THE misconception among many Jamaican mothers that babies must be plump and chubby in order to be healthy is one

of the main
contributors to childhood obesity here, nutritionists argue.
To tackle the problem of children becoming overweight and obese, this cultural perception must be eliminated from the minds of parents.
Food and nutrition consultant Heather Little-White said many Jamaicans believe that fatter babies are healthier and "nice and cute", and so
from an early age, mothers tend to overfeed their infants, not realising that this practice eventually follows them into adolescence and
adulthood.
"Parents must recognise that while chubbiness is nice, it is not always a factor that you want to encourage," she said. "We have to try to cut
back on the overfeeding."
Fatness perceived as prosperity
Little-White further said this perception was often continued into adulthood, as fatness is often perceived as a sign of health and prosperity
for many Jamaicans.
"A man will see a woman and say, 'I like that one because she is nice and chubby', versus the more slender woman, not knowing that the
plumper one might be less healthy," she said.
Nutritionist Patricia Thompson said from a very early stage, mothers must guide their babies' eating habits so that they stop eating when
they are full.
"Your new-born infant needs to be breastfed on demand. That way the child not only consumes what they want but they develop their
internal physiology so that they eat when they are hungry, and when hunger is satisfied they stop eating," she said.
This practice, she said, would eliminate the problem of overeating and eating more than the body needs.

The nutrition experts further said public education and counselling were also important to change the mindset.
They said parents needed to be educated on the nutritional value of food and how and what to prepare so that they are feeding their
children a balanced and healthy diet.
"Sometimes we feed the children too much starch and empty calories, they need to have a good balance of vegetables and protein," LittleWhite said.
She said parents must make a conscious decision, despite the hard economic times, to provide their children with wholesome, healthy
foods.
"It's a trade-off, because if they go for the fast food with the empty calories because it's cheaper, they are going to end up spending more
for the doctor bill," she said.
Both nutritionists also agreed that parents must closely monitor what their children eat when they are away from home, particularly while
they are at school.
athaliah.reynolds@gleanerjm.com
Obesity effects damaging
Athaliah Reynolds, Staff Reporter
CHILD PSYCHOLOGIST Dr Gemma Gibbon says children who are overweight or obese are just as likely to experience learning problems
in school as a child who is undernourished.
She said this is because obesity can affect the child's brain function and ability to retain information in the same way that being underfed
can affect an individual.

"(Similar to) malnutrition, you're going to lack a lot of brain function, because you're not getting enough vitamins and you're eating too much
sugar, so you will have less focus, less attention and you will have problems attaining and retaining information," Dr Gibbon said.
She further said children who were obese or overweight might also experience problems sleeping and this could also influence how they
functioned at school.
"They won't be able to sleep properly at night, they won't be able to get up properly in the morning, and they'll often feel tired and drained,"
she said.
She said nutrition played a very key role in how children learned and if they were not eating properly, that is, having a balanced, healthy
diet, it often caused them to perform quite poorly.
Getting too much nutrition
"People think that because you're eating a lot you're getting proper nutrition, but you're getting too much of the wrong things," Dr Gibbon
said.
She said proper nutrition, especially in children, was very important for brain function and for feeling good about themselves. "Being healthy
has a strong psychological impact on a person," Dr Gibbon said.
Psychologists also argue that obese or overweight children might also develop low self-esteem and or depression tendencies, which can
also affect how they behave and learn in school.
A recent study from The Mayo Clinic in the United States suggests that the psychological and social effects of obesity are just as damaging
to children as the other physical health problems to which they are prone.
The study further said that overweight children were likely to experience low self-esteem, teasing and bullying and often suffered an
increased risk of depression.

Dr Gibbon, however, suggested that this might be different for some Jamaican children, as being fat is not as much of an issue as it is in
other countries, such as the US and the United Kingdom.
"It's quite a mixed bag ... but the generation coming up now is far more aware of body shape, as opposed to about 10 years ago," she said.
Self-esteem issues
Dr Gibbon, however, said psycho-logical or self-esteem issues might arise if the child is picked on or has a problem with his/her weight.
"But if they're just having a bad diet and they don't even realise it, and no one is calling them names, then it's not a problem for them really,"
Dr Gibbon reasoned. "It's only a problem if they feel themselves fat, ugly or horrible, that they can't do anything, or that people pick on them
all the time."
She said it was very important for parents who noticed that their children were overweight or obese to seek professional assistance in
getting them on a proper healthy diet.
How do you know a child is overweight?
Dr John Royes, paediatrician at Kidz Klinic, said parents should monitor their children's weight according to their height, not their age. He
said that just by looking at a child's parents, a weight issue could be determined.
"Even with the untrained eye, you would be able to know that something is wrong - whether the child is a little bit meagre or overweight, just
by the appropriateness of his body contours," he said.
He said the correct thing to do is to chart the child's height and weight to determine whether the child's weight is appropriate.

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Discussion
Jamaican adolescents are at risk of developing T2D and CVDs. In studies of children/adolescents of
primarily Caucasian cohorts, girls were more likely to have T2D, whereas boys were more at risk for
CVDs.2426 In our study, girls had significantly more risk factors than did boys and were less
physically active. Our findings on clustering of the risk factors related to overweight were similar to
previous research,5 ,27 ,28 which found that overweight children and adolescents had at least one
cardiovascular risk factor. Our participants, whether overweight or not, had three or more risk factors
of T2D and CVD. The number of risk factors was higher than expected when compared to US-based
studies.5 ,28,29 Knowledge of the prevalence of overweight and the number of risk factors in this
population is vital, since obesity during childhood and adolescence transcends into adulthood.27 ,30 It
is likely that the accompanying risk factors of hypertension, AN, hyperglycaemia and hyperlipidaemia
will also be manifested in the adult years.
Differences in risk for T2D and CVD by BMI classification
The findings of high BMI and its association with risk factors for T2D and CVDs were in agreement with studies conducted in minority and Caucasian
children.1 ,2 There was evidence of a high prevalence of obesity indicators: BMI, WC and WHR, which are considered as risk factors for T2D and CVDs in US
adolescents.1 ,5 ,26 The prevalence rate of overweight among Jamaican adolescents was twice that of US adolescents (35% vs 17%) 26 and exceeded previous
findings of Jamaican adolescents overweight.8 ,9 ,31 Higher BMI might have been related to outliers, which were not removed from our analyses due to the small
sample size.
We found a high prevalence of underweight and overweight adolescents (24.6% and 35%), which supports the notion that over nutrition and under nutrition coexist
in resource-poor countries.28 This phenomenon, which is referred to as the obesity paradox, occurs when underweight and obesity are found in the same
impoverished family.32 We found significantly more overweight mothers compared with fathers, consistent with other studies on Jamaican adults.7 ,30 Other
literature suggested that the presence of more overweight mothers may be due to the more domestic lifestyles of women, especially because women are in charge
of food preparation and have more access to food. Results on BMI, gender and age are similar to previous findings, 8 which reported that more Jamaican girls than
boys aged 1015 years tended to be overweight, and this trend continues into adulthood. 30

Risk fa