Across the world, the waistlines of children and adolescents are expanding alarmingly, making obesity among the young one of the most serious health challenges of the 21st century. In 2016, the World Health Organisation (WHO) estimated that the number of overweight children under the age of five was over 41 million.

Consequences of childhood obesity

A recent study in 2017 by the Health Promotion Board (HPB) has found that seven in 10 children who are overweight at seven years of age will remain overweight well into their adult years. This puts them at greater risk of developing life-threatening cardiovascular diseases and diabetes. Childhood obesity can also cause problems related to low self-esteem and depression.

Ms Ethel Lim, Dietitian, Nutrition and Dietetics Department at KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group, emphasises that weight issues can have emotional as well as social consequences in children, “They may be teased by other kids about their weight and become overly self-conscious.”

Obesity in Singaporean kids

In Singapore, like in other parts of the world, obesity among children and adolescents has increased tenfold over the past 40 years. In 2016, the obesity rate among school-going children in Singapore stands at 12%, and is continuing to rise.

Since obesity in children is largely due to excessive calorie consumption and inadequate physical exercise, Ms Lim says it is crucial that parents help their children develop positive eating habits. Sometimes, parents lack the necessary nutritional knowledge and are obese themselves. Consulting a dietitian could benefit the health of the whole family.

A nutritious and balanced diet is all the more important for children as they not only need nutrition for day to day activities, but also for growth and development. Just like adults, children 2 years old and above need to consume a variety of healthy foods, including lean meats, low-fat dairy products, whole grains, fruits and vegetables, while keeping fats and sugar to a minimum. However, Ms Lim emphasises, it is important to allow children small amounts of their favourite foods once or twice a week, so they don’t feel deprived.

Tips for parents to prevent obesity in kids

Ms Lim suggests that parents:

• Be active role models to the children by making healthful food and beverage choices.
• Make eating together at the dining table a priority. Eating in front of the TV is distracting and can lead to overeating.
• Encourage regular meals, including breakfast, since a child who skips meals tends to snack more. Avoid frequent food nibbling or 'grazing', especially after school.
• Suggest their kids drink water instead of sugary drinks to quench their thirst.
• Put emphasis on greater physical activity and outdoor play.

Mr Micheal Lim, Head and Senior Clinical Exercise Physiologist at the Sports Medicine Programme, KK Women’s and Children’s Hospital​ (KKH), a member of the SingHealth​ group, recommends that children should aim to accumulate 60 minutes of moderate to vigorous intensity physical activity daily to keep them healthy.

Children should be encouraged to engage in a wide range of physical activities, including both unstructured and structured activities, throughout the day. Unstructured activities are brief, unplanned and usually not directed or supervised by an adult. Activities can be incorporated into children’s lifestyle by getting them to help out with household chores, walking to school and using the stairs. For younger children, unstructured activities can include 'active free play' such as playing at the playground, playing ball games, and playing tag with their friends. These activities enhance children’s enjoyment for movement and can contribute to their overall physical and social development.

Structured physical activities are planned, and usually intended or supported by an informed adult. When performed and sustained at a moderate-vigorous intensity, it can provide long-term fitness and health enhancing benefits. These can include activities such as jogging, swimming and cycling.

Playing sports activities including basketball, soccer, netball, badminton, is a fun way to engage children to be more physically active. Participating in sporting activities together can also improve bonding within the family, and as an active role model, encourages and motivates the child to sustain an active lifestyle. “However, it is important to find out the child’s interest before deciding on the type of activity or sports. Exercise should be fun and he or she must enjoy it before benefiting from it,” Mr Lim says.

Besides encouraging the child to be more active, parents should aim to reduce time spent on sedentary activities. If the child is glued to his or her computer or gaming console, try to impose limits and aim to reduce recreational screen time to less than 2 hours a day.

Parents can replace some sedentary gaming time with active gaming such as playing Wii and Kinect, but these should not be used as a surrogate for participation in sports and recreational activities. Parents should also limit prolonged sitting over extended periods. Encourage regular active breaks between study or screen time.

Inadequate sleep can affect the child’s energy level during the awake hours, resulting in poor attention and focus in school, and lack of energy to be physically active. This can affect their academic performance, lead to weight gain and have a significant impact on their long-term health. Children between the ages of 5-17 years should be encouraged to get 8-11 hours of uninterrupted sleep each day.

Tips for parents to improve children’s physical activity levels

Mr Lim suggests that parents:

• Set realistic targets for their children.
• Work with their children as a team. Find out what activities they enjoy. Discuss and set realistic goals to increase their activity levels progressively.
• Be an active role model for their children. Make physical activity a part of the family’s routine.
• Use pedometers (step counters) or wearable devices to monitor daily activity. Create fun activity challenges within the family to see who can accumulate the most steps in a week or month.

In summary, staying physically active, reducing sedentary activities, having adequate sleep, together with small but permanent changes in eating habits, can go a long way towards maintaining a healthy weight.

Ref: N18