It was a warm winter evening and 10-year-old Ramya could hear children playing dodgeball in the community park. Part of her ached to join in the fun, but one glance at the mirror and she abandoned all thoughts of going out. "At 10, she weighed 60 kg and had difficulty in walking and carrying out daily activities,," says her mother, T Suhasini, a Chennai-based school teacher. Her friends would hide her lunch, saying that eating more will make her grow even fatter. The snide remarks coupled with the constant state of exhaustion were making Ramya a graying, hypertensive, emotional wreck. Her blood tests later revealed high insulin and triglyceride levels.
In another Chennai school, 15-year-old Shobhana was suffering quietly as well. Weighing 88 kg, she complained of hirsutism, severe hair-loss, 50 percent graying of hair, amenorrhea (no periods) for two months and polycystic ovarian syndrome (PCOS). At that young age, Shobhana looked like a 23-year-old, and her classmates would tease her by calling her akka or elder sister. "She found comfort in food and became an emotional eater - be it chips, chocolates, cream biscuits and even raw sugar," says her mother, Sreelata Kaushik, a TV newsreader.
In 2011, both cases were presented to Dr Kousalya Nathan, lifestyle management and anti-ageing consultant. She wasn't surprised. Since 2009, she had been steadily getting more cases of children with early onset of adult diseases. Be it premature menarche, high blood pressure and cholesterol levels, hypertension, arthritis, graying hair, polycystic ovarian syndrome and fatty liver - 5-to-19-year-olds were ailing with lifestyle disorders commonly associated with adults. Today 30 per cent of her practice is related to such cases.
Delhi-based Arvind Taneja, chief advisor, Max Healthcare, and consultant for pediatrics and infectious diseases, too has seen a rise in such cases in the past two to three years. "Out of the 15 patients that I see in a day, two to three come in with these lifestyle disorders." Obesity is usually at the centre of these disorders, and the culprit is the nutrient-poor and calorie-rich food intake. "The other day a ten-year-old girl came in. She weighed a whopping 95 kg," he says. "Mostly it's the parent's fault. They have a fixation with having a plump child, especially in the younger years. So they ask for nutritional supplements, a habit which I absolutely discourage."
Listening to the doctors rattle off factors that lead to the early onset of adult diseases, it feels like these are things that we have read and heard of endlessly and yet have chosen to ignore them. For instance, countless articles have been written about the link between television and mechanical eating. Then there is the addiction to gadgets like the iPad that weans them off exercise. "Children are listening to such loud music on the earphones that we are seeing signs of early deafness," says Taneja. Coupled with this is the fact that children are not exposed to sport of any kind.
It is no wonder then that children have started putting on weight at the ages of 4 and 5. Constant consumption of heavily salted foods like potato chips has resulted in hypertension, while Type II diabetes - a disease commonly associated with the ageing population - is now being detected across 5 to 19 year-olds. Unable to support their own weight, 10 to 12 year-olds are also complaining of aches and pains in the joints. Growing up on a junk food diet, pre-adolescents and adolescents suffer from deficiency of Calcium, Vitamin D and B, which can result in osteopenia later on in life. "These complicated conditions associated with obesity result in the ageing of organs at three times faster than the normal rate," explains Taneja.
Onset of adult diseases or Rs negative ageing' as Nathan calls it, essentially means that the functionality of the organs is not in accordance with an individual's actual age. It is a series of programmed changes happening in the body, well ahead of time. "There are certain molecular aspects of ageing which should be the biomarkers for doctors to detect negative ageing in children. One is glycation which is an unhealthy way of a glucose substance attaching to a protein or a fat molecule producing harmful end products," she explains. Then there is cellular inflammation that causes tissue damage, pain and dysfunction. And also, oxidation that directly affects genetic structure and functions.
For doctors, one of the grave consequences of this biological alteration is the early age of menarche. "Earlier girls attained puberty between 11 and 13 years of age. Now girls as young as 8 or 9 are menstruating while boys are developing early facial hair," says Seema Thakur, senior consultant, department of clinical genetics and fetal medicine, La Femme Fortis. The shift from the natural to the artificial is blamed hugely for these adverse changes. "I have read that on a daily basis we consume some 3,000 chemicals a day - be it through the insecticide-coated vegetables or artificial preservatives," says Taneja.
