Weighing in on childhood obesity

The original article can be found in: Cayman Compass By: Norma Connolly

A third of children entering primary school in the Cayman Islands are obese or overweight, analysis of screening of new pupils has shown.

Of 530 children, the majority of whom were aged four to six, entering schools in September last year, 92, or 17.4 per cent were obese, and 86, or 16 per cent were overweight.

As well as finding young children whose body weight was higher than it should be, the screenings also revealed that 8.3 per cent of the children entering Cayman’s schools were underweight. In all, only 58.3 per cent of the children were deemed to fall within a healthy weight range.

The Public Health Department screenings were carried out using body mass index measurements, or BMI, which calculates body fat based on weight and height.

The department has been screening school entry children since 2009. The percentage of children considered to be overweight has remained consistent during that period, with 15.7 per cent in 2009; 15.8 per cent in 2010; and 15.9 per cent in 2011. The percentage of children who were obese has fluctuated, being 13.5 per cent in 2009, rising to a high of 23.3 per cent in 2010, and dropping again to 13.7 per cent in 2011.

The Public Health Department also provided the Caymanian Compass with results of screenings of Year 6 children, aged 10 to 13 years old, who were screened in 2011. Statistics for this school year are still being analysed, according to the department.

Dr. Kiran Kumar, head of the Public Health Department, admitted that while the figure of one-third of entry school level children being above a healthy weight is worrying, statistics of year 6 pupils may be a cause for hope. Of the 557 Year 6 pupil screened, 107 of them, or 19.2 per cent, were overweight and 18.1 per cent, or 101 of them, were obese. 

But, Dr. Kumar pointed out that the screenings done in the 2007-2008 year showed 22.2 per cent of Year 6 students were obese, meaning there has been a drop of 4 per cent in the percentage of obese pupils in those intervening years.

“We definitely want to reduce the number of overweight children, but at the very least, we should be aiming for obesity to be controlled for school-entry children,” he said, adding that the Public Health, along with the ministries of education and health, planned to mount more public education and awareness to combat the problem.

According to the Public Health Department, the annual health screenings are done to “provide early detection and treatment of health problems that impact a student’s health and academic achievement.”

Children are screened as they enter school, whether at reception level in public schools, at kindergarten in private schools or if coming from overseas and starting at a school in Cayman for the first time, and also when they are in Year 6, during the second quarter of the year in preparation for their entry into high school.

Endocrinologist Dr. Diane Hislop-Chestnut, who is part of the Children’s Health Task Force, said the weighty issue of the unhealthy diets of Cayman’s children was a time bomb waiting to explode, as obesity leads to a plethora of health problems, such as diabetes, high blood pressure and heart disease.

While a number of local organisations have been advocating, with some success, for healthier food in schools, with young children entering school already having weight issues, there is a need to educate parents on how to control their children’s weight – and, in many, cases their own. “We’ve been giving information leaflets to the paediatricians about eating healthy for children and also for mothers during pregnancy,” said Dr. Hislop-Chestnut. “We’ve been telling mothers not to put cereal in milk bottles. They put the cereal in the formula to get the children to sleep better at night… They put bigger holes in the nipples of the bottles so it can go through. It’s to fill the children’s tummies so they sleep more overnight. It’s a huge amount of calories late at night. “Also, lots of calories are consumed in juices and sodas – the children need to get their calories by eating rather than drinking. Children here go onto juice very young. I’ve seen kids 10 months old drinking juice.”

She added: “Kids aren’t getting as much sleep as they need, especially the children under three, they’re sleeping less than they should. A lack of sleep plays a big role in obesity. “Sleep, activity and food choices are the three major factor in childhood obesity. People try to blame food choices, but really it’s all those three combined.”
One advantage kids have over adults in losing weight is that children are still growing, so if their weight gain can be controlled as they grow a few inches, that impacts their BMI.

A health factor risk survey of 2,000 households carried out by the government late last year indicated that obesity is an even bigger issue among adults, with 36.6 per cent of those surveyed found to be obese and 34 per cent overweight – meaning nearly three out of four people in Cayman are heavier than is considered healthy.

People are considered to be of normal weight if their BMI is 18.5 to 24.9, overweight if their BMI is 25 to 29.9 and obese if their BMI 30 and above.

Dr. Hislop-Chestnut pointed out at a seminar to address obesity issues last year that pre-schoolers who are overweight have a 25 per cent chance of being obese as adults and that kids who are obese at the age of six have a 50 per cent likelihood of being obese grown-ups. Once a child turns 10 and is overweight, there is an 80 per cent chance of that child becoming an overweight adult.

Highlighting the importance of identifying which children have weight issues and who are at risk of becoming overweight, Dr. Hislop-Chestnut said: “The earlier we start, the more impact we can make on these kids.”

She advocates the introduction of healthy eating and wellness education into all classes, not just health education classes, in Cayman’s national school curriculum.

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