Confined to their homes amid the COVID-19 pandemic, children are facing a higher risk of obesity due to increased intake of junk food, lack of socialisation and physical activities, healthcare experts have warned.

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COVID-19 is expected to possibly worsen the problem of obesity in middle and high socioeconomic groups, they said. The economic, food and health systems disruptions resulting from the COVID-19 pandemic, healthcare experts said, are expected to continue to exacerbate all forms of malnutrition.

The latest National Family Health Survey, which was conducted in 22 states in pre-pandemic times, presented a dire picture of the nutrition of children in the country. While on the one hand, it showed a rise in malnutrition in several states, the government survey also presented an increase in obesity among children in 20 of the 22 surveyed states.

A senior official said tackling obesity is going to be a major area of focus for the government under the newly launched Mission Poshan. However, healthcare experts have said that the possible implications of COVID 19 in worsening the situation of overweight and obesity cannot be ignored. "COVID 19 is expected to possibly worsen the situation of overweight in middle and high socio-economic groups since the tendency for home confined young and school-aged children and adolescents to indulge in frequent munching or consumption of high calorie and empty nutrient value snacks such as 'namkeen', biscuits, bread, buns, noodles, ice creams, cookies and cakes, fried snacks, sweetened beverages would increase".

"These items are rich in carbohydrate, sugar and fat and are sought routinely and consumed to get relief from boredom", said Dr. Sheila Vir, Director, Public Health Nutrition and Development Centre, Delhi. She said parents also encourage feeding such items to meet the stress of constant demand for food fed to younger children. "Moreover, these children unable to play outdoors spend many more hours sitting in front of the computer or television", she said.

Dr Sujeet Ranjan, Executive Director stated, "The Coalition for Food and Nutrition Security said children in India presently suffer from double jeopardy of malnutrition; children are afflicted with over-nutrition as well as suffer from effects of under-nutrition". "During the lockdown and restricted movement, children had constrained access to socialisation, play, and even physical contact, critical for their psychosocial wellbeing and development. School closures were preventing children from access to learning and limiting their interactions with peers," he added. Schools across the country were closed in March to contain the spread of COVID-19. They were partially reopened in some states from October 15. "Children felt confused and at loss with the current situation, leading to frustration and anxiety, which only increased with the overexposure to mass and social media," he added.

Warning of ill-effects of obesity, he said childhood obesity is associated with a higher chance of premature death and disability in adulthood. "Lack of dietary diversity is one of the reasons for rising obesity, overweight children and high undernutrition. The change in diets and consumption of high carbohydrate and high sugar foods have an impact on the health of the children", he said.

Regular and excessive consumption of foods high in salt, sugar and fat leads to obesity and is a risk factor for many diseases. Sports for development (S4D) for physical fitness, balanced diet, reducing Television viewing are the four pillars through which obesity can be reduced among children, Ranjan said. Dr Somasekar Ramaswamy, Professor of paediatrics at the Madras Medical College, said not just children but obesity will also impact adults. "When it comes to children, one of the major cause could be online classes, while on the other hand it could be, work from home for adults. In both the cases, they have to sit for hours with excessive consumption of junk food and almost no physical activity resulting in an imbalance between intake and expenditure of calories, leading to accumulation of more weight, weeks-after-weeks," he said.

For the prevention of overweight in young children 6-23 months, Vir said caregivers should ensure that wise selection of food items and proper feeding practices are followed. "Overfeeding a child, if undernourished earlier, should be strictly avoided. TV time should be restricted and playtime encouraged. Regular weight monitoring, as far as feasible, should be encouraged. In fact, the entire family should 'Eat Right' since the overweight problem in mothers is also associated with overweight and obesity in their offspring. Also get into the habit of checking the nutrient content which is printed on the food packets, as per the government/FSSAI policy," she said.

Interventions at the school and community level that promote awareness and education about healthy eating habits, lifestyle patterns and regular exercise are essential to prevent obesity in children. Stringent advertisement guidelines and media intervention that prevents false propaganda of unhealthy foods by celebrities that children adore is another step in this regard, Vir said.

"Thus, interventions at a biopsychosocial level using a multi-disciplinary team approach forms the cornerstone in the effective management of childhood obesity," Vir added.