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National Childhood Disability Awareness Lecture

National Childhood Disability Awareness Lecture



As September is a National Childhood Disability Awareness Month, here is one lecture for the same. So far for Indian Population this is the first lecture ever.

As September is a National Childhood Disability Awareness Month, here is one lecture for the same. So far for Indian Population this is the first lecture ever.



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    National Childhood Disability Awareness Lecture National Childhood Disability Awareness Lecture Presentation Transcript

    • Welcome, friends! Childhood Obesity Awareness Gayatri Ajay Upadhyay Physiotherapist
    • How many of you have increased salivation seeing this? 9/30/2013Gayatri Ajay Upadhyay 2 If this is you, think of kids!!!
    • Is this your child? Are you worried? SEPTEMBER - MONTH OF CHILDHOOD OBESITY AWARENESS 9/30/2013Gayatri Ajay Upadhyay 3
    • • The World Health Organization (WHO) has labelled childhood obesity as the most serious public health problem of the twenty first century. • There has been a dramatic increase in childhood obesity in the past couple of decades. 9/30/2013Gayatri Ajay Upadhyay 4
    • Introduction  Obesity is a major public health problem across the world.  Obesity results from excessive caloric intake, decreased energy expenditure and/or from a combination of the two. 9/30/2013Gayatri Ajay Upadhyay 5
    • Prevalence of Childhood Obesity in India • Do you know the number of children who are obese in India? • One in four school children in Indian metros is overweight. • One in six in non-metro cities. • Around 20% of children show signs of obesity. 9/30/2013Gayatri Ajay Upadhyay 6
    • • Obesity higher in kids from North India. • Karnataka has 24.6% underweight schoolchildren, according to a nationwide health and fitness survey. 9/30/2013Gayatri Ajay Upadhyay 7
    • Latest Survey in India • The survey threw up some worrisome findings: • One in two children is not fit enough to compete in sports as he/she lacks the desired flexibility, body strength or explosive power. • Also, 39.2% of the children do not have the right BMI. 9/30/2013Gayatri Ajay Upadhyay 8
    • Is your child suffering from childhood obesity? • Indians in general believe in being 'healthy' and take pride in it. • English people and Indian people have different notions when it comes to the term HEALTHY • According to the Oxford Dictionary, 'Healthy' is defined as 'the state of being free from illness or injury'. • The Indian definition is also the same, but the difference is that the lines between 'healthy' and 'obese' are so blurred that they are considered one and the same. • What most people don't get is the fact that 'healthy' and 'obese' are not the same, and that obesity leads to health decline. 9/30/2013Gayatri Ajay Upadhyay 9
    • • What is more alarming is the fact that parents are delusional and keep calling an obese child 'healthy'. • According to a renowned nutritionist "This is highly dangerous as it makes the child believe that his/her current way of living and over-consumption is normal." • Over showering of love in the form of food tends to make a child obese. 9/30/2013Gayatri Ajay Upadhyay 10
    • What is childhood obesity? • As per definition, 20 per cent excess in the calculated ideal weight for age, sex and height of a child is defined as obesity. • If a child has excess of accumulated fat in his/her body, then the child is said to be obese. 9/30/2013Gayatri Ajay Upadhyay 11
    • Why is it a threat? • The main reason why childhood obesity is on high alert is due to the problems that it leads to. • Obese children have a higher risk of developing diabetes, cardio-vascular problems, obstructive sleep apnoea, orthopaedic and psychosocial problems. • "Consider it a ticking time bomb!!!“ • Research shows that children who are fed with junk food have lower IQ than their counterparts who eat nutritious food. • Besides increasing risk of other diseases, junk food decreases your child's efficiency. 9/30/2013Gayatri Ajay Upadhyay 12
