Urban child obesity rising fast in Bangladesh

Despite a major reduction in child being under-nutrition and undersize over the last three years, there has been a considerable increase in obesity among children in Bangladesh, say studies.

A health study, published on 24 April shows the number of undersized children decreased from 41% to 36% and the percentage of underweight malnourished children came down to 14% from 16% in last three years.

However, a survey conducted by the Centre for Control of Chronic Diseases of the ICDDR,B with support from the National Nutrition Services of Institute of Public Health Nutrition says ten out of every 100 children, aged 5-18 living in Bangladesh’s urban areas, are overweight while 4% are obese.

Around 4,100 children living in 30 wards of each of the seven city corporations were brought under the study.

Another survey conducted separately by ICDDR,B shows the same result.

The study was carried out using 19 years of demographic surveillance data to identify the changing risk factors behind childhood malnutrition.

A total of 40,349 under-five children were enrolled in the surveillance system at ICDDR,B’s Dhaka Hospital and Matlab field sites between 1993 and 2012.

The emerging epidemic of childhood obesity is mainly attributed to dietary and lifestyle modifications, especially in urban areas.

Fast-foods and high caloric beverages, reduced physical activities due to lack of playgrounds in schools and housing societies, widespread use of electronic gadgets by this tech-savvy generation are contributing to this modern epidemic.

As childhood overweight and obesity tend to follow through adulthood, in longer terms, there is increased risk of developing chronic illnesses, said children's nutrition specialists.

Tahmeed Ahmed, director of Centre for Nutrition and Food Security at ICDDR,B told Prothom Alo, "When a country develops financially, the number of its undersized children decreases and obese kids increases. Same is in the case of Bangladesh."

"While childhood under-nutrition is still highly prevalent in the country, there has been a steep rise in childhood obesity and overweight in the last two decades leading to double burden of malnutrition. So we should be cautious of the situation before it is too late," said Tahmeed Ahmed.

Reasons for worries: The study conducted by ICDDR,B shows about 56% of children had a normal weight while 30% weighed less than the normal weight (malnutrition). About 14% children had a weight above the normal ranges while 4% were obese.

The assessment of their diets reveals that 98% children consumed rice or bread at least four times a week. Consumption of other types of food was less than three times in a week. These were meat (24%), egg (60%), legume (71%), vegetables (61%), milk (56%) and fruits (22%).

The study says more than half of the children had frequently taken local fried snacks such as singara, samosa, chop, beguni, peaju while about 20% children ate calorie-rich fast food -- pizza, burger, and fried chicken and so on.

Rising trend of overweight and obesity is emerging as a serious health concern in Bangladesh, creating higher risks of diabetes among urban children.

Fouzia Hossain, head of Pediatric Endocrinology, Birdem General Hospital who gives treatment to diabetes-affected children, told Prothom Alo, "Type 2 diabetes mellitus is the most common endocrine metabolic disorder in childhood and adolescence. Beside this, they are also suffering from heart diseases and high blood pressure. If their obesity increases they could be attacked by liver cirrhosis in the long run."

Why obesity: According to World Health Organisation (WHO), children must play sweaty outdoor games at least an hour every day.

The urban children of Dhaka, however, do not get the opportunity to play outside due to lack of playgrounds in schools and housing complexes.

There are only 11 playgrounds in both Dhaka south and north city corporations' command areas and many of them do not have facilities for playing.

And, so majority of the urban kids spend their time watching television and playing video games.

After having chats with 10 schoolchildren's guardians, this correspondent came to know that most of the schools in Dhaka do not have playgrounds.

A guardian of a Biam Laboratory School student said, "The playground of the school is too small to play outdoor games forcing students to spend free time playing 'pen fight' on the bench."

"The playground that Monipur High School has is now tiles-fitted. And so, its students cannot play on it," said another guardian.

A mother of an English-medium school student said, "Although the school has a large playground, many guardians do not want their kids to play on it blaming wastage of time."

Several doctors, referring American Journal of Pediatrics said the children, aged below two years can watch television for around two hours while the kids above two years should be discouraged to spend time in front of the box for long.

However, a study titled 'Risk Factors with Overweight and Obesity among Urban School Children and Adolescents in Bangladesh: A Case Control Study', conducted on schoolchildren of seven reputed schools of Mohammadpur and Siddeshwari shows that they spend around four hours before television.