COVID-19: How to avoid obesity in children during this period

Childhood obesity is a growing global threat which seems to be worsening with the COVID-19 pandemic lockdown. With children at home and indulging in foods like noodles, fries, cakes, pizza, among others, there is growing concern about, how much trans-unsaturated fatty acids also called trans-fatty acids (TFA) or trans fat, they are ingesting in these foods and what it may mean for their health. – Adie Vanessa Offiong writes.

When COVID-19 came knocking and schools were shut, expectant mother of one, Carol Yahaya was worried about how she would cope with home-schooling her daughter. She also worried about the domestic chores that would multiply.

“I was happy that I would spend more time with her but did not at all fancy the home-schooling part of the lockdown,” she said.

She also did not foresee that “the likelihood of my six-year-old becoming obese during the pandemic, would be a source of concern for me.”

Yahaya, who now operates her fabric selling business from home due to the pandemic, said she did not immediately take note of how her daughter’s dietary needs would change as a result of the lockdown.

On school days, her family followed a planned timetable which included healthy meals that her daughter also took for lunch.But being at home these last four months has meant eating more, including junk food.

She said: “Before the lockdown, we used two cartons of noodles monthly. Now, I am buying three. She also wants treats of pastry, pizza or chicken and fries.”

Yahaya is not the only parent struggling to keep her children in shape during the pandemic.

Taiwo Ayoola, another parent, said: “My children can watch television for Africa and their watching is accompanied by food.

“My five-year-old, Junior, worries me the most. He has gone up one dress size since the lockdown and I believe it is largely due to his indulgence in noodles and chicken and chips.”

Junior told his father that eating popcorn while watching television, should go hand in hand.Ayoola is worried that Junior, who could conveniently pass for a six and maybe even a seven-year-old, is already overweight and may be bordering on being obese. With social distancing being a fundamental rule for preventing the contraction and spread of the coronavirus, it has been impossible for children to indulge in outdoor activities as they usually would.

While Yahaya is worried about her six-year-old’s lurking obesity, she is oblivious of the harm she is exposing her unborn infant to, with her new COVID-19 dietary style which now prominently features pizza, chicken, fries and other such foods. These foods which Yahaya, her daughter and Ayoola’s children are consuming more of, due to the pandemic, contain trans fat.

Temitope Alale, a member of the Institute for Dietetics in Nigeria, explained that, it is a type of unsaturated fatty acids or trans fatty acids that occurs naturally in meat and dairy milk, and is healthy when appropriately consumed. However, there is a second type of trans fat which is formed artificially/industrially when manufacturers turn liquid oils into solid fat through a process called hydrogenation.

A common parlance used to describe such oils in Nigeria is that, “the oil is sleeping.” Alale, who belongs to the Association of Nigerian Dieticians, said: “Trans fat is considered the worst fat you can eat. They are dangerous and everywhere. They are the most commonly used fats in processed and ready-made foods. They are sold by fast food chains and contained in products like noodles because they are a cheaper alternative.“Since they are popular, avoiding them is not easy.”

A study by the European Journal of Clinical Nutrition has linked high trans fat diet to overweight children.The research shows that the detrimental health effects of trans fats may be passed from mothers like Yahaya to their infants, “with data showing that mothers consuming over 4.5g of trans-fats per day were over five times more likely to have a body fat greater than 30 per cent, and their infants were over two times more likely to have body fat over 24 per cent.”

“Trans fats are attractive for the food industry due to their extended shelf life and flavour stability, and have displaced natural solid fats and liquid oils in many areas of food processing,” as are found in the foods children are indulging in, during the COVID-19 pandemic.

The foods Yahaya and Ayoola mention, as well as white bread, are the main sources of industrial TFA were fast food, according to a cohort study on Dietary Intake of Trans Fatty Acids in Children Aged 4–5, published by the National Center for Biotechnology Information journal.

Although it was a study conducted on children in Spain, its findings are not far from trends in Nigeria. A National Bureau of Statistics (NBS) survey on Nigeria reveals that Bayelsa state has the highest under-five child overweight prevalence rate of 2.9%, while Nasarawa and Taraba states each have 2.4%.

Kasarachi Omitiran, Abuja-based public health specialist, explained that the consumption of trans fat is linked to early onset of obesity. Obesity has also been implicated in a lot of non-communicable diseases (NCDs) such as hypertension, cardiovascular diseases, diabetes, “which have been shown to reduce the quality of life of individuals”.

“Due to its chronic nature and our poor health seeking behaviour, accessing health care for NCDs can pose a problem in Low and Middle Income Countries (LMICs) where a greater proportion of individuals live below poverty line and have to pay out of pocket to access health care,” she said.

Speaking on the kind of threat it poses to children, she said it causes increased weight gain and obesity.

