The story appears on

Page C1 - C2

January 26, 2010

GET this page in PDF

Free for subscribers

View shopping cart

Related News

Home » Feature

Fat city, fat kids

MORE than 16 percent of Shanghai kids are obese - seriously overweight - and it's urgent that they shed pounds, exercise and eat right.

Doting parents and grandparents must tell them "no." Zhang Qian weighs in. When Li Sumei brings out the soup, she is surprised to see that her 11-year-old grandson has already finished off a big dinner, wolfing down a chicken leg, several meat balls and a bowl of rice. Now he is eagerly awaiting the soup.

The boy is now 1.42 meters tall and weighs 48 kilograms. He is obese. His body mass index (BMI) is 24 - 22 is definitely overweight.

Li knows it too, but the typically indulgent grandmother just can't deny her grandson another helping. The boy knows it too, but when he sits down to eat, he has no self control - young brains are not fully developed and there's poor impulse-control.

There's a Chinese saying that child with a round broad face, like a tiger's, is sturdy, healthy and smart - but it doesn't mean fat. "Tiger head, tiger brain" ("hu tou hu nao"), it goes.

Chunky sturdy kids are not the problem. Fatties are, both kids who are overweight and those who are obese, a more serious condition.

China's rapid economic development and higher income, the taste for fast-food and more sedentary lifestyles have resulted in rapid weight gain by the population as a whole in the past 20-30 years - and this includes obesity and health problems.

The rate of obesity among Chinese adults has increased from 6 percent to 22.8 percent in the 10 years from 1982 to 2002, according to the national Chinese Resident Nutrition and Health Report 2002. The rate is also increasing for children, and it's quite apparent.

The number of overweight and obese children in China has reached 12 million, accounting for one-third of the world's fat kids, according to the 2009 Chinese Child Nutrition and Health Report. It's based on studies conducted by the Chinese Association for Student Nutrition and Health Promotion.

The report also says the rate of overweight and obesity among children seven to 17 years of age has tripled to 8.1 percent in the past 10 years. It's expected to climb quickly.

"Without proper and timely intervention, the rate of obesity for Chinese children may quickly catch up with the rates for Europe and America," says Ma Guansheng, vice president of Chinese Association for Student Nutrition and Health Promotion.

The situation is worse in big cities like Shanghai, according to Dr Tang Qingya, director of the Clinical Nutrition Center of Xinhua Hospital.

The rate of obesity (seriously overweight, not just heavy) for young people up to 18 years of age reached 16.1 percent in 2007. More recent statistics are not available, but the rate has clearly gone up. If overweight kids were counted, the rate would be extremely high.

BMI, or body mass index, used to assess healthy adult body weight can also be applied to kids, though the standard is different depending on age and sex, says Dr Hong Li, chief of the Clinical Nutrition Department of Shanghai Children's Medical Center.

BMI is body weight divided by the square of his or her height; though it does not specifically measure fat, it's a good indicator of weight problems.

For adults, a BMI of 24 is a warning. For children, the figure ranges from 17 to 22, depending on age and sex. A child with a BMI over 22 is definitely overweight.

Being fat, of course, is not only an appearance problem but also poses threats to health. Chronic ailments like high blood pressure, diabetes and high blood fat are also found among fat children today. Moreover, accumulated fat and cholesterol clog arteries and put stress on the organs. Too much fat can damage the respiratory system, digestive system, immune system and internal secretion system.

Experts say the risk of high blood pressure is three to four times higher for fat (both overweight or obese) children than those of average weight. The occurrence of digestive problems is 15 percent for fat kids, compared with 4 percent for kids of average weight. The rate of fatty liver among fat kids is as high as 80 percent.

Being fat also has social and emotional consequences.

"Some fat kids lack self-confidence and are unsociable as they cannot move as quickly as others," says Dr Tang.

Fat kids are often teased and shunned by other kids, which increases their isolation.

Improper diet is the major cause. Many parents serve their only child whatever he or she wants to eat and most kids themselves have not developed self control about eating.

Rampant snacking makes things worse.

Lack of knowledge about health and nutrition contributes to the problem.

The case of Li Sumei and her grandson is typical.

"I know he is fat and he also knows he needs to lose weight," says Li. "But whenever he starts eating, he forgets about losing weight and I cannot stay tough and take the food away."

Lack of regular physical exercise aggravates the problem. Using computers and watching TV has replaced physical exercise for many youngsters, as well as adults. Taking taxis and elevators replace walking and taking the stairs.

The 2009 child health and nutrition report says 64 percent of primary and middle school students don't get enough exercise to burn calories.

