It has been a while since I saw a child with kwashiorkor or marasmus. These two, were common conditions a decade ago when I started practicing medicine. In their place, overweightness and obesity are taking over.
For child health practitioners, the latter are a global health concern. Their short and long-term impacts on the individual in an already strained health system’s cost ramifications, are good discussion points.
The Ministry of Health’s 2015 STEPwise survey, found 27 percent of Kenyans as either overweight or obese, with 38.5 percent being women and 17.5 percent men.
Amongst urbanites, prevalence was 12 percent and seven percent for rural dwellers. A notable feature of devolution being morphing of rural areas into urban ones, this portends doom for rural counties’ statistics as well, as they urbanise.
My observations of childhood obesity in neighbourhoods, suggests a rather concerning situation. No major distinctions are seen between low and high-income areas, although the former fare slightly better. This may be corroborated by research data.
JW Kamau and team’s 2011 paper, Prevalence of overweight and obesity among primary school children in Nairobi province, Kenya, found that 6.9 percent of pupils in private schools were obese while 16.7 percent were overweight. In public schools, 1.6 percent were obese and 5.7 percent overweight respectively.
In the same year, Kristi B A and team’s study, comparing urban and rural children with their Canadian peers, noted “inflexibility” of the urban children in the Kenyan group. It suggested that this group of children were beginning to show signs of “the nutrition-physical activity transition”. The phrase may refer to reduced physical activity due to weight related reasons.
Obesity concerns though aren’t just in children. A paper by Dr Gershim Asiki and colleagues titled, Sociodemographic and behavioural factors associated with body mass index among men and women in Nairobi slums, notes similar findings.
Their study suggests that obesity, long thought to be a condition of the wealthy, is instead making inroads in urban informal settlements, which will be the next frontiers for NCDs, unless public health interventions are undertaken.
Various reasons have been advanced for this shift, with changing foods and sedentary lifestyles being main culprits. Predatory unhealthy food marketing, a growing junk food industry, as well as lack of time and spaces for children to play are to blame.
The solution is education on healthy nutrition as well as promoting more outdoor play time for kids.
The latter is a challenge, especially in informal settlements where playgrounds have been grabbed. The Nairobi Metropolitan Authority and residential associations should strive to reclaim lost play spaces. Parents and health workers too have a role to play, encouraging physical exercise as a routine family activity.
Although the papers cited did not look into trends over time, it is thought that every decade worsens these statistics. It would be interesting to see how participants in the studies above fared on in adulthood, decades later.