Take Charge of Your Health
An article by Dr. Kirtland Culmer

Your Children's Health
Looking back in time can conjure up some bitter as well as sweet memories. I remember the great times we had in Nassau, Grand Bahama, Ragged Island, Rum Cay, Andros, Long Island and Cat Island. Swimming, cycling, sailing, hunting, walking, running and playing vigorous games in the open air were usually parts of our daily routine. Coconut tree climbing was one of our favourite games because the reward at the top of the climb was the delicious jelly coconut and water. We walked, ran and skated everywhere. No cars or taxis were available, and we found a fun way of getting to our destinations. We ate fresh fruits and vegetables grown in our own gardens and fields. We had lots of fish, and usually meat only on Sundays. Daily exercise and game participation were mandatory in all the schools.

The amazing thing is that I am hard pressed to remember a single boy or girl who was fat or said to have diabetes in all those early years.

The American Diabetes Association is sending out an alarm because of the rising trend of overweight, obesity and diabetes mellitus in young children. Children used to be afflicted primarily with type 1 diabetes (formerly called juvenile diabetes), but in the past few decades, there is an explosion of not only obesity, but also type 2 diabetes ( formerly called middle age diabetes). Type 2 diabetes mellitus which was once considered a rare condition in the pediatric population, now accounts for 15% to 45% of all newly diagnosed cases of diabetes in children and teenagers. This epidemic results from a number of factors, the most important of which appears to be an increased rate of obesity in children.

Approximately one quarter to one third of children and teens are overweight – an increase of 2- to 3- fold in the past three decades. This is paralleled by the increase in the incidence of type 2 diabetes in this age group. Risk factors for this disease also include racial background. It has an especially high prevalence in African Americans, Latinos and American Indians. The incidence is also rising in Bahamians. In the United States, 25% of white children newly diagnosed with diabetes are diagnosed with type 2 diabetes. Children and teens of first and second degree relatives afflicted with type 2 diabetes are also at great risk.

There is a prevailing fallacy in thinking that children and teens are not as susceptible to the serious and fatal diseases as obese and diabetic adults. These young ones are similarly at risk for strokes, heart disease, kidney failure and serious liver disease, and may die at a very early age if the proper measures are not taken.

The largest baby that I have delivered in my career weighed 12 lbs 2 ounces. His mother was obese and diabetic. He was obese during his entire short life, and unfortunately died of heart and kidney failure before reaching adulthood.

Not only is the physical health of these young ones at risk, but also their mental health is incessantly challenged. A tenth grader in Georgia shouted, “ I can’t take it any more”, as he shot himself in front of his classmates at school. They had teased him mercilessly. A young boy in Florida hung himself in his backyard to avoid going to school in the new school year.

How are we to take charge in these situations? It is obvious that the most practical things to be done are to somehow get our children to limit their intake of calories, and to exercise more. This may take some maneuvering since in these times, both parents may be out to work, and they may not be able to prepare proper meals. So the evening fast foods are the way out. Parents, teachers and even community organizations need to find a way to teach children proper eating habits. The word diet should be taken from their vocabulary, and they should be directed to the low calorie foods that they like, and away from the high calorie non-nutritious foods. Breakfast should contain one third of their normal daily calorie requirement, and lunch should contain one quarter. They need to be shown how to be satisfied with smaller portions, and not stuff themselves at mealtime. They must learn to have three meals a day, and no between-meal snacks. Something needs to be done about the kind of lunches that are sold by vendors at our schools.

Because of the necessary emphasis on safety nowadays, the bicycle as a means of transportation is becoming a thing of the past. Children are being driven, taxied or bused to and from school, only to sit in front of the television set eating their fast meal when they return in the evenings. Parents must find a way to reduce televiewing, computer chatting and electronic games as outlets for their children and devise some fun filled exercise time and venue. Schools need to be more proactive in their exercise programs.

It is a known fact that exercise, proper eating habits and weight control can prevent obesity and type 2 diabetes, and drastically reduce the risks if the conditions actually exist. TAKE CHARGE OF YOUR CHILDREN’S HEALTH. The represent our precious future.