"Most of the food we eat is turned into energy to support daily activities," says Dr Tang. "When we take in more calories than we consume, fat is stored. Fat kids are eating too much and not burning it off."

Research shows that kids with overweight parents are more at risk of being fat than kids from normal-weight families, because their parents set bad examples. The rate is 80 percent for kids with both parents overweight, 40 percent for those with one fat parent and only 10 percent for kids from an ordinary-weight family.

Hereditary factors may play a role, but overeating and unhealthy lifestyle are the big problems. Parents should set examples of healthy eating and regular exercise.

Eating three nourishing meals on time is the first principle of a healthy diet. Kids who skip breakfast often over-eat at lunch; large late suppers mean fat accumulates and there's little calorie-burning during sleep. The same is true for adults.

For both children and adults, healthy diets should be balanced, including carbohydrates (which are turned to sugar to provide energy), protein, fat and fiber. Food should be rich in vitamins and minerals. Carbohydrates should represent at least 30 percent of each meal.

Fat kids should eat fewer fats, sweets and animal protein (cholesterol) and eat more fruits and vegetables.

Fish, eggs, shrimp and beans are good sources of protein. Meat and chicken should be lean.

Steaming, boiling and braising are better than frying in oil. A little sesame oil is good for flavoring as it adds few calories.

Children, and everyone, should eat slowly so they don't eat too much. It takes a while for the brain to send the "I am full" signal, so it's easy to overeat before feeling satisfied.

Chewing food 10 times before swallowing can help kids enjoy their food more, and help them eat less.

Protein and foods with fiber, like fruits and vegetables, make one feel full. Don't let kids snack or hide snacks. Offer healthy snacks and fruit.

Physical exercise is important. Kids should take 30-60 minutes of physical exercise every day. Exercising with parents can keep them motivated to continue.

"Losing weight is a tough task, and many kids give up halfway," says Dr Hong.

"It's best to set short-term, achievable goals for kids in advance, such as taking off 1-2 kilograms each month, and make detailed diet and exercise plans accordingly."

Praise and rewards (not food) are important when a child reaches each weight-loss goal.

"This can maintain the momentum and encourage them to keep going." BMI Index

Body mass index (BMI) is a statistical measurement that compares a person's weight and height. It's the weight divided by the square of the height.

Though it does not actually measure the percentage of body fat, it is used to estimate healthy body weight.

Since it's easy to calculate, BMI is the most widely used diagnostic tool to identify weight problems, including underweight, overweight or obese.

The formula universally used in medicine produces a unit of measure of kg/m2.

An adult with a BMI index over 24 is considered overweight; over 28 is considered obese.


Snacking is a way of life in Asia and it can really pack on the pounds.

"The Guidelines on Snacks for Chinese Children and Adolescents" released by the Health Bureau in 2007 classifies foods into three categories - the ones that can be eaten often, eaten cautiously and eaten seldom.

It applies not just to snacks, but all foods.

Green light

Foods that can be eaten often are low fat, low salt and low sugar.

They include low-fat yogurt, no-sugar oatmeal, lean meat, shrimp, fish, eggs (not too many yolks), nuts (don't make a meal of them), fresh fruits and vegetables, boiled corn, plain soy milk, plain tofu, boiled corn, boiled or steamed potato and sweet potato, fresh fruit juice.

Yellow light

Foods that should be eaten with caution are high in fat and sugar.

They can be eaten in small amounts a few times a week, not daily. They include chocolate, cheese, and sugar-coated snacks.

Foods that should be eaten cautiously: chocolate, bacon, beef jerky, moon cake, cakes and pastry, sweet or salty soybean milk, dried fruits with sugar or salt coating, cheese, and juice with sugar additive.

Red light

Foods to avoid for anyone trying to lose weight are high in fat and sugar. They should be eaten no more than once a week.

They include sweets, deep-fried foods, canned fruit and condensed milk, hamburger, hotdogs, french fries, instant noodles, fried tofu or tofu with odor, potato and other chips, soda, and ice cream.

Junk fast-foods and sugary soft drinks, of course, should be avoided completely.

Water and pure fresh juice are best for kids, and everyone else.

Every child should drink about 1,000-1,500 ml water daily, more in summer and after vigorous physical exercise. Though fresh juice is nutritious, it cannot replace water. Too much juice will reduce kids' appetite for other foods, and cause problems.


Copyright © 1999- Shanghai Daily. All rights reserved.Preferably viewed with Internet Explorer 8 or newer browsers.

沪公网安备 31010602000204号

Email this to your friend