    • World Health Organization (WHO) definitions for obesity BMI = Weight kg/Height m² • Morbidly obese (Grade III): 40 or above BMI • Super obese (Grade IV): BMI >50 9/30/2013Gayatri Ajay Upadhyay 13
    • What is junk food? • A diet low on nutrients and high in salt, sugar and fat is commonly referred to as junk food. • It is dangerous for health, as it lacks nutrition and is loaded with only calories (refined carbohydrates) 9/30/2013Gayatri Ajay Upadhyay 14
    • Environment & Physiology of Gaining wt. • Older environments: an unreliable food supply & high need for physical activity to procure food to survive. • No logical reason for humans to develop a strong physiological defense against weight gain. • The weak physiological regulation of energy balance was effective. • Today’s environment provides a constant supply of high energy food with reduced needs for physical activity. 9/30/2013Gayatri Ajay Upadhyay 15
    • Remarkably Short History for Caloric Beverages: Might the Absence of Compensation Relate to This Historical Evolution? AD BCE 10000BCE 200000BCE Beginning ofTime 100000 BCE 200000 BCE Homo Sapiens Pre-HomoSapiens 200,000BCE-10,000BCE OriginofHumans ModernBeverageEra 10,000BCE-present 0 Earliest possible date Definite date Water, Breast Milk 2000 BCE Milk (9000 BCE) Beer (4000 BCE) Wine (5400 BCE)Wine, Beer, Juice (8000 BCE) (206 AD) Tea (500 BCE) Brandy Distilled (1000-1500) Coffee (1300-1500) Lemonade (1500-1600) Liquor (1700-1800) Carbonation (1760-70) Pasteurization (1860-64) Coca Cola (1886) US Milk Intake 45 gal/capita (1945) Juice Concentrates (1945) US Coffee Intake 46 gal/capita (1946) US Soda Intake 52/gal/capita (2004) 9/30/2013Gayatri Ajay Upadhyay 16
    • How has the obesity epidemic arisen? • Most of the Affluent population has been in slight positive energy balance over the past 10-15 years. • Gradual weight gain of up to 1 kg/month, can be produced by a very small degree of positive energy balance of 50 kcal/day. • Decreased physical activity as technology & urbanization promotes sedentary life style 9/30/2013Gayatri Ajay Upadhyay 17
    • Obesity: Environmental Influence Current environment Past environment Genetic susceptibility BMI% 9/30/2013Gayatri Ajay Upadhyay 18
    • Built environment • Includes transportation systems, architectural design, use of land, parks, and public spaces. • Life style discourages physical activity & encourage automobile use • Neighborhoods without sidewalks - discourage walking. • Tall buildings discourage stair case & encourage elevator and escalator use 9/30/2013Gayatri Ajay Upadhyay 19
    • Commercial environment • Low cost junk food available everywhere - heavily advertised especially to children. • The effects increase manifold when celebrities endorse such products. • Many schools have vending machines & fast food outlets. • Heavy promotion of activities and products that discourage physical activity. • Sedentary forms of entertainment e.g. Home entertainment systems, etc 9/30/2013Gayatri Ajay Upadhyay 20
    • Environment factors that promote overeating • Availability of fast food & snacks • Easy accessibility • Low Cost • Good taste • Big Portion Size • High Fat Content • Energy Dense soft Drinks 9/30/2013Gayatri Ajay Upadhyay 21
    • Environmental factors that reduce physical activity Technological advances reduce need for physical activity • For daily living and household activities • In schools • Competition from attractive sedentary activities: • television, video/DVD, video/computer games, internet 9/30/2013Gayatri Ajay Upadhyay 22
    • In 1980s, more than 50 percent of students were eating green vegetables “nearly every day or more.” But by 2000, that figure had dropped to about 30 percent. From the statistical sourcebook “A Nation at Risk: Obesity in the United States.”
    • By 2000, even the milk consumption decreased by almost 40% percent in children ages 6-11, while consumption of fruit juice rose 55 percent, fruit drink consumption rose 70 percent and consumption of carbonated soda rose 150 percent.
    • In 1970, about 25 percent of total food spending occurred in restaurants. By 2000, 40 percent of food money were spent away from home.
    • The number of fast-food outlets in India is also on a huge rise!!!
