LETTER TO EDITOR
EPIDEMIC OF OBESITY:
PREVENTION MUST START IN CHILDHOOD
I read with interest the
recent article by Qidwai and Azam[1]
discussing the issue of obesity. The authors are to be congratulated for preparing
such a comprehensive, well-referenced and timely publication. Firstly, it
describes the burden of obesity and its associated health hazards. Secondly, it
nicely presents that in-spite of better understanding about obesity among study
subjects, measures to control body weight are lacking. Authors very rightly
stated that study population was not representative of general population of
Childhood obesity
has reached epidemic proportion; worldwide, approximately 22 million children
under five years of age are overweight.2
Large number of epidemiological studies proved obesity as a significant risk
factor for cardiovascular diseases. Pathogenesis of atherosclerosis, the
underlying cause of cardiovascular disease, begins in early childhood, although
it clinically manifests in adulthood.3
It is also evident that risk factors for cardiovascular diseases can best be
modified at young ages, as in childhood, thus improve the health outcomes in
adult life.
Pakistan, where
over 43% of the population is comprised of children,4 it was
observed that children are adopting more and more unhealthy lifestyles. A trend
away from active leisure pursuits and recreational sports has been evident, and
reliance on sedentary entertainment, including television, computer and video
games has increased. There is also an increasing trend of eating junk and empty
caloric foods by children. Khuwaja et al5,
found that majority (58%) of the school children had at least one modifiable
risk factor for cardiovascular diseases like physical inactivity, unhealthy
dietary habits, overweight and obesity.
In context of
direct and indirect cost, the impact of obesity on the lives of people is
devastating when measured in terms of premature morbidity, mortality and
disabilities. Pakistan which already has poor health and economic indicators
cannot afford the emerging costly epidemic of obesity. Thus, every effort
should be made to prevent and modify unhealthy lifestyle by increasing health
promotion and disease prevention measures while the condition still is in the
early phase.
In this regard, it
is important for Family Physicians to play a leading role, as they understand
the natural history and disease process and are engaged to provide
comprehensive preventive and curative health care to all family members
including children and adolescents. To promote healthy lifestyle among individuals
and families, family physicians should intervene earlier in life thus beating
the epidemic of obesity and other lifestyle risk factors for cardiovascular
diseases in later life. At the same time, it is important to educate and
encourage parents (being a role model) to personally adopt and practice a
healthy lifestyle, especially with regard to diet and regular physical
activity. There is also an immense need for more research to explore this issue
in more details and to find and implement more cost-effective intervention
programs in accordance to our culture and needs.
Ali Khan Khuwaja
Dept. of Family Medicine and
Community Medicine
Aga Khan University, Karachi.
Fax: (92) 21 4934294
Tel: (92) 21 48594922/ 4930051
Ext. 4811.
E-Mail:
ali.khuwaja@aku.edu
REFERENCES
1.
Qidwai W, Azam SI. Knowledge, attitude and
practices regarding obesity among patients at Aga Khan University Hospital,
Karachi. J Ayub Med Coll 2004;16(3):32-4.
2.
Rocchini AP. Childhood obesity and diabetes
epidemic. N Engl J Med 2002; 346(11):584-5.
3.
Ucar B, Kilic Z, Colak O, Oner S, Kalyoncu C.
Coronary risk factors in Turkish schoolchildren: Randomized cross-sectional
study. Pediatrics International 2000; 42:259-67.
4.
Population growth and its implications. National
Institute of Population Studies, Islamabad, Pakistan. 2002: 3-20.