Mind what your child eats

Sirula, a chubby, shy, 9-year-old girl was out playing with her friends during break at school when she experienced an unfamiliar discomfort in her tummy. She rushed to the rest rooms, only to find her underclothes soaked in red. She couldn’t wait to get home and seek answers from her mum. Mum did not disappoint. She gave her a pep talk on what it meant to be a woman. Despite the conversation, Sirula did not realise then just how insufficient the talk was in preparing her for the transition to womanhood.

Nine years old? Yes, Sirula received her first period at nine years of age. She weighed 90 kilos yet she was only in class five. Her diet was not the problem, she ate regular, unprocessed home-made meals. The challenge was that she ate it in huge quantities. She ate from a bowl as a regular plate was not large enough! 

A few years later, shortly after she joined high school, Sirula was taken seriously ill. Her legs started swelling and changing colour, her whole body became puffy and she became fatigued all the time. Upon a review by the doctor, she was hospitalised for three months, missing out on an entire school term. She did not really know what was wrong with her, except that her blood pressure was abnormally high. She had no idea what that meant.

Sirula was only 14 years old by then. She was asked to watch her diet, avoid fatty foods and exercise. She was prescribed for some medications which the school nurse faithfully dispensed to her in school for months. Being in a boarding school with no control over the menu, she was sentenced to a special diet of potatoes, soup and rice while the rest of the students on a regular diet ate githeri, ugali, rice, beans and sukuma wiki.

The medication also came with its own burden of passing urine all the time. The alternative medications will less side effects were too expensive for her family to afford hence they were not always available. Sirula, either due to juvenile ignorance or teenage rebelliousness, continued to eat the same foods as before. By the time she was in university, she weighed a whopping 110 kilos.

Sirula may have carried around her burden for two decades but one day while in her third year of university, Sirula decided she had had enough. She was tired of lugging around the weight, the swollen legs, the constant fatigue and the daily medication. Something in her subconscious snapped and she made up her mind to lose the weight. 

She put on her jogging shoes and hit the track. She bid her big bowls farewell and changed her diet. In the background of skepticism and mockery from colleagues and friends, her steadfast determination held strong. There was no room for failure. A year down the line, she proudly stood at 50Kg less!

Sirula’s story may not be unique, but it represents a ubiquitous deficiency in health education. Children are under the care of their parents, caregivers, guardians and teachers. Their lifestyle choices are molded by their environment, society and cultural norms. Household pressures that affect their socio-economic status directly determine what the child eats, how the child dresses, where they sleep and what access they have to schools, recreation and healthcare.

Sirula suffered from childhood obesity, a condition in which a child is significantly overweight for his or her age and height. Physically, an overweight child may have excessive sweating, a double chin, have excess fat around the abdomen and waist. They may also binge eat, have shortness of breath and complain of excessive exhaustion after mild physical activity.

The causes of childhood obesity include high-calorie diets, a lack of exercise, family factors, psychological factors like depression and low self-esteem and socioeconomic factors that affect the child’s lifestyle choices. The obesity easily leads to physical complications such as diabetes, high blood pressure, high cholesterol and sleep disorders. Emotionally, childhood obesity can lead to bullying, low self-esteem, learning and behaviour problems and depression.

Treatment consists of improving the lifestyle of the entire family. One cannot purport to treat the child without addressing those who put food in the table. This is the best way to achieve a healthy weight in the child. The dietary modifications include a low carbohydrate and low-fat diet, with plenty of high-fibre foods and proper portion control. A nutritionist should be able to offer individualised meal plans.

Children should be encouraged to remain active, limit screen time and encourage outdoor fun physical engagements including team sports, swimming, excursions, walks and hikes. This keeps them both entertained and active and foster good interpersonal skills. Weight loss is gained when the child burns more energy than they are consuming. It takes the concerted effort of all to help them adjust better into adulthood without the mental and physical pressures that obesity brings.

As care providers, parents and guardians, we must be patient. The road to health takes time. Listen to your children. Remember they are children, not small adults. Be the parent or guardian or caregiver and offer direction, affirmation and direction.

Sirula is now a grown woman in her forties, living healthy after decades of physical and mental health challenges. Let her journey inspire you to make better choices today for you and your family!

Dr Bosire is an obstetrician/gynaecologist