty of Livestock, Fisheries & Nutrition at the
Wayamba University of Sri Lanka)