World Anti-Obesity Day: Is your child's obesity giving you nightmare?

November 26, 2016

New Delhi, Nov 26: After the United States of America, the epidemic of childhood obesity is gripping India. According to an international journal, by 2025, India will have over 17 million obese children and stand as second highest country in the world with obese children as per Pediatric Obesity.

obsThe rising prevalence of obesity in children is also bringing with it countless other adverse health effects, which make this condition a serious public health concern.

According to Satish Kannan, Co-founder and CEO of DocsApp, Obese children are at a greater risk of acquiring diabetes, high blood pressure, high cholesterol, cardiovascular diseases, bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-image.

Parents can be attributed to some degree for this problem as they often neglect the unhealthy dietary habits and patterns followed by these children. Popular culture that introduces them to junk food, snacks, colas etc and markets these items in the most attractive of ways adds to the issue.

Childhood obesity is a complex health issue which is not just influenced by unhealthy dietary habits, but also by the lifestyle and behavioral choices made by parents and children alike.

Children nowadays prefer to stay indoors than playing outside and are more exposed to screens like TV, tablets and mobile screens like never before. Meanwhile, there are parents who pressurise their kids to focus more on academics with little or no motivation to indulge in any outdoor games or sports. This lack of physical activity, which is a key determinant of energy expenditure and a fundamental part of energy balance and weight control, triggers obesity and chronic health conditions in them, said Kannan.

Genetic conditions are yet another factor that only increases the chances of obesity in children, which means children with overweight parents can also inherit the problem.

However, genetics alone cannot cause obesity. They merely increase one's propensity to put on weight easily. Ultimately, it's only the children who eat more calories than they need for their growth and energy who become obese.

No matter how much parents are to be blamed, the good news is that only they have the potential to influence their child's lifestyle and weight. For them, it can be difficult sometimes to figure out whether their child is overweight because a child may not look particularly heavy to be overweight.

Moreover, with a growing number of children becoming heavier at a younger age, they become used to seeing bigger children.

In such situations, determine the body fat directly is difficult and the diagnosis can be done through BMI rate. Children with a BMI equal to or exceeding the age-gender can be called obese.

Parents can do a lot to help their child maintain a healthy weight. To begin with, they can simply take charge as their role models by inculcating good habits in their children and encouraging them to be active and eat well by doing so themselves.

Parents must start a ritual of going for walks or cycling every day with their kids instead of watching TV or surfing the internet. This will not only make them realize that being active can be fun, it will be a great way for the entire family to spend time together.

Children crave for attention and care and those who are deprived of it, have a higher risk of obesity. So instead of using food as a comfort measure, parents must help them develop healthy eating habits by initiating ways to make their favorite dishes healthier, and reduce calorie-rich temptations by letting them enjoy those goodies as well once in a while as a treat.

Parents should also avoid serving their children oversized portions and start with small servings. They must also be encouraged to eat slowly in their set mealtimes. The mealtimes can be further utilised as an opportunity to catch up on their day to day activities.

Both the parents and children must make it a custom to eat healthy and aim for five or more portions of fruit and vegetables every day in the form of juices, smoothies, beans, and pulses, to ramp up their fiber, vitamins and minerals intake.

The idea is to get a maximum number of calories from healthier and nutrient-rich foods like fruit and vegetables, bread, potatoes, fish, chicken, rice and whole grains instead of sugary or high-fat foods like sweets, cakes, biscuits, sugary cereals, and sugar-sweetened fizzy drinks.

Children are the future pillars of a nation and their health and fitness are crucial for the overall growth and development of the country.

So, it becomes not just the responsibility of the parents, but the entire community around them including schools, child care settings and medical care providers, government agencies to be equally concerned about childhood obesity and take meaningful steps to nip the problem in the bud.

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Dr G K Sudhakar Reddy
August 4,2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of  arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip. 

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology.  Leptin is one of the hormones causing knee osteoarthritis. 

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.    

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor. 

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. 

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. 

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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Agencies
February 6,2020

Researchers have found the rates of lung cancer are higher in young women than men.

The study, published in the journal Pediatrics, examined lung cancer rates in young adults in 40 countries across five continents and uncovered a trend of higher lung cancer rates in women compared with men in recent years.

