More RI children battling the bulge

More RI children battling the bulge

By Bruce Emond

JAKARTA (JP): Check out an upmarket mall on a Sunday and watch
as a veritable army of little children carrying a few extra
kilograms marches by.

Diminutive nannies can be seen struggling to keep in hand not
so little moppets who are eagerly clutching burgers or candy. The
toy giveaways and kids' specials bring the children in to the
fast-food restaurants dotting the malls, but it is the greasy
treats which keep them coming back for more.

Chubbiness in children has long been associated with wealth
and health in Asia, including Indonesia; a sign that parents were
able to keep their offspring amply fed come feast or famine.

Although the view persists in some circles, more parents are
realizing that an overweight child may well grow into a fat
adolescent, with the excess weight becoming even more difficult
to shed as the years go by.

"People still want chubby children, particularly in some
ethnic groups like the Tapanuli (Batak) and Chinese communities,"
said pediatrician Dr. Widagdo from the School of Medicine at
Trisakti University in West Jakarta.

"I sometimes have parents come in who want their children to
be bigger although the kids are normal weight. There is the
misunderstanding that bigger means healthier."

The health dangers include an increased risk for heart disease
and diabetes in later life, although Widagdo said juvenile
diabetes remained a rarity in Indonesia. Australia's ABC
television network recently reported on a study which found that
some children eating a high-fat, high-caloric diet showed
premature signs of hardening of the arteries.

Pediatrician Dr. Abu Purwanto said it appeared there were
increased rates of obesity among children from upper-income
families.

"The impression is that, yes, more children from the middle
class and upper class are getting fatter," said the doctor, whose
practice is in Kebayoran Baru, South Jakarta.

Both pediatricians blamed changing diets and a more sedentary
lifestyle for the expanding waistlines of affluent Indonesian
children.

"People are eating a lot more high nutrition food, even when
sometimes they don't need it," Purwanto said. "Instead of regular
full-fat milk, they give a high-protein milk to their kids. And
then the children spend their time playing PlayStation instead of
going out to play soccer."

Widagdo said the economic crisis, which led to nutritional
deficiencies and malnutrition among many children from low-income
families, also appeared to zap the ballooning weight of his
middle-class child patients.

"Before the crisis, I would say about 2 percent to 4 percent
of the middle-class children I saw were overweight. Now it's
about 1 percent. But it's still around the same percentage of up
to 4 percent among children from upper-income families."

He said it was important to determine if children were
overweight because of extra fat or whether they were naturally
muscular.

Dieting kids

The fat of the land usually have fat pocketbooks as well.
Seeing a very large opportunity, a host of diet centers and
programs have emerged in recent years, promising to help the
overweight, including children, in the battle of the bulge.

"The percentage of our children as clients in Indonesia ranges
from 5 percent to 8 percent," said Aileen Chua from slimming
center Marie France Bodyline. "Over the years, there has been a
gradual increase in children taking up slimming, nothing
drastic."

Chua agreed with the doctors that diets high in fat and a lack
of exercise were major contributors to obesity among children.
"Outdoor games and sports are very good ways to keep children fit
and healthy."

She said parents were sometimes also to blame through
mistakenly equating heaviness with health.

"Parents (have an) inclination to keep their children fat and
chubby for 'cuteness', and think that fat equates to growth. With
such encouragement from parents, it's easy for the child to
become obese. When this happens, only then do parents realize
that it's a serious problem."

All three said parents played an important role in guiding
their children onto the right path for better health.

"It's very difficult with children," Purwanto said. "We have
to show their parents the standards for ideal weights, and show
them where their children are. We give them an education about
the quantity and quality of food that their children need."

It is also important for parents to remember they are dealing
with sensitive, impressionable children when helping their
children diet.

"John", now in his early 30s, said his mother's hysterical
reaction to his few extra kilograms when a child led to a chronic
struggle with his weight.

"I remember it clearly like it was yesterday. I was about 8
and I wasn't supposed to have a second piece of cake but I
sneaked back into the kitchen anyway. When my mom caught me, she
went ballistic, telling me I would be so fat by the time I was 20
if I didn't go on a diet."

He eventually became anorexic and then bulimic. "Today, I am
obese and it's really hard for me to make that distinction
between when to eat out of hunger because I spent so many years
repressing the urge."

Chua said parents could show their children through doing.

"Parents should help educate their child on the importance of
eating healthy and choosing the right food, and avoiding
overeating. Parents should also encourage their child in doing
some form of natural exercise."