The diet of children is crucial in fighting obesity. PHOTO/SHUTTERSTOCK
Ten-year-old Joel, a once active child, now struggles with his weight and daily tasks, including climbing stairs and running around with peers.
Over the past few years, since the Covid-19 lockdown, Joel’s weight has steadily increased, leading to physical discomfort and emotional distress.
His mother, Mercy Nabirye, recalls how different things were just a few years ago.
"He used to run around all day, playing soccer with his friends and was always full of energy but not now. Joel no longer goes outside as much. He prefers to sit and watch TV or play video games," she explains.
But Ms Nabirye soon noticed the shift in Joel's weight when he preferred more processed food while staying home.
Lockdown routine
"During the lockdown, the school gave Joel more assignments. He would stay home and study and more often feed on junk food like chips, fried chicken, sugary drinks, and fast foods since he was alone. He was kept so busy that the only free-time activity he would do was watching television,” she says.
"He gained weight shortly after and started complaining of leg pain and shortness of breath after small tasks like walking up the stairs or carrying something heavy. I thought it was just a phase, but the weight kept piling on," Ms Nabirye laments.
Crisis of childhood obesity
"Joel's weight gain has had a significant impact on his confidence. At first, he didn’t seem to care, but recently, he started to become more withdrawn. He avoids taking off his shirt in front of his cousins, and he doesn’t want to swim anymore. He told me some of the children at school call him 'big fatty' and it hurts me to see him go through this," She says.
Joel’s situation is not unique, as Uganda is witnessing a growing crisis of childhood obesity. Health experts link this to a combination of genetic, environmental and consumption factors.
The 2024 World Health Organisation (WHO) report on obesity and overweight shows that in Africa, the number of overweight children under 5 years has increased by nearly 23 percent since 2000, with more than 390 million children and adolescents aged 5–19 years being overweight by 2022 worldwide.
Push for balanced nutrition
The experts say parents should prioritise creating a healthy environment by encouraging balanced nutrition, limiting processed foods, and ensuring children engage in regular physical activity to prevent obesity and related health risks.
Ms Samalie Namukose, the assistant commissioner in charge of nutrition at the Ministry of Health, says many non-infectious diseases among young adults have been triggered by unhealthy diets both in schools and homes.
"Currently, about 2.8 percent of children under the age of five are obese and exhibit strong evidence that this is associated with non-communicable diseases like cancer, heart diseases and also high blood pressure. It is recommended to consume foods that are not over-refined and have roughage," she says.
Ms Namukose adds: "If you eat over-refined food, it becomes very difficult for the digestive system to actually expel these components from the body, and it keeps accumulating poison that ends up causing these non-communicable diseases. In terms of pumping the blood to the various parts of the body, the heart becomes very weak to carry quite several nutrients to the different body organs."
Mr Daniel Kamara, a nutritionist from the Nutrition Rehabilitation Centre, cautions that many children and young adolescents do not meet dietary diversity but rather depend on processed foods that have high trans-fats and sugars which are the biggest causes of obesity in children as they dominate their dietary intake.
Problem of sugary foods
"We did a study with Save the Children and we found out that 7 in 10 semi-urban adolescents depend on sugary products carrying extra calories which the body converts into fats that will start manifesting outside," she says.
Save the Children is a global organisation that works to protect children's rights, safety, and well-being.
An annual nutrition performance report by the Ministry of Health for the Financial Year 2022/2023 shows that the prevalence of overweight in children under five years is 5 percent.
Lack of physical exercise
Ms Namukose also raised concern over the lack of physical activity among children, noting that many are not engaging in exercise at school and even at home, and are not involved in any form of work.
"Parents should encourage them to do household chores, walk to the market, and eat natural, unprocessed foods instead of relying on packaged meals. Schools also need to ensure physical activity is part of the daily routine to help children stay active and healthy," she emphasises.
Dr Sabrina Kitaka, a paediatrician and adolescent health specialist, highlights the complications associated with obesity that can hinder psychological growth, attaching the disorder to not only unhealthy foods but also genetic factor.
