We recently had the privilege of interviewing Dr. Nataniel Viuniski, world famous paediatrician and nutritional expert, whose main areas of interest are weight management and childhood obesity.
Dr. Viuniski is an advisor to Brazil's Health and Education Ministry for Childhood Obesity, and an invited speaker on nutrition in many Brazilian and International Universities. He has given lectures on healthy lifestyle in more than 30 countries across all continents.
He is also the author of "Childhood Obesity - A Practical Guide" and Ali Mente Ação (a successful book about healthy lifestyle and weight control), as well as many other scientific published works and book chapters.
Being a Herbalife Nutrition Advisory Board member, Dr. Nataniel Viuniski was in Singapore as part of Herbalife Wellness Tour 2017. It was our pleasure to gain some valuable insights on childhood obesity in Singapore. Here are some key takeaways from our conversation:
1. What exactly is childhood obesity?
We are curious. When exactly is a child considered obese, and when is it not just 'puppy fat'?
Dr. Viuniski informs us, "There are cut points. In adults, we use BMI as a parameter, which takes a person's weight and height into consideration. For children, we have charts and graphics, based on gender and age. We work on percentiles, and obese is when the child is over 95th percentile for his age and gender."
"And then, there are some periods in children where its common to put on weight, like the pre-puberty phase. They store energy in the form of fat, and it's completely normal and healthy."
"More than the amount of fat, where it is stored is important. The big issue is when you start storing fat around the belly, in the abdominal region. Risk factors for diseases like heart disease and diabetes are often related to abdominal fat."
What are the risks involved in childhood obesity?
Says Dr. Viuniski, "Childhood obesity leads to poor quality of life and various medical complications (which may be immediate, or happen later on in adult life). The immediate complications are hypertension, variation of fat in blood and childhood diabetes. In the US , children make up to 30 % of new cases of diabetes, that is 3 out of 10!
Other issues include sleep apnea and knee and joint pains. When children have poor sleep, they are unable to focus. Some types of kidney, gut and thyroid cancer have their roots in childhood obesity.
Then, of course, there are psychological and emotional problems like being bullied and isolation from peers. Children who are obese at 2, have a 50% chance of turning obese as adults. For those who become obese in adolescence , chances for adult obesity are 70%."
"In Singapore, 30 % of children are overweight, we are slowly narrowing the gap with Western countries like the U.S., where it is 50 %."
2. Pregnancy and childhood obesity
Dr. Viuniski emphasises that the fight against childhood obesity begins from the womb, "In pregnancy itself we can prevent childhood obesity. It has been observed that mothers who gain too much weight during pregnancy (due to gestational diabetes or otherwise), or mums who suffer some sort of malnutrition like placental malnutrition (usually found in smokers), also lead to their children being obese later on in life."
"Also, did you know that while in the womb, the foetus is exposed to different tastes through the amniotic fluid? If an expectant mother eats a lot of sugary food, the taste of her amniotic fluid will vary, as opposed to a pregnant mum who eats a healthy diet." In effect, from the womb itself, if the foetus is conditioned to sugary taste, chances are that later on in life she would tend to prefer that sort of taste in her food!
Hence during pregnancy, a healthy lifestyle and diet should be adopted. Good nutrition, exercise and self control are essential.
3. Link between breastfeeding and childhood obesity
According to Dr. Viuniski, a key factor in the fight against childhood obesity is breastfeeding, "Breastfeeding is one of the most important tools. It protects children in childhood and adult life. The WHO recommends exclusive breastfeeding for 6 months, and continued breastfeeding along with appropriate complementary foods up to two years of age or beyond."
"Breastfeeding is important, not only for preventing obesity but also for immunity and prevention of cancer. There are even studies that show that breastfeeding is related to a child's intelligence."
4. Hereditary, race and cultural factors for childhood obesity in Singapore
According to Dr. Viuniski, there is a strong link between obesity and genes, "When both parents are obese, children have a 70 % chance of being obese, if it's just one parent, there is a 50 % chance of the same. If the parents are not obese, chances go down to 25 %."
In Singapore, we have 3 prominent races, Chinese, Malay and Indian. Are certain races less susceptible to being obese?
Dr. Viuniski replies, "More than the race, or ethnicity, lifestyle plays an important role. Ultimately what you eat and the amount of physical activity is what determines obesity."
"I do feel, however, that some cultural factors may play a role. For example, many Indians are vegetarian. Plant protein is known to protect against disorders like heart disease, more than animal protein."
5. Sugar - The silent culprit
One culprit that Dr. Viuniski kept blaming for childhood obesity is SUGAR.
He says, "A doctor once performed some tests on a rat, which was addicted to cocaine, through periodic infusion into the blood. Shockingly, when the rat was offered sugar, in just 36 hours this rat changed it's addiction from cocaine to sugar! And we are talking about little children here!"
"Today, sugar constitutes a large part of a child's diet. MRI scans have shown that sugar stimulates the same parts of the brain as cocaine!"
"One can of soda provides more sugar than what a child needs for 24 hours. Some parents think that it's healthier to exchange soda for apple juice, but you'll be surprised that some brands of store bought juice have more added sugar than soda!"
"Also, babies should not be given any salt or sugar in the first year of life, and no cow's milk."
6. Prevention of childhood obesity
Dr. Viuniski lists his fundamentals to prevent childhood obesity, "There are 3 places to promote prevention of childhood obesity, home, school and society. Everyone in the house who shares a refrigerator must be taken into consideration, and avoid keeping unhealthy food in the fridge."
"Some children might be trying to compensate for an inner emptiness through food. They are probably addressing an emotional need or distress through food."
"Again, I want to stress on the importance of breastfeeding. In schools, healthy lifestyle should be advocated, especially because children usually have at least one meal in school."
"I feel that no matter what the drink or food is, there is no good food or bad food. For example, broccoli is considered super healthy, but if we eat it continuously for 30 days, we might get sick. So quantity matters. It is okay to have the occasional junk food like soda or burgers. Family should set limits based on the child's condition."
"Anything that is forbidden instantly becomes more appealing. So instead of total avoidance, practise reducing the frequency of unhealthy food."
"Lastly, our body is developed and designed for movement. Nothing makes kids so sedentary like today's computers, phones and TV."
7. Herbalife Nutrition Study findings
Global nutrition company Herbalife recently released findings from its Asia Pacific Balanced Nutrition Survey. This is what was observed in Singapore:
- Over 77 % of Singapore consumers are eating less than half of the recommended serving of fruits and vegetables, more than half do not drink enough water, and more than half do not get enough exercise.
- The top 3 obstacles to a daily nutrition approach are a lack of time (54 %), lack of motivation (49 %), and lack of money (36 %).
Dr. Viuniski sums up with, "Most parents are okay to make changes in their child's life, but make excuses when it comes to their own life. Children pay more attention to what we DO than to what we SAY."
"Also, in the same family, you might have a chubby child, and a child who does not want to eat. The solution for both is a healthy lifestyle and diet, it works equally well for both."
Also READ: Childhood obesity on the rise in Singapore!
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