    • Lack of public information • Some people can not judge which products are high in fat and by how much. • Food manufacturers display macronutrients in grams, when the correct way would be to express their contribution in energy. 9/30/2013Gayatri Ajay Upadhyay 27
    • Children eat nearly twice as many calories (770) at restaurants as they do during a meal at home (420).
    • According to a national study, 92 percent of schools do not provide daily physical education classes for all students throughout the entire school year.
    • Statistics from the recent survey throughout India are alarming. Around 20% of children show signs of obesity.
    • Why children are physically inactive? • Lack of awareness regarding the of physical activity for health fitness and prevention of diseases • Social values and traditions regarding physical exercise (women, restriction). • Non-availability public places suitable for physical activity (walking and cycling path, gymnasium). • Modernization of life that reduce physical activity (sedentary life, TV, Computers, cars). 9/30/2013Gayatri Ajay Upadhyay 31
    • Six out of 10 children ages 9-13 don’t participate in any kind of organized sports/physical activity program outside of school, and children whose parents have lower incomes and education levels are even less likely to participate. Nearly 23 percent don’t engage in any free-time physical activity.
    • Lack of public information • Advertising gives children confused messages about nutrition, and can change their food preferences and buying behaviour. • Subsidies on food products play an important part, as children as well as adults, are influenced by cheap prices. 9/30/2013Gayatri Ajay Upadhyay 33
    • The typical Indian child spends about 45 hours per week using media outside of school.
    • Tackling Obesity The WHO’s 1997 interim report argues that it is not enough to tackle obesity at individual level and that a society-wide public health approach needs to be employed. • Medical profession should work with the food industry to promote a healthier diet for everyone from childhood to adult life. • Management of obesity in Primary Care by a motivated well-informed multi- disciplinary team could achieve and maintain weight loss by promoting sustainable changes in lifestyle. 9/30/2013Gayatri Ajay Upadhyay 35
    • GOALS OF PROGRAM Policy components:  Choosing a strategy to change the environment  Behavior changes - Best to Begin with small changes Outcome Objectives:  Primary prevention of weight gain  Prevention of further weight gain  Weight loss  Prevention of weight regain 9/30/2013Gayatri Ajay Upadhyay 37
    • National policy • Controlling food inports & food labelling • Improving facilities for sports and making the streets safe for walking or cycling • Education programmes for all, directed towards promoting healthy lifestyles and explaining the risks associated with obesity. 9/30/2013Gayatri Ajay Upadhyay 38
    • Management 39 • Prevention is the Key • Team work • Individualized goal of weight loss • Components: • Education & motivation • Diet modification • Increased activity • Parents are role models • Medicines & surgery 9/30/2013Gayatri Ajay Upadhyay
    • Educate & Motivate Children • Public support for healthier lifestyles needs to begin with our children. • Teach early - why physical activity and healthy eating are so important. • Provide them with the knowledge and the cognitive skills to manage energy balance in the modern environment. 9/30/2013Gayatri Ajay Upadhyay 40
    • Education points to address • Resist temptation to always clean your plate • Do not eat while talking on the phone or watching TV • Avoid appetizer and dessert in restaurants • Eat a healthy snack before going to a holiday party so you will feel full 9/30/2013Gayatri Ajay Upadhyay 41
    • Your Eating Habits • Small, frequent meals at regularly scheduled times • Regularly scheduled snacks of fruit or vegetables • Do not skip meals • No foods are off limits however in order to encourage success moderation is the key 9/30/2013Gayatri Ajay Upadhyay 42
    • WHO guidelines for recommended dietary allowances *Maximum 1% energy from Trans fat (2-2.5gm/day) *Less than 10% energy from free sugar *Fats: 15% - 30% of total calories *Carbohydrates: 55-75% of total calories *Proteins: 10- 15% of total calories *Sugar: 20-25 gm/day added sugar *Salt: 5-6 gm/day 9/30/2013Gayatri Ajay Upadhyay 43