The major changes in the blood vessels occur in the form of blockages with fat plaques and micro clots. "Such changes in blood vessels are seen prematurely in persons with diabetes mellitus and high cholesterol," says Anil Sachdev, vice chairman, department of pediatrics, Institute of Child Health, Sir Ganga Ram Hospital.
Yet another surprising finding is that children are suffering from fatty liver, something that is associated with alcoholics."Children in the age group of 5 to 10 have abnormalities in their lipid profile and show instances of fatty liver. This may not lead to immediate cirrhosis but increases the chances in the future," says Archana Dayal Arya, senior consultant, pediatric endocrinology, Institute of Child Health, Sir Ganga Ram Hospital.
It is ironic that at a time when the medical fraternity is talking about increased life expectancy in India, the young are suffering from such disorders. According to Nathan, the medical system seems to have missed on preventing, improving and restoring the quality of life. "In fact the World Health Organisation has predicted that globally, lifestyle disorders will be a major cause of premature deaths in 2025. If we take this warning seriously then we must understand that today's children will be prey to this statement," she adds.
Grave as the situation is, it is not impossible to prevent or control these disorders, as Nathan managed to do with Ramya and Shobhana. With the personalised lifestyle management programme, that included changing the cooking medium to gingelly oil, removal of high glycemic foods such as banana and jackfruit, and introduction of high protein food, Ramya was able to lose 5 kg just after 6 months and her insulin levels dropped from 40 to 20 and her triglyceride touched normal. "For Shobhana we started integrated therapy, which included counselling, stress management, breathing dynamics, yoga and gradual calorie restriction," says Nathan. Having shown an interest in kabaddi, Shobhana trained with a teacher in school and is now a district-level player. "It took 12 months for her PCOS to reverse and she lost 12 kg. She is a different person now," beams Kaushik. The key is the parent's involvement in the child's lifestyle management through positive parental behaviour, encouraging a healthy lifestyle and increasing appropriate rewarding. "These children are our future. And by inculcating the right habits, we should raise a healthy nation," says Thakur.
(Some names have been changed on request)
In another Chennai school, 15-year-old Shobhana was suffering quietly as well. Weighing 88 kg, she complained of hirsutism, severe hair-loss, 50 percent graying of hair, amenorrhea (no periods) for two months and polycystic ovarian syndrome (PCOS). At that young age, Shobhana looked like a 23-year-old, and her classmates would tease her by calling her akka or elder sister. "She found comfort in food and became an emotional eater - be it chips, chocolates, cream biscuits and even raw sugar," says her mother, Sreelata Kaushik, a TV newsreader.
In 2011, both cases were presented to Dr Kousalya Nathan, lifestyle management and anti-ageing consultant. She wasn't surprised. Since 2009, she had been steadily getting more cases of children with early onset of adult diseases. Be it premature menarche, high blood pressure and cholesterol levels, hypertension, arthritis, graying hair, polycystic ovarian syndrome and fatty liver - 5-to-19-year-olds were ailing with lifestyle disorders commonly associated with adults. Today 30 per cent of her practice is related to such cases.
Delhi-based Arvind Taneja, chief advisor, Max Healthcare, and consultant for pediatrics and infectious diseases, too has seen a rise in such cases in the past two to three years. "Out of the 15 patients that I see in a day, two to three come in with these lifestyle disorders." Obesity is usually at the centre of these disorders, and the culprit is the nutrient-poor and calorie-rich food intake. "The other day a ten-year-old girl came in. She weighed a whopping 95 kg," he says. "Mostly it's the parent's fault. They have a fixation with having a plump child, especially in the younger years. So they ask for nutritional supplements, a habit which I absolutely discourage."