“There’s growing scientific evidence that genetics play a significant role in how a person’s body stores fat and processes food with certain genes influencing how the body metabolizes nutrients and signals feelings of fullness,” she says.
Risks of obesity
"Obese children often face joint pain, difficulty in breathing, and a loss of self-esteem. Unfortunately, they are also more likely to experience body shaming and bullying, which can have lasting psychological effects,” she adds.
Dr Kitaka warns that childhood obesity is a leading cause of serious health conditions such as type 2 diabetes and heart disease, which were once considered only adult problems.
"Obesity during childhood is a risk factor for chronic diseases later in life, including heart disease and diabetes. In some cases, these health problems are already being diagnosed in children as young as 10 or 11," she explained.
Managing obesity in children
Experts agree that there are several approaches to managing and preventing obesity in children.
Mr Kamara emphasises lifestyle changes in terms of dietary modifications, reducing fat and carbohydrate intake as crucial for managing obesity and also regular physical activity at least 60 minutes a day.
“Prevention must start early, with schools playing a significant role in promoting physical activity, and healthy eating habits, especially the food items vended at canteens. We need to educate children from a young age about nutrition, and schools should incorporate physical education and nutrition education into their curriculum," he says.
“First of all, the government should invest a lot in educating these schools which are now responsible for our children’s health since they spend almost 70 percent of the time with them. Portion meal controls should be monitored by parents at home, meal planning and timing, as well as public awareness campaigns where public health specialists work together with us [nutritionists] for reverse references,” Mr Kamara proposes.
Fact guide on obesity
Causes of Childhood Obesity
Lack of physical activity
High consumption of sugary drinks (soda, ice cream)
Excessive screen time (TV, video games)
Frequent intake of snacks and fast foods high in sugar
Genetic factors
Hormonal imbalances and medication side effects
Effects of Childhood Obesity
1. Diseases
Increased risk of type 2 diabetes
High blood pressure and heart disease
Joint pain and difficulty in movement
Breathing problems, including sleep apnea and asthma
2. Psychological and Social Impact
Low self-esteem and body image issues
Bullying and social isolation
Increased risk of depression and anxiety
Reduced life expectancy due to obesity-related diseases
Prevention of Childhood Obesity
Balanced diet – Consuming fruits, vegetables, lean proteins, and whole grains.
Regular physical activity – At least 60 minutes daily, including sports and outdoor play.
Portion control – Teaching children to eat in moderation and recognize hunger cues.
Reducing sugary and processed foods – Cutting back on junk food, soda, and carbohydrates.
Encouraging high water intake
Limiting screen time – Reducing TV and gaming time to promote active lifestyles.
Regular health checkups – Monitoring BMI and seeking medical advice if necessary.
Structured meal times – Establishing routine eating habits to prevent overeating.
Foods to Eat (Healthy Choices)
Fruits – Apples, oranges, bananas, berries, watermelons, pineapples.
Vegetables – Spinach, carrots, broccoli, cabbage, cucumbers, green beans.
Whole grains – Brown rice, whole wheat bread, whole grain pasta, oats.
Lean proteins – Chicken, fish (tilapia, Nile perch), eggs, beans, peas, lentils.
Dairy (low-fat options) – Skimmed milk, yogurt, cheese.
Healthy fats – Avocados, nuts (groundnuts, almonds), seeds (sunflower, chia).
Water
Foods to Avoid/Reduce Consumption
Sugary drinks – Soda, energy drinks, processed fruit juices, ice cream.
Fast food – Deep-fried chicken, fries, burgers, pizzas, cheese.
Processed snacks – Chips, biscuits, instant noodles, flavored popcorn.
Refined carbohydrates – White bread, white rice, processed cereals.
Sugary treats – Cakes, doughnuts, ice cream, sweets, chocolates.
Fatty and fried foods – Chapatti, samosas, crisps, deep-fried meats, processed sausages, canned foods, instant soups.
