Childhood obesity, once considered a problem for high-income countries, is now emerging as a serious public health concern in developing nations like Kenya. 

With lifestyles rapidly changing and access to processed foods increasing, parenting in the era of rising childhood obesity has become more challenging than ever.  

One subtle, but significant factor contributing to the problem is the culture of rewarding children with sugary treats.

From chocolate for good grades to ice cream after completing a school project and superhero-themed birthday cakes, such habits, though well-intentioned, are shaping unhealthy food preferences and normalising excessive sugar consumption.  

Affluence too is a contributor 

“Unhealthy diets that are high in fats and sugars and low in vegetables and fruits are the key causes and contributors of overweight and obesity in children. In addition, children are eating bigger portion sizes that are too big for their age,” says Dr MaryJoy Kaimuri, Lecturer & Dean, School of Nursing, Meru University of Science and Technology. 

Characterised by the abnormal or excessive accumulation of fat that harms a child’s health, obesity is increasingly being reported across urban and rural areas, signalling a troubling trend. 

However, according to Kabii Thuo, an author and social researcher with an interest in expressed human behaviour, the most obese society in the world is also the most affluent and advanced in most spheres of life.

The reason is that affluence comes with a social-cultural change, and food habits feature prominently. 

Different generations are affected differently 

This notion of affluence is actually borrowed from societies that have developed food cultures and habits leading to obesity.

This means our problems are not inherently ours, but culturally transferred from the very societies we regard as trendsetters.  

“That is how unhealthy and actually obviously unwise food habits have been able to replace otherwise healthy food that comes with minimal health consequences,” says Thuo. 

According to Thuo, a glance at obesity problems across generations indicates a pattern of deteriorating health problems from one generation to the next because of the shifting causes and consequences;  for instance, obesity due to healthy food is very different from obesity resulting from highly processed foods containing high proportions of sugar, fats and salts.

Same problem, but glaringly different impact on the overall well-being of children. 

Lack of secure playing spaces 

Physical inactivity is another driver of overweight and obesity in children, mainly due to increasing sedentary lifestyles that have extended to recreational activities.

For instance, increased screen time, few or no extra-curricular activities in schools, lack of play areas in some of our schools, urban developments that have no consideration for play areas for children etc.  

Before, children used to play till darkness, but today social dynamics have allowed that darkness to arrive even when the sun is at its noon intensity.

Because of lack of secure spaces, even parents who understand the value of play for children would rather deal with the differentiated consequences than risk their safety. 

“Safe and secure playing spaces are often costly and far from home, adding a cost and convenience angle that is an obvious hurdle for many parents,” adds Thuo. 

Healthy balanced diet 

Genetics do also play a role in childhood obesity: if the parents are obese or there is a family history of obesity, then this can also predispose the child to the same. 

“Prevention and health promotion activities are the best interventions to curb overweight and obesity in our children. Consistent interventions that are in-built within the life and activities the child is involved in are the most sustainable going into adulthood,” says Dr.Kaimuri. 

Such interventions include a healthy, balanced diet focusing on the right portion sizes for the age of child.

A basic guide is that half of the plate of the child should be fruits and vegetables (will give vitamins and other micronutrients), a quarter should be the carbohydrates/ starches (energy-giving foods), and the other quarter is proteins such as meats, cereals/legumes (body-building food).

Further, the foods should be whole foods, limiting the highly processed foods and increasing consumption of fruits and vegetables.  

Be deliberate 

She urges parents/caregivers to be very deliberate about their children’s feeding practices and patterns right from infancy and across all the phases of growth.

Working with nutritionists for meal planning for children who are already overweight and obese is vital to ensure loss of weight in a healthy and sustainable way.

Other health care professionals might be involved in the management of such children. 

“We are seeing a lot of increase in the screen time for children, where the children spend most of their day watching TV, on the mobile/tablet, playing video games and very little time spent on anything else. Limiting screen time to less than 2 hours per day is the recommendation by the World Health Organisation. The children should be out playing, not glued to the screen the whole day,” she adds. 

Exposure to NCDs 

Are there early signs that a child is at risk of obesity, and how should parents respond?

Dr Kaimuri says that higher weight for age during the regular well baby clinics, especially during the first year of life, a child that is overweight compared to their height and age, shortness of breath during physical activity and when performing activities of daily living like showering, and complaints of joint pain with the back and knees being mostly affected. 

“The key recommendation is whole foods such as beans, green grams, locally available vegetables, fruits that are in season, adopting traditional foods that are nutritious and whole,” she adds. 

The bad side of childhood obesity, according to Dr Kaimuri, is that children who are overweight and obese are likely to stay obese into adulthood, which predisposes them to non-communicable diseases such as high blood pressure, diabetes, and heart disease, among others.