Poor diets in toddlers and the lack of nutritional education among parents about the risks of obesity were key findings from rare research conducted in the UAE.
Dr Dana Al Tarrah completed a study on preschool children at a school in Al Ain, of which 97 per cent were Emirati children, to identify risk factors of pre-school obesity and test the impact of a six-month lifestyle intervention.
A simple intervention proved effective in encouraging parents to switch children to a healthier diet and physical-activity habits.
"I was aware of the cultural factors around childhood obesity in the region and the lack of parental recognition of their child's weight status," said Dr Al Tarrah, assistant professor at the faculty of public health, social and behavioural sciences at Kuwait University, which led the research in collaboration with UAE University and University College London.
“Children are a sensitive population, and we tried to avoid the terminology of obese and fat.
“Most parents were unconcerned about the heaviness of a child, and one noticeable trend was that plumpness was viewed as a sign of prosperity.
“Overall, parents were not aware of obesity being a problem in children.”
Childhood obesity has reached epidemic proportions globally and poses a considerable burden on a child’s short- and long-term health. Most obesity presents in the early pre-school years, and once established tracks into later life.
While the rising UAE prevalence of childhood obesity is a major public-health concern, few previous studies have explored its risk factors.
Dr Al Tarrah aimed to identify the risks linked to pre-school obesity in the UAE, describe the children's dietary intake and, in a randomised controlled trial, investigate the effectiveness of the Eat Right Emirates tool, a simple leaflet intervention designed to encourage a healthy lifestyle and prevent pre-school obesity.
“The misclassification of their child’s weight status among parents was about 80 per cent, which is comparable to other studies in Saudi Arabia and the UAE,” Dr Al Tarrah said.
“While the school had 402 preschool children, only 150 were willing to participate.
“It is a cultural issue, because not many people in this region are exposed to this kind of research.
“Mothers generally were not aware that children tend to refuse unfamiliar foods, and only through repeated exposures will they influence their child's acceptability."
Following the study, many mothers wanted more information on obesity, particularly related to portion size for pre-school children.
The study found a longer duration of breastfeeding and later introduction of complementary foods were associated with a lower BMI score in toddlers.
When compared with British dietary guidelines, researchers also found pre-school children in the UAE exceeded intakes of protein, but did not meet recommended intakes for fibre.
A high carbohydrate intake as a percentage of energy was associated with a lower BMI score, and high fat intake with a higher reading.
Researchers concluded that a simple intervention offering parents simple and concise information on healthy dietary habits and physical activity was an effective tool in preventing obesity.
In December, the first Abu Dhabi Childhood Obesity Forum vowed to take dietary education into the classroom, to encourage children to make more informed healthy-eating choices for themselves.
“We envision the UAE school environment to be one that promotes the health of the children, healthy food options, physical activity opportunities and mental well-being,” said Dr Shatha Al Ghazali, head of cancer prevention at the Department of Health – Abu Dhabi, who said the school environment is critical to a successful campaign against childhood obesity.
“We are proposing to transform the classroom design in schools to include different kinds of physical activities that children like and will be engaged in.”
The long-term vision is to equip all schools with technology-driven solutions that not only reduce the number of children suffering from being overweight and obese, but also gets the teachers and parents more involved.
Dr Gowri Ramanathan, chief medical officer at King’s College Hospital London in the UAE, said one of the reasons childhood obesity has grown to such high levels is because of the problem parents have spotting it.
“In the UAE, the problem is compounded by a majority of parents who self-diagnose,” she said.
“Self-diagnosis bypasses primary care by professional health-care providers and often leads to the loss of valuable information.”
A study conducted last year by Sharjah Education Council’s health care division showed that among 40,770 students in Sharjah’s 125 public schools, 410 suffer from asthenia (abnormal physical weakness or lack of energy), 586 pupils from asthma and 2,425 from obesity.
The survey also revealed that 357 students suffer from anaemia, 74 students were found diabetic and of these most suffer from the Type 1 diabetes.
Rajaa Basheer, supervisor of Sharjah Health and Safety department, said that surveys covering all Sharjah public schools are carried out annually to list the number of students suffering from diseases and to identify change from last year’s results.
“Some sick students are offered help through medical programmes, while others are referred to specialised physicians,” she said.
“We also organise awareness campaigns in co-ordination with the Ministry of Health about the types of the most prevalent diseases.”