ABU DHABI // Obesity is being diagnosed in children as young as four, putting them at risk of long-term health problems including diabetes and heart disease, says a specialist doctor. Experts fear that unless action is taken to halt the increasing number of overweight children, the problem will place huge strain on the nation's healthcare system in the future.
Dr Ian Jefferson, a specialist paediatrician endocrinologist at Sheikh Khalifa Medical City in Abu Dhabi, said he had treated four-year-old children for obesity and diabetics who were just seven. He sees more than 350 diabetic children in the hospital's clinic, a significant proportion of whom are obese. "There is a lot of obesity in the childhood population in the Emirates," he said. "The biggest problems are towards the end of childhood and in early adolescence.
"We see it in children younger than four. We certainly see it in the first five years of life." Last week, Dr Jefferson saw a six-year-old boy who was 50 per cent heavier than he should have been. His healthy weight would have been 30kg but he tipped the scales at 45kg. "Unfortunately that is not particularly unusual in the clinic," said Dr Jefferson. "It worries me because of the risk of diabetes.
"Once you start down the path then the obesity itself gets in the way of exercise. It is very easy to stay in that spiral." But Dr Jefferson said obesity in childhood was easily preventable. "The reasons really are escapable," he said. "Obesity is always due to an imbalance of energy input and energy expenditure. They wouldn't be obese if they weren't eating more than they needed." According to Dr Jefferson, if a child were to eat an extra packet of crisps every day for a year but otherwise maintain a healthy lifestyle by taking in as much energy as he put out, he could still gain 7kg.
"It does not take much, this is what people should realise," he said. Twelve per cent of the country's young people are overweight and 22 per cent are at risk of becoming obese because of poor diet and a lack of exercise, Ministry of Health statistics show. The increasing trend was not the fault of the children but their parents, said Dr Jefferson. Parents needed to ensure that their children ate healthily and took enough exercise, he added.
"Five-year-olds are not feeding themselves, adults are preparing their food. "I commonly hear parents say they do not give their children healthier diets because the children do not want it, or they cry. "But I ask whether they would let their children run across the road if they wanted to? They say no. So why do they give them whatever food the children want, even though they know it is bad for them? It is taking years off their lives."
Although efforts have been made in recent years to boost the amount of exercise children take, the amount of time allocated by schools for physical education is still significantly less than in other parts of the world. Many UAE schools have only one hour set aside each week for physical education, while schools in some countries encourage pupils to be active for up to three hours. This month, the Ministry of Education said it would create a department of physical education to develop PE and health curricula in schools.
The move comes after a study published last year in the World Health Organisation's Eastern Mediterranean Health Journal said 21 per cent of pupils in private secondary schools in Dubai did not play any sport and 48 per cent had a "poor level of sport practice". Dubai Health Authority said this year that more than half of the city's private school pupils admitted they were too lazy to exercise, and more than one in three were overweight or obese.
Fatmeh al Ahmad, mother of Omar, 10, and Ammar, eight, said a lack of open-air recreation facilities in Abu Dhabi was a problem for parents. Her sons played indoor basketball and table tennis but spent hours on their PlayStation at home, she said. On top of this, they had two hours of PE a week at the International Choueifat School. "It is not enough," said Mrs al Ahmad. "They can't play outside because of the heat and indoor sports are not the same."
She believes the problem of overweight children is not so much with diet but, rather, with physical inactivity. Ziad Hamdan, a father of three daughters and one son, said he wished his children could play outside but added: "It's too hot, there are workers on the streets, too much traffic and we don't want them to be exposed to that. The only physical activity that they have is in the house, which is not much at all.
"We usually wait until the weather gets cooler so we can take them to a garden. But otherwise, we know that they need to move more." Hala Douma, mother of Ismail, 12, has gone to great lengths to ensure her son gets his fair share of sports, arranging for him to take tennis lessons with a professional trainer. "In general, Abu Dhabi lacks clubs, it lacks options for children," she said. "It's not just about keeping your children occupied. PlayStations are not enough. It's about health and fitness. There needs to be more focus on it. There needs to be more awareness that it is missing."
According to Dalia Shukri, a clinical dietician at the American Hospital Dubai, the problem stems from "children spending most of their time at home playing video games and computer games. The importance of activity is overlooked." Dr Alya Ahmed, a paediatrician at the City Hospital in Dubai, said: "In the UAE we are still at the awareness stage with childhood obesity. "People do not see it as a disease yet, but it is, and it is the responsibility of the parents, doctors and teachers to act to prevent children from becoming overweight by encouraging them to exercise and eat healthily."
Dr Ahmed, who is also UAE spokeswoman for the American Academy of Paediatrics, said parents should encourage their children to take more and regular exercise, and limit the time they spent in front of the television or playing computer games. In advance of World Heart Day tomorrow, Dr Ahmed urged children to do at least one hour of exercise every day to avoid heart disease in the future. Walking, running, swimming and even free play for younger children would all be beneficial, she said.
Tommy Wingrove, head coach at Manchester United Soccer Schools in Dubai, said one hour a day should be "easy for children to achieve". He said facilities such as Dubai Sports City meant children had access to world-class sports on their doorsteps. The Academies Campus, which opens in January, will offer swimming, rugby, cricket and hockey to thousands of youngsters each week. Mr Wingrove said: "Children across the UAE need to see exercise as a normal part of their daily lives if we are to see a reduction in the alarming rates of childhood obesity and cut rates of heart disease in the future."
munderwood@thenational.ae * Additional reporting Zahra Hankir