The emerging trend was widespread, affecting countries across varied geographic locations and income levels.

The changes appeared to be driven by a rising rate of adenocarcinoma lung cancer among women, said the study researchers from University of Calgary in Canada.

Lung cancer rates have been higher among men than women because men started smoking in large numbers earlier and smoked at higher rates; however, recent studies have reported converging lung cancer incidence rates between sexes.

Among men, age specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men.

For the findings, lung and bronchial cancer cases between 30-64 age group from 1993-2012 were extracted from cancer incidence in five continents.

The study found the higher emerging rates of lung cancer in young women compared to young men.

According to the researchers, future studies are needed to identify reasons for the elevated incidence of lung cancer among young women.

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Agencies
June 20,2020

At a time when the country is yet to recover from the shock of losing 20 Indian soldiers in a violent clash with the Chinese People's Liberation Army (PLA) troops in Ladakh's Galwan Valley, another shocker has come to light with news coming of a malware hitting the Indian Railways network and snooping its data for foreign countries, including train movements, sources in the intelligence agencies said on Friday.

Meanwhile, Railways Board Chairman V K Yadav said that the national transporter keeps on receiving malware security threats and the engineers in the railways keep on taking all precautions and keeps on updating the firewalls to prevent data theft.

The news comes a day after the Dedicated Freight Corridor Corporation Limited (DFCCIL) decided to terminate the 417-km signalling project worth Rs 471 crore with Chinese firm Beijing National Railway Research and Design Institute of Signal and Communication Group Company Limited (BNRRDISC) due to non-performance.

According to intelligence agency sources, the system of the Railways has been hit by the APT 36 Malware campaign. The source said that the intel agencies have also alerted the Railway Board to instantly disconnect the system with the Internet and change the password immediately.

The source said the APT 36 Malware is connected to Pakistan, which is a close ally of China. The source further said that following the red flag from the intel agencies, the system of a senior Principal Executive Director of the Railways, working in its vigilance department, has been taken for cleaning the malware threat.

As per the source, through the APT 36 Malware campaign, data stored in the Indian Railways systems were being stolen and stored in foreign locations, including the movement of the trains.

He further claimed that the APT 36 Malware also tried to take defence movement data. 

The source said the APT 36 Malware effect was reported from at least four systems of the Indian Railways.

Responding to queries, the Railways Board Chairman said: "Whether it is our systems or the IRCTC, we continuously update it with firewalls, and it is an ongoing process as we get the updates." 

Yadav said that our system is updated time to time. "We get malware threat on a regular basis. And we look at it continuously," he said. 

When pressed further about the malware threat in four railways systems, he said: "It has not come to our notice that some information has been leaked. Our systems are secure and our engineers keep on working on it."

According to intel sources, besides Railways, there was also malware threat in the defence, central police organisations, education and healthcare sectors, the source said.

In view of the threat, the intel agencies have asked the departments concerned to change the passwords of emails and online services from secure computers, format the hard-disk of the affected computers after taking back-up and re-install the operating systems and other softwares.

Sources in the Railways had said on Thursday that DFFCIL, which is looking after the work of the Dedicated Freight Corridor Project, has decided to terminate the tender with BNRRDISC.

A source in the Railway Ministry said that it has informed the Railway Board and the World Bank to take the final decision in the matter.

The source said the project was awarded to the Chinese firm in 2016 for signalling and telecommunication work on the 417-km Kanpur-Deen Dayal Upadhyaya section of the Eastern Dedicated Freight Corridor (EDFC). 

The source disclosed that the contract was awarded to the Beijing National Railway Research and Design Institute in June 2016. The source further said that even after four years, the progress in the project was only 20%. The issues that led to the termination of the project are reluctance by the company to furnish technical documents, as per the contract agreement, such as logic design of electronic interlocking.

The source further said that other issues like non-availability of their engineers and authorised personnel on site were a serious constraint. Even physical work could not progress as they have no tie-up with local agencies. 

The 3,373-km DFC, a flagship project of the Railways, aims to augment rail transport capacity to meet the growing requirement of movement of goods by segregating freight from passenger traffic.

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