RECENT studies, both domestic and international, paint a bleak picture of children's health in the country. Malnutrition and obesity are on the rise among children in urban areas. Indeed, going by what has been made public by a research conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), we understand that 14% of urban children suffer from overweight problems while 4% are obese. This is hardly surprising given that our major cities including Dhaka have transformed over the decades into concrete jungles, where public spaces such as parks and playgrounds have systematically been downgraded nearly down to the point of non-existence. It has brought about fundamental changes in the way our children are now brought up in the confines of homes where computers, the internet and gaming consoles have replaced essential physical activity that are an essential part of a growing child's health needs.

And it is not just the lack of physical activity that is the problem. The food habits of children have also undergone a sea of change. With the global rise of the fast food phenomenon, a trend that has become part-and-parcel of our fast paced urban life, the constant bombardment of commercials in electronic and print media on foods that are anything but nutritious and the general acceptance of parents that such foods are alright for consumption for children, all compound the problems of poor nutrition among children. Traditional foods are increasingly being pushed to the side to make way for deep fried foods and other foods, both solid and liquid that is rich in sugar content. High calorie diets that have little food value are effectively elbowing out traditional, nutritious, slow cooked foods. The World Health Organisation (WHO) terms childhood obesity "one of the most serious public health challenges of the 21st century" and not without reason. 

For any child, tackling the social stigma that comes with a condition such as obesity automatically translates into psychological problems, and more importantly serious health issues. One simply cannot discount the fact that an overweight child is the butt of jokes in the schooling system. Such external circumstances lead to a sense of lower self-esteem, less than average academic scores and a general withdrawal from social interaction.  When we look at some of the health risks such children face, studies have pointed out that obese children run the risk of developing various disorders like hypertension among other things. An obese or overweight childhood can easily run into adulthood and the chances of developing cardiovascular diseases increase exponentially. Indeed, there is also evidence that spinoffs from hypertension in children can translate into lower than expected life expectancy as they grow to adulthood.

So what is to be done? Given the space constraints in cities like Dhaka where big business takes precedence over the quality of life for its citizens, i.e. every inch of green being transformed into shopping malls, commercial or private space and laws being formulated and implemented to that effect, raising a hue and cry over lost playgrounds obviously is not going to make much difference on the ground. What we can do is effect a change in mindsets, to cope with the realities of our urban existence and that begins with education. Treating the issue of obesity merely as a medical problem is obviously not going to bring desired results. Rather it is parents and guardians who need to be brought into any national campaign that targets better eating habits for children from a younger age. As pointed out by some health professionals, particularly nutritionists, a unified approach is required to manage the issue of obesity and that means developing mechanisms whereby different stakeholders ranging from health professionals  to parents work together to stop the menace of poor choice in food intake to more rigorous exercise for our children. 

Children need to be taught in schools and at homes to distinguish between good and bad foods. The media has to be part of any campaign strategy if we are really serious about handling the whole overweight issue. Parents need to be made aware of what their children are consuming and what they should be consuming. As responsible adults, parents need to take responsibility for the overall wellbeing of their children so that the next generation may have a better chance of not contracting diseases like diabetes and heart conditions. In fact, more can be achieved at a family level than any national campaign. 

Children's physical fitness can be addressed in our educational system in the form of "indoor" exercises where "outdoor" activities opportunities are limited. Small-scale gymnasium facilities can be built and operated within school or college premises. These are not impossible scenarios, given that the State passes legislation, which is acted upon to make it mandatory for schools to provide physical education to children. These are some of the ways the issues of malnutrition and obesity may be tackled. What is required of course is the political will to face the real threats our children are facing today. 

The writer is Assistant Editor, The Daily Star.