    • Suggestions by IAP's task force *Banning availability and accessibility of junk food in schools and within 300 metres radius *Banning commercials promoting junk foods (TV, print media and online ads) at least before 9pm *Advertising Standards Council of India needs to make more stringent measures on junk food ads *Inclusion of compulsory daily physical activity of around 60 minutes in the school time table *Celebrities concerned may come out in support of the cause by refusing to endorse such brands like in case of alcohol and cigarettes *Celebrities could also showcase their own lifestyle to promote healthy habits *Food Standards & Safety Regulations of India (FSSAI) should also include 1. Regulations to reduce salt, sugar and fats in junk foods; 2. Change labelling rules for Trans fat, sugar and salt and making them mandatory for any food product 9/30/2013Gayatri Ajay Upadhyay 44
    • Regulations on junk food around the world *In Britain, availability of a variety of fresh fruits is mandatory in school canteens. The only drinks available would be bottled water, low fat milk, pure fruit juices, yogurt and milk drinks with sugars less than 5% *The former governor of California, Arnold Schwarzenegger had signed a bill banning the sale of sodas in schools and set fat, sugar and calorie standards of all foods. In school vending machines, yogurt, nuts and milk have replaced candy bars, chips and colas *Disney announced in January 2013 that it was banning junk food ads aimed at kids on its TV networks 9/30/2013Gayatri Ajay Upadhyay 45
    • *Australian Association of National Advertisers (AANA) has introduced AANA Food and Beverage Code and AANA Children's Code dealing with advertising or marketing communications in any media directed primarily at persons 14 years of age or younger *Countries where there total ban on ads on junk food has been implemented include Sweden, Norway, Ireland and Quebec province of Canada *Study in Quebec, where fast food advertising geared specifically towards children has been banned both online and in print for the last 32 years, has shown that the province has the least childhood obesity in Canada, and the ban decreased children's consumption by an estimated two or four billion calories 9/30/2013Gayatri Ajay Upadhyay 46
    • Portion Sizes • Most of us underestimate the amount of food we eat • Limiting portion sizes is critical for good health • Check serving sizes listed on packages & learn to judge sizes more accurately. 9/30/2013Gayatri Ajay Upadhyay 47
    • Cutting Back On Calories But Feeling Full • Add vegetables to as many things as possible • Eat several servings of fruits daily • Avoid processed & fried foods, red meat, ghee butter, cream & chocolates • Some fat is needed to provide essential nutrients to the body; use veg. oils like olive & sunflower, but avoid saturated fats. • Watch foods labeled “fat-free” or “low-fat”; you may consume more calories overall. 9/30/2013Gayatri Ajay Upadhyay 48
    • Cutting Back On Calories But Feeling Full  Traditionally, dieters cut cereals, pasta and potatoes to control weight  These are sources for complex carbohydrates that help you feel full and maintain a healthy weight  Avoid high-fat toppings on carbohydrates and try plain or low-fat yogurt.  Foods high in protein are often high in fat, so limit protein to 10-15% of total daily calorie intake 9/30/2013Gayatri Ajay Upadhyay 49
    • Food Diaries • Most people do not realize the amount of food they eat per day and what they are doing at the exact time they are eating that food • Suggest taking notebook and taking a one week diary • Note in diary all intake of food, snacks, drinks and activities while eating 9/30/2013Gayatri Ajay Upadhyay 50
    • Management 51 • For overweight children small reduction in calories allows gradual decline in BMI • For obese children & adolescents weight loss of 0.5-1 kg/week is the goal. • Rapid wt loss can lead to electrolyte disturbances ( K+, uric acid) • Special diets like protein rich diet not recommended 9/30/2013Gayatri Ajay Upadhyay