“These are the immediate outcomes and could have a lot of consequences on the different dimensions of childhood development,” she said.

In section 8 of its draft 2019 Fats & Oils regulations on ‘Labelling of Trans Fats’, the National Agency for Food and Drugs Administration and Control (NAFDAC) prohibits “the manufacturing and importation of any oils and fats, including emulsions with fat as the continuous phase, either alone or as part of processed foods, which are intended for human consumption or assumed to be intended for human consumption, in the retail trade, catering businesses, restaurants, institutions, bakeries, etc, of which the content of trans fat exceeds 2 grams per 100 grams of oil or fat”.

In its efforts to sensitise the public about how detrimental trans fat can be to the health, the Global Health Advocacy Incubator (GHAI) in collaboration with NAFDAC, developed public service announcement sensitisation tools. The food and drugs regulator is also working with the Network for Health Equity & Development (NHED) to get the percentage trans fat in some selected foods and has also been involved in the training of journalists organised by the Corporate Accountability and Public Participation Africa (CAPPA) on reporting trans fat.

According to the WHO, 41 million children under the age of five were overweight or obese in 2016, and over 340 million children and adolescents aged five to 19 were overweight or obese in 2016. The health agency said industrially produced TFA have no known health benefits.

WHO also estimates that 500,000 people die from trans fat related cardiovascular diseases yearly, and is calling for a total elimination of TFA use all over the world. In its plan to eliminate industrially-produced trans-fatty acids from global food supply, the UN health agency urges governments to use the REPLACE action package to eliminate industrially-produced trans-fatty acids from the food supply.”

According to the package, eliminating TFA is one of the priority targets identified in the draft 13th general programme of work, which will guide the work of the WHO from 2019 to 2023.

Tedros Adhanom Ghebreyesus, WHO director-general, said: “Implementing the six strategic actions in the REPLACE package will help achieve the elimination of trans fat, and represents a major victory in the global fight against cardiovascular disease.”

Alale, therefore, cautioned expectant mothers like Yahaya on the need to be worried about their consumption of trans fat because, they are associated with heart disease and after digestion, they become part of cellular membrane.

On the ways to check the situation, Omitiran said there is need for intensified health education, awareness creation interventions, to inform the populace on the harmful effects of TFAs.

She said there should also be ways to identify public foods that contain TFAs, as well as ensuring policies that promote transparency in labelling foods.

She suggested that there be public health campaigns to encourage deliberate increase in fruits and vegetable intake, decreased intake of commercially baked products, deep-fried fast foods, packaged snack foods, etc. Children should be encouraged to participate in safe physical indoor activities in order to help keep fit and encourage the metabolism of TFA in the body, lowering their levels.

Peace Emezue, a certified personal trainer of the American Council on Exercise, encouraged parents to creatively engage their children in fun foods and activities, especially those in the age where they easily get bored.

Emezue’s journey to staying trans fat free and avoiding unhealthy eating started seven years ago, weighing 137 kilograms, when she took ill and her doctor said: “You will go to bed one day and not wake up. Your heart is over laboured.”

“I was such a sweet tooth and would indulge in all sorts of junk food until it became a matter of life and death. I was fortunate to get the wake-up call at the time I did, but I know many have not and want to advise the public to take this very seriously,” she said, adding that “You can do without trans fat, if you make it a lifestyle to eat healthy.”

For Emezue, the onus is on parents to ensure their children are not overweight or obese. They must be willing and committed to see that their children stay healthy. Parents should also consider their children’s diet by placing them on portion-controlled meals and making the meals fun and interesting. This is so that the children would be willing to eat.

She suggested that parents who can afford it can explore online videos of fitness trainers with exercises and workout sessions that families can do together.

“Parents should get their involved in age appropriate house chores like cutting the lawn, doing the dishes, cleaning the house creating spaces for them to run around, where possible,” Emezue said.

“Another idea is organising a dance party which could very easily be organised within the home and include every family member. The goal is to exercise the body whether or not the child is a good dancer. Just get them moving and in a way that they don’t get bored easily.”

Like Emezue, Omitiran said it is necessary for Yahaya, Ayoola and other parents with children currently on lockdown, “to pay attention and be deliberate about what we feed our children; it’s important to ensure they eat the right foods in the right proportions and also have adequate physical exercise.”

Alale pointed the likes of Yahaya and Ayoola to ways they can limit their children’s intake of trans fat. Parents should read food labels and avoid foods with partially hydrogenated oil, while using healthy cooking fats in moderation. She asked parents to encourage their children to eat more whole foods like fruits, vegetables, whole grain, skimmed milk, beans, nuts, fish, lean meat and poultry.

Alale also advised that the consumption of processed foods such as cakes, cookies, meat pies, biscuits and burgers should be cut down, and fried foods be avoided.