OVERWEIGHT AND OBESITY IN ADOLESCENTS

The world is experiencing a rapid nutritional transition characterized by persistent nutritional deficiencies, as evidenced by the prevalence of stunting, anaemia, and iron and zinc deficiencies. On the other hand, there is a progressive rise in the prevalence of obesity, diabetes and other Nutrition Related Chronic Diseases (NRCDs).

Ministry of Health Adolescent Health Officer Olivian Mangolwa explains that what is fuelling this seemingly 2 opposites- an overfed and a starving world? With Adolescents interests at heart, this article gives an overview of nutrition in adolescents highlighting the two ends of being overweight and obese and the other end undernutrition. It highlights the effects of either end of the spectrum on the adolescents. With the negative impacts appreciated, it is hoped that adolescents, guardians and all stakeholders will pay more attention to providing adequate nutrition to adolescents in this stage characterised by rapid growth if the health and economic productivity of the nation is to be assured. The call to action is timely.

Nutrition is the process of taking in food and using it for growth, metabolism, and repair. The need for adequate nutrition is high during Adolescence because it is the second most critical period of physical growth in the life cycle after the first year.

“Twenty five percent of adult height is attained during adolescence. For many adolescents, inadequate quality and quantity of food are the prime determinants of nutrition problems. These conditions may be due to household food insecurity, intrahousehold allocation of food that does not meet their full range of dietary needs, livelihoods insecurity and lack of nutrition knowledge. Micronutrient malnutrition and chronic energy deficiency resulting in thinness (low Body Mass Index or BMI1) and stunting stem primarily from poor diet. Excessive physical activity patterns (e.g., heavy workloads and walking long distances) and infection may also contribute to undernutrition” posits WHO, in its Adolescent Nutrition at a Glance article published in 2003.

Inadequate nutrition in adolescence is linked to not attaining full productivity potential in adulthood affecting the economic growth of the nation in the long ran.

Urbanization, its resultant sedentary lifestyles, reduced intake of nutrient dense foods preferring junky fast foods compounded by physical inactivity have contributed to the problem of obesity and overweight in developing Countries.

According to WHO “Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health”. For Zambian urban adolescents, the rising obesity and overweight trend is attributed to an increase in caloric and fat intake through excessive sugar intake in soft drinks, increased portion size, and steady decline in physical activity with most hours spent on technological devices.

Obesity and overweight affect both the physical and psychological health. The obese adolescent is likely to stay obese into adulthood and more likely to develop non-communicable diseases such as high blood pressure, diabetes mellitus and heart diseases. Obesity can profoundly affect children’s self-esteem, social, emotional well-being; can lead to poor academic performance and alcohol and substance abuse.

It is important to appreciate the fact that the environment and the foods children are exposed to at an early age determine whether or not they take-up healthy eating habits. Parents and guardians play a vital role in introducing and monitoring consumption of healthy foods by their children. Giving children too much junk food sentences them to obesity and a craving for more unhealthy food. This vicious cycle results in a lack of appreciation of the taste of nutritious food, an undesirable behaviour that may continue in adulthood.

It is a common practice nowadays for parents to stock their fridges and their children’s lunch boxes with crisps, chips, biscuits, cakes, sweets etc. and to go to fast food restaurants to consume fatty and calorie rich foods. Unfortunately, in most schools there is no control of the types of food sold in canteens, tuck-shops or outside school premises to promote healthy eating habits. Worse still most private and newly built public schools not only lack space but also teachers to promote sports or physical activities to counter the effects obesity.

A multisectoral approach is very crucial to prevent and address overweight and obesity through creation of supportive systems that encourage healthy eating habits and physical activity at household, community and school levels.

Eating fruit, cooked nutritious food such as vegetables, food rich in protein and complex carbohydrates like nshima, boiled potatoes and cassava coupled with physical activity namely walking, cycling, dancing, doing house chores and sports should be the common message by all.

Behaviour change messages sent out consistently at household and community levels can contribute to sustained health and nutrition impacts. The Ministry of Health delivers health messages to adolescents through health facilities, Youth Friendly Spaces located in the community and at health facilities, print and electronic media, radio and face-to-face communication. Parents and teachers should however play a bigger role.