Have you ever calculated the amount of sugar you consume in a day? According to a study conducted by the Food and Environmental Hygiene Department in 2014, 30% of the Hong Kong population consume more than 50 grams of sugar on a daily basis, 2 times higher than World Health Organization’s (WHO) most recent recommendation for sugar intake. Drinking a can of regular coke with 39 grams of sugar would bring you over the limit, not to mention hidden sources of added sugar in our diet, like the 4 grams of sugar in a tablespoon of ketchup!
What is the current situation in Hong Kong?
Increased consumption of processed foods and sedentary lifestyle have caused obesity, in particular childhood obesity, to emerge as one of our society’s major public health concerns. Referring to statistics published by the Center of Health Protection and Department of Health (DOH) in March 2015, roughly 20% of primary and secondary students are overweight and obese in 2013/14. The study also positively correlates the prevalence of childhood obesity to obese family members, sleep deprivation, skipped breakfasts, westernisation of diet and lack of physical activities.
What is childhood obesity?
Body mass index (BMI) is the most commonly used parameter to determine childhood obesity worldwide. BMI is calculated by dividing your weight (kg) by the square of your height (m). According to the Center for Disease Control, children with BMI over the 95th percentile are considered to be obese. In Hong Kong, the Student Health Service of the DOH screens children as obese when their body weight is 120% of median “weight for height” (see attached diagram). BMI is often criticised for its limitation concerning calculation of fat distribution and body composition, researchers have suggested waist circumference an alternative to better evaluate obesity and future cardiovascular risks.
Childhood obesity has long been linked to cardiovascular diseases, dyslipidemia, diabetes mellitus, osteoarthritis and other comorbid conditions. In addition, childhood obesity has been shown to have blunting effects on a child’s psychological, academic and social wellbeing. Low self-esteem and poor performance in school are common stress factors that may fuel eating and mental health disorders, thus further worsening the obesity epidemic. Moreover, childhood obesity often translates into higher risk of morbidity and mortality in adulthood, causing lifelong distress to affected individuals and their loved ones.
What are the available treatments?
Behavioural interventions like healthy dieting, regular aerobic exercise and adequate sleep have been proven to be effective when the changes are family- based. This should be considered as the first line treatment as it is the least invasive. Drugs prescribed to obese adults are also being considered as possible remedies for obese children. However, these drugs alter gut hormone activities, nutrient absorption and central nervous system activities. They have demonstrated considerable side effects in clinical studies and may be detrimental to the child during developmental years. For severe cases, bariatric surgery may be considered. Recent research suggests that surgical intervention can largely increase the health outcomes of childhood obesity and achieve sustained weight loss. That said, surgical intervention should not be seen as an easy way out. According to a research conducted on 300 adolescents who have undergone the surgical procedure, over half of the subjects experienced micronutrient deficiency and around one- tenth experienced surgical complications. Owing to the wide array of causes of childhood obesity, there is no uniform treatment for obesity. Treatments should be comprehensive, safe and tailored to the individual’s condition.
Written by: SS
Revised by: Professor Albert Li
References:
– http://www.chp.gov.hk/files/pdf/ncd_watch_mar2015.pdf
– http://www.chinadailyasia.com/…/20…/17/content_15204147.html
– http://www.who.int/medi…/…/releases/2015/sugar-guideline/en/
– http://www.lcsd.gov.hk/en/healthy/fitness/over.html
– https://www.cdc.gov/obesity/childhood/defining.html