Life Styling Our Kids-The Best Vaccination !

Over time we realise that apart from infections, the single most important cause for illness is poor lifestyles. Innumerable adult diseases are now linked to unhealthy lifestyle practices. Lifestyle habits take roots at a very young age and then become fixed onto adulthood. Inculcating healthy lifestyle practices is the biggest vaccination against all these diseases! Life style practices such as type of food eaten, sleep time, screen time and play time have huge effects on overall kid’s health. Here is a brief overview of the current situation and how we as paediatricians can make a huge difference.

Can We Measure a Child’s Life Style ?

As we know the various parameters of a child’s life that constitute their life style can be simply classed into EAT-PLAY-CONNECT. Eat – which deals with all the recommendations related to food. Play- Vigorous physical play and screen play. Connect- Connect with Nature, Connect with family and connect with self through meditation & sleep. In an attempt to quantify the life style practices of children and their adherence to the global recommendations a short survey was conducted, in May 2019, by PEOPLE TREE Hospitals, involving parents between ages of 2 yrs to 16 yrs. Survey designed to understand the practices of children around their food, play, screen time, sleep, nature time and family time. With reference to the recent WHO recommendations of life style in under fives and the American Academy of Pediatrics recommendations on sleep and screen time a scoring questionnaire was formulated and distributed to parents. Each answer was given a unique rating based on the compliance to the global recommendations set for children. A final score was generated as a percentage. A perfect score will be 100 % which means complete compliance to the recommendations, anything less needs to be worked on ! Amongst 383 responders the preliminary survey results show that there is only 70 % compliance to these recommendations.

What is the Current Problem?

A poor diet: Currently urban children’s diet mostly comprises fast foods and processed foods. They are constantly gorging on burgers, pizzas, sweets and carbonated drinks. We call them empty calories as they provide calories without any nutrients namely vitamins minerals and fibre Hence children of today are overfed but undernourished. A food predominantly made of empty calories is rightly called junk food. Such food is also very high in solid fats, sugar salt & preservatives all of which have long term negative health effects. Unfortunately “Mall”nutrition is the new malnutrition. Home food can also become junk if it has too much empty calories or processed elements high in solid fats salt, sugar or preservatives. Children are thus deprived of nutrition that a good diet of fresh, homemade foods, vegetables and fruits provides. Children are encouraged to eat 5 things on their plate- half their plate as fruit & vegetables, quarter grains preferably whole grains and quarter proteins especially from vegetarian sources and have 1 cup diary like curd every meal. Our survey showed 47% of responder’s kids did not have vegetables or fruits on a daily basis.

Lack of physical activity: Most children nowadays are not getting enough physical activity and the results are disastrous. Children spend most of their time hooked to their smartphones, playing games, watching TV or surfing the net. The rising rates of childhood obesity metabolic syndrome, hypertension, Vitamin deficiencies is the result.

Excess screen time -Easy availability of electronic gadgets like the television and video games mean children are spending countless hours in front of these gadgets and living a sedentary lifestyle. This leads to Obesity, Myopia, sleep disturbances and several behaviour issues. WHO recommends no screen time till 2 years of age and a maximum of 1 hour during child hood.* Our survey shows 82% default in preschool years, 61% in school age and 48 % during teens.

Compromised sleeping hours due to late bedtimes and need for waking early for school. About 13 hrs of sleep for pre-schoolers, 11 and 9 during school age and teenage years. Only about 50 % are compliant across the ages for recommended duration of sleep.

Nature Deprivation- Most children now are completely disconnected with nature, this is a serious deprivation of vitality in their lives, impacting their overall health. From vitamin deficiencies to behavioural and emotional disorders. We call this Vitamin N deficiency ! In our survey 73% of children did not get even one hour of nature time a day.

Limited Family Time- Lack of time, supervision & emotional support from parents due to busy life styles of parents does have a negative impact on their kids life styles. Only 62 % of kids get regular daily family time and only 38 % say they eat meals together as a family without any media distraction.

Effects of a poor Life Style in children ?

We had conducted health screening for over 5000 school children in 3 schools in Bengaluru for 2 consecutive years 2015 & 2016. We never realised the value of this venture until we analysed the data. The statistics are alarming. One in every 3 high school children was Overweight/Obese; Over quarter of them had eye problems; a third of them had dental caries a fifth of them had pallor suggesting anaemia. This screening program unearthed hidden malnutrition in these kids.

Problems include

Overweight and Obesity :Obesity during childhood can have a harmful effect on the body in a variety of ways. Children who have obesity are more likely to have high blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD), increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes, breathing problems, such as asthma and sleep apnea, joint problems and musculoskeletal discomfort and Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).

Diabetes & Metabolic Syndrome: Diabetes is a metabolic disease, in which increased blood glucose levels ultimately lead to damage to the eyes,kidneys and nerves.

Malnutrition & Nutritional deficiencies: This leads to recurrent infections and poor quality of life in children.

Eating disorders: Eating disorders can cause many dangerous medical and psychological illnesses in children.

Constipation: Chronic constipation may lead to complications like anal fissure,stool withholding and recurrent urinary tract infections.

Screen addictions, Gaming disorders: These lead to irregular sleep patterns,poor academic performance,behavioral issues in children

Behavioural, Emotional & Relationship problems:These include disruptive, depression, anxiety and pervasive developmental disorders.

Sleep difficulties: Poor sleep quality and/or quantity in children is associated with a host of problems, including academic, behavioral, developmental and social difficulties, weight abnormalities, and other health problems. It also impacts family dynamics and parental or sibling sleep.

We must make changes in our kids’ lives before this entire generation of children will be medicated! So, lets re look at our children’s lifestyles and set it right, to make them healthier and happier !

References
  1. WHO guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.
  2. American Academy of Pediatrics recommendations on Media use in children 2016
  3. Children and Adolescents and Digital Media PEDIATRICS Volume 138, number 5, November 2016: e 20162593
  4. U.S Department of Agriculture, ChooseMyPlate.gov Website Washington , DC, My Plate. http://www.choosemyplate.gov/MyPlate.accessed.Nov 10 2018
  5. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine Shalini Paruthi, MD; Lee J. Brooks, MD; Carolyn D’Ambrosio et al; Journal of Clinical Sleep Medicine, Vol. 12, No. 6, 2016
  6. The IDEFICS intervention trial to prevent childhood obesity: design and study methods., Pigeot I1,2, Baranowski T3, De Henauw S4; IDEFICS Intervention Study Group; IDEFICS consortium.. Obes Rev. 2015 Dec;16 Suppl 2:4-15
by

Dr Supraja Chandrasekar
MRCPCH Fellowship Critical Care, Chief Paediatrics
PEOPLE TREE Hospitals

Dr Sharmila Nayak
DNB, Fellowship Endocrinology, Paediatric Endocrinologist
PEOPLE TREE Hospitals