Obesity in children

Obesity in children can lead to Type 2 diabetes. Diabetes nurse educator, Christine Manga, shares how parents can prevent obesity.

Obesity stats

Africa is ranked as having the highest rate of obesity in preschool children in the world. South Africa was also listed as one of the top countries that have obesity issues. These stats were presented in  October 2016 at a World Obesity Day presentation.

If the current rate of increase continues, by 2025, there will be approximately 3,91 million overweight (BMI 25-29,9) and obese (BMI > 30) school children. This would result in 120 000 children with impaired glucose tolerance (pre diabetes) and 68 000 with overt diabetes.

Childhood obesity also carries other health risks:

  • Breathing problems, such as sleep apnoea and asthma.
  • Joint and musculoskeletal discomfort.
  • High blood pressure and high cholesterol which are cardiovascular risk factors on their own.
  • Fatty liver disease and heartburn.
  • Psychological and social problems, including discrimination and poor self-esteem.

Birth to Twenty

A study, Birth to Twenty (BT20), conducted in Soweto, showed that obese children between the ages of four and six were 42 times more likely to be obese in their teens, compared to their peers of normal weight. Childhood obesity is also a strong predictor of adult obesity. Once obesity in childhood is established, it is very difficult to treat. But it is not impossible.

Cause of childhood obesity

The causes of childhood obesity are complex. The most obvious causes are overeating and under exercising. Other reasons obesity may occur include: sleep deprivation, poverty, and genetic predisposition as well as social and environmental components.

As much as psychological issues can be caused by obesity, they too can lead to obesity. Kids who are stressed, bored or depressed may become emotional eaters. Certain cultural beliefs about body shape may further exacerbate the obesity pandemic.

Exercise and dietary recommendations

With under activity being one of the major contributory factors, it is worth noting the WHO exercise recommendations. Children in the five to 17 year age band should be getting a minimum of 60 minutes of exercise a day. This can be incorporated into play and sport.

The other main contributor of obesity is over eating. An average calorie intake for a child of the following ages should be:

  • 2 – 3 years = 1000 per day.
  • 4 – 8 years = 1200 per day.
  • 9 – 13 years = 1600 per day.
  • 14 – 18 years = 1800 per day.

These calories should include no more than 100 calories from added sugars. This equates to 25 grams of sugar or less than six teaspoons a day.

It is very easy to overshoot these numbers, considering that a 330ml can of Coke contains seven teaspoons of added sugar and contains 139 calories (already more than the daily quota for added sugar). While a medium chocolate muffin contains 364 calories.


Poverty also plays a huge role as energy dense food (often high in unhealthy fats) cost less than the healthier, low energy dense options, such as fruit, vegetables and protein.

Energy dense food contains high levels of calories per serving. These foods tend to fill you up, but often have poor nutritional value. They will usually contain hidden sugars, fats and salt.

For more information on the nutritional value of food, read the food labels on the packaging. Fatsecret South Africa is a very helpful website and can be downloaded as an app.

Sleep deprivation

Sleep deprivation is associated with poor eating habits and significantly increases the risk of becoming obese. The National Sleep Foundation recommends that three to five year olds should get between 11 to 13 hours of sleep a night, while six to 13 year olds should get nine to 11 hours.

So, how do parents prevent children from becoming obese?

Firstly, we need to lead by example. Parents are the single biggest influence on their children. We need to make healthy food choices as often as possible. Don’t keep high sugar and fat foods at home. Let your children learn that there are healthy everyday foods. These should be readily available where possible.

Then, there are ‘sometimes’ foods; these should not be kept at home or readily available. Be aware of the foods that are being advertised on TV and social media. Children are susceptible to this conditioning.

Packing lunch boxes

When packing a lunch box, make one swap a week to replace the unhealthy options until eventually you have a nutritious box packed. For example:

  • Swap dried fruit, which is high in calories and sugar and easy to over consume, for a fresh fruit.
  • Add a crunchy vegetable; they add colour and are high in nutrients.
  • Replace a cold drink with water. Flavour it by putting in a few berries or cucumber and mint.
  • Let your child experiment. Shift from white bread to whole grain.
  • To keep your child interested, try to vary between rolls, pita and regular bread.
  • Change the filling from jam or chocolate spread to a protein, such as cheese, egg or a nut spread.
  • If you are unable to make school lunches at home, get involved with the school tuck shop. Even if you are physically unable to help out, make suggestions of foods that should be offered and those that should not be.

Do not use food as a reward

Praise your child when making healthy food choices. Do not use food as a tool to bribe, punish or reward behaviour. It can cause an unhealthy relationship with food.

Eat as a family at a table

Where possible, sit together as a family to eat. Avoid eating in front of the TV or computer as this leads to mindless eating and often over eating.

Encourage activity

Encourage your child to take part in sport. Activity is of paramount importance in preventing obesity.

Obesity is preventable and it is a parent’s responsibility to assist in preventing it.

Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.


Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.