    • Atkin’s diet 52 • High-protein low-CHO diet • Induces ketosis. • Caloric intake as protein is less prone to fat storage than the equivalent caloric intake as carbohydrate, • Has no supporting physiologic basis. • No long-term data to evaluate safety. 9/30/2013Gayatri Ajay Upadhyay
    • Dieting and Eating Habits • Maximum recommended daily calorie intake: 1600 calories: house wives & older adults 2200 calories: most children, teen girls, active women, and sedentary men 2800 calories: teen boys & active men 9/30/2013Gayatri Ajay Upadhyay 53
    • Diet: Bottom Line 54 • Follow the food pyramid • Low calorie, low fat, low saturated fat diet • Avoid junk food & extra salt • Practice moderation, not avoidance • Parents are the role models • Permanent changes to family eating habits 9/30/2013Gayatri Ajay Upadhyay
    • Physical Activity and Exercise Physical Activity ExerciseHousehold Chores Running Errands Gardening/ Yardwork 9/30/2013Gayatri Ajay Upadhyay 55
    • Physical Activity • Burns calories and keeps metabolism geared towards using food for energy instead of storing it for fat. • Increase house & daily activities • Sports & structured exercise • Begin slow and gradually increase exercise time to 30-60 minutes per day 9/30/2013Gayatri Ajay Upadhyay 56
    • Exercise: Bottom Line 57 • Use “life activity” not formal exercise programs whenever possible • Find partners :friends, family • Home activities 3 kcal/min • Walking 4 kcal/min • Jogging 6 kcal/min • Running 8 kcal/min • Running up the stairs 10 kcal/min 9/30/2013Gayatri Ajay Upadhyay
    • Exercise vs. Lifestyle Physical Activity Exercise Lifestyle Physical Activity 9/30/2013Gayatri Ajay Upadhyay 58
    • Behavior 59 • Most people resist change • Patterns are learned over a lifetime • Limit T.V., internet, games <2hr/day • Family therapy not just the child • Psychological dimension 9/30/2013Gayatri Ajay Upadhyay
    • Fasting for wt loss? • Fasting is popular because it can provide dramatic weight- loss but it is primarily water rather than fat • Lost water is regained quickly when eating is resumed. • Prolonged fasting is not recommended and may lead to nutritional imbalances 9/30/2013Gayatri Ajay Upadhyay 60
    • Conclusions • Obesity is not a disease, it is a public health problem and it is a risk factor for several chronic diseases. • Understanding the role of environmental factors on development of obesity help in control & prevention. • Healthy eating combined with increased physical activity is the answer 9/30/2013Gayatri Ajay Upadhyay 61
    • Summary •No miracle “cures” or products •No “revolutionary” diets •No pill or potion •No magic •Your will and your lifestyle are in control of weight management. 9/30/2013Gayatri Ajay Upadhyay 62
    • REMEMBER!!!! • Change towards this needs to be made at all levels – Domestic, School, Community, Administrative and Policy. 9/30/2013Gayatri Ajay Upadhyay 63
    • Why say no to childhood obesity? *More than 33% of diseases & 60% of premature deaths among adults are associated with behaviours or conditions that begin or occur during adolescence *More than 1.8 million adolescents die every year due to preventable causes *Problems in adolescent nutrition include changing lifestyle, skipping breakfast, dining outside often, fast food and junk food *59% clientele of fast food giants are students 9/30/2013Gayatri Ajay Upadhyay 64
    • *59% clientele of fast food giants are students *Obesity ranks as the fifth leading global risk for mortality. It contributes towards 44% of diabetes, 23% of ischemic heart disease and 7-41 % of certain cancers *WHO estimates that worldwide 2.8 million people die each year as a result of being overweight and obese *Risks of heart disease, stroke, type 2 diabetes and cancer increase steadily with increasing body mass index (BMI) *There are an estimated 35 million overweight /obese children in developing countries, compared to eight million in the developed countries 9/30/2013Gayatri Ajay Upadhyay 65
    • View Notes Thanks for your attention 9/30/2013Gayatri Ajay Upadhyay 66 FOR INSPIRATION Your favorite ACTORS/ACTORESS who lost weight. Look how UGLY they were earlier, but they lost their weight!!!
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    • LETS DISCUSS 9/30/2013Gayatri Ajay Upadhyay 75