So I'll put the boxing gloves away.
I will outline for the next few minutes some important issues that everyone should be getting....
Some interesting statistics have come out. Foremost, we already know that South Asians are at an increased risk of cardiovascular disease. Further research has also determined that South Asian children not only have an increased prevalence of childhood obesity, they also have precursors for diabetes known as insulin resistance. I'm going to touch upon some of these issues.
Another interesting statistic that comes to mind is that the earliest age at which atherosclerosis, which is a form of plaque that forms in the blood vessels of the heart, has been shown to manifest is actually between the ages of three to ten. Having said that, put this together with the pandemic we have of obesity starting in children, and we have to try to come up with ideas to address this.
Other interesting statistics have come from the International Obesity Task Force, and they have suggested that by 2010, over half of North American kids will be overweight or obese. Now, when we hear this statistic we always look to our neighbours down below and say, well, it's really a problem of the Americans, their eating habits. In fact, the same group has looked at the prevalence of obesity that is rising in our children in the U.S. and in Canada, and it is rising by 0.5% in the U.S. and by 1% per year in Canada. In fact, between 1981 and 1996, American childhood obesity has doubled, but it tripled in Canada.
We know that overweight and obese kids have nearly an eightfold increased risk of developing high blood pressure and high cholesterol, not to mention diabetes, which goes hand in hand with childhood obesity. Once you develop diabetes, you are considered at a very high risk, increasing your risk of strokes, heart attacks. In fact, children who are obese, adolescents particularly who are obese, over the next twenty years, have a doubling of mortality. They're at a twofold increased risk of dying.
Speaking of the South Asians particularly, there is interesting research that has come out, some through England, some through Canada. I will mention a couple of interesting studies to you. One comes out of Birmingham. They noticed in Birmingham that 12% of Caucasian teenaged girls aged 14 to 16 and 23% of the boys were found to be overweight or obese; however, these proportions increased to 42% and 41% in the South Asian population in the same age group.
I've already mentioned to you that the same age group in children in the South Asian population, for some reason, already have precursors for diabetes, whether or not they're obese. Taken together with the obesity, that raises their mortality and morbidity figures quite significantly.
Other recent studies have suggested that there are not just genetic factors, but there are environmental factors that go hand in hand with children becoming obese. One such factor they have determined--and this was published recently--was that watching more than eight hours of television per week led to the development of obesity in young children. Also, when they looked at the age bracket between two and four years of age, they found other parameters, including parental obesity, that is, kids are now looking at their parents, finding them to be obese. They are accepting that body habitus much more so than if their parents were of standard body habitus.
Another parameter they found was short sleep duration. Less than 10.5 hours per night at age three was linked to the development of obesity later on in the children's lives. Early development of body fatness in preschool years was also related to development of childhood obesity and later consequences.
Certainly, there are genetic factors that play a role. However, the main message that we must maintain should be that it is the environment. It's not enough to say it's a genetic tendency that explains the recent rise in the prevalence of obesity in our population.
You've heard of some nutritional and other socio-economic parameters as to why this could be occurring. But what we need to do, of course, is to adopt a nutritional and healthy lifestyle. If we take Singapore as an example, they developed what's called a trim and fit scheme. It was a comprehensive ten-year program that actually began in 1992 and continues today. It featured teacher education, training, assessment of students, a program that involved reducing sugar in beverages that children consume, and more physical activity during school hours. They re-evaluated the program recently. They found that not only were these kids becoming more fit, but the prevalence of obesity was much less.
Some key points are outlined in the brief you will have. I will end with some tips we have for parents, especially South Asian parents.
One is to respect the child's appetite. Children do not need to finish every bottle or every meal. I don't know if many of you have had the opportunity to eat with a South Asian family, and looking around there's only one South Asian amongst us--shame on you guys--but what you'll find is that due to the cultural tendencies, the parents will make the kids finish their meals. Moreover, they will actually encourage them to take seconds and thirds. It is considered rude to not finish your meal, to leave any scrap on your plate. However, this is not the case in the non-southern areas. Some other Southeast Asians also have similar cultural tendencies.
We also need to tell the parents to avoid pre-prepared and sugared foods. What are these? We're living in an era where everything is at a fast pace. We're all busy professionals, and as a single, busy professional, sometimes I find myself going to the grocery store to purchase these pre-prepared foods, where all I have to do is microwave it or take it out of the can and heat it up. These types of foods are very high in calories, and high in preservatives, which leads to other problems.
Another piece of advice is to limit the amount of high-calorie foods kept in homes. If you ever visit a South Asian home, all you need to do is open up a few of the kitchen cabinets. There is always what's called a junk food cupboard. These junk foods aren't necessarily what we see in the non-South Asian population. They are not necessarily only pretzels. They are deep fried, full of preservatives, packaged foods that actually come from the South Asian countries and are bought locally in our grocery stores, even places like Loblaws.
We need to provide ample fibre in the child's diet. We need to be aware that we cannot reward action by food, by sweets. This is done quite a bit in the South Asian population. To encourage their children to finish their homework, or to encourage them to do something else, they'll give them a piece of something sweet. We also shouldn't offer sweets in exchange for finishing meals.
We should limit the amount of television viewing--and I've already outlined a study that dealt with this--encourage active play, and establish regular family activities, and this particularly applies to the South Asian population.
A recent study suggested that unless we get the parents involved with the education required to help their kids lose weight, to help them participate in the activities required for the kids to lose weight, it isn't going to be as successful.
There are a couple of other behavioural modifications that I want to mention. Recent studies have also suggested--and this was published two weeks ago, I think--self-monitoring, checking weight every day. Before, we used to say there was no need to check our weight every day, that we were becoming too obsessed. But in fact that auto feedback is an excellent tool to help not only the children but their parents realize what impact the interventions they are making are having on their kids.
For the sake of time, I'll end there and leave the rest for the question and answer period.