Listening to the doctors rattle off factors that lead to the early onset of adult diseases, it feels like these are things that we have read and heard of endlessly and yet have chosen to ignore them. For instance, countless articles have been written about the link between television and mechanical eating. Then there is the addiction to gadgets like the iPad that weans them off exercise. "Children are listening to such loud music on the earphones that we are seeing signs of early deafness," says Taneja. Coupled with this is the fact that children are not exposed to sport of any kind.
It is no wonder then that children have started putting on weight at the ages of 4 and 5. Constant consumption of heavily salted foods like potato chips has resulted in hypertension, while Type II diabetes - a disease commonly associated with the ageing population - is now being detected across 5 to 19 year-olds. Unable to support their own weight, 10 to 12 year-olds are also complaining of aches and pains in the joints. Growing up on a junk food diet, pre-adolescents and adolescents suffer from deficiency of Calcium, Vitamin D and B, which can result in osteopenia later on in life. "These complicated conditions associated with obesity result in the ageing of organs at three times faster than the normal rate," explains Taneja.
* * *
Onset of adult diseases or Rs negative ageing' as Nathan calls it, essentially means that the functionality of the organs is not in accordance with an individual's actual age. It is a series of programmed changes happening in the body, well ahead of time. "There are certain molecular aspects of ageing which should be the biomarkers for doctors to detect negative ageing in children. One is glycation which is an unhealthy way of a glucose substance attaching to a protein or a fat molecule producing harmful end products," she explains. Then there is cellular inflammation that causes tissue damage, pain and dysfunction. And also, oxidation that directly affects genetic structure and functions.
For doctors, one of the grave consequences of this biological alteration is the early age of menarche. "Earlier girls attained puberty between 11 and 13 years of age. Now girls as young as 8 or 9 are menstruating while boys are developing early facial hair," says Seema Thakur, senior consultant, department of clinical genetics and fetal medicine, La Femme Fortis. The shift from the natural to the artificial is blamed hugely for these adverse changes. "I have read that on a daily basis we consume some 3,000 chemicals a day - be it through the insecticide-coated vegetables or artificial preservatives," says Taneja.
The major changes in the blood vessels occur in the form of blockages with fat plaques and micro clots. "Such changes in blood vessels are seen prematurely in persons with diabetes mellitus and high cholesterol," says Anil Sachdev, vice chairman, department of pediatrics, Institute of Child Health, Sir Ganga Ram Hospital.
Yet another surprising finding is that children are suffering from fatty liver, something that is associated with alcoholics."Children in the age group of 5 to 10 have abnormalities in their lipid profile and show instances of fatty liver. This may not lead to immediate cirrhosis but increases the chances in the future," says Archana Dayal Arya, senior consultant, pediatric endocrinology, Institute of Child Health, Sir Ganga Ram Hospital.
It is ironic that at a time when the medical fraternity is talking about increased life expectancy in India, the young are suffering from such disorders. According to Nathan, the medical system seems to have missed on preventing, improving and restoring the quality of life. "In fact the World Health Organisation has predicted that globally, lifestyle disorders will be a major cause of premature deaths in 2025. If we take this warning seriously then we must understand that today's children will be prey to this statement," she adds.
* * *
Grave as the situation is, it is not impossible to prevent or control these disorders, as Nathan managed to do with Ramya and Shobhana. With the personalised lifestyle management programme, that included changing the cooking medium to gingelly oil, removal of high glycemic foods such as banana and jackfruit, and introduction of high protein food, Ramya was able to lose 5 kg just after 6 months and her insulin levels dropped from 40 to 20 and her triglyceride touched normal. "For Shobhana we started integrated therapy, which included counselling, stress management, breathing dynamics, yoga and gradual calorie restriction," says Nathan. Having shown an interest in kabaddi, Shobhana trained with a teacher in school and is now a district-level player. "It took 12 months for her PCOS to reverse and she lost 12 kg. She is a different person now," beams Kaushik. The key is the parent's involvement in the child's lifestyle management through positive parental behaviour, encouraging a healthy lifestyle and increasing appropriate rewarding. "These children are our future. And by inculcating the right habits, we should raise a healthy nation," says Thakur.
(Some names have been changed on request)