05/08/2025

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Malaysian Paper

/thesundaily /

High NCD risk behind childhood obesity T HE phrase “so cute” still rings out at family gatherings, often directed at chubby, round-faced o Chubbiness could be masking symptoms of illnesses

children with hearty appetites – signs of them being “healthy and happy”. For generations, a little extra weight on a child was seen as a sign of well-being. But health experts warned this mindset is outdated and increasingly risky for a child’s long-term health. Childhood obesity is far from harmless. It is a serious medical condition linked to long-term health complications, including non communicable diseases (NCDs), most commonly type 2 diabetes, heart disease, fatty liver and even some cancers. As long as society continues to view chubbiness as cute and harmless, children will continue to pay the price with their health. Malaysia’s NCD burden Dr Muhammad Yazid Jalaludin, who is a senior consultant paediatric endocrinologist at Universiti Malaya Medical Centre and UM Specialist Centre, pointed out many global organisations have recognised obesity as a disease. He also said obesity is not just about size or body mass index (BMI) exceeding a certain level, but is dangerous due to its association with chronic NCDs, which can severely impact health and even be fatal. According to the World Health Organisation (WHO), NCDs are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. NCDs disproportionately affect people in low- and middle-income countries, where nearly three quarters of global NCD deaths (32 million) occur. According to a 2024 report Prevention and Control of Noncommunicable Diseases in Malaysia: The Case for Investment (jointly prepared by the Health Ministry, WHO and the UN Inter-Agency Task Force on NCDs), each year, NCDs in Malaysia cause 72% of all premature deaths. Economic analysis of data from

Boys are at a higher risk of obesity than girls.

2021 has estimated NCDs cause RM64.2 billion in economic losses per year, including RM12.4 billion in healthcare expenditure and disability payments, and RM51.8 billion in productivity losses. The total social and economic losses due to NCDs is equivalent to 4.2% of the nation’s gross domestic product. The 2024 report also highlighted another concern: Malaysia is experiencing the double burden of malnutrition and undernutrition, and overweight and obesity, causing diet-related NCDs. Fatty liver Yazid said obese children are at risk of developing type 2 diabetes earlier than usual. “I’ve treated children as young as eight years old who had type 2 diabetes, which usually affects older adults. These children (with diabetes) often also have cholesterol issues, putting them at risk of heart disease much earlier than other people. “When we see people having a heart attack at age 40, we used to think they are too young to get it, but now people as young as 28 are having heart attacks due to severe obesity at a young age, plus cholesterol, hypertension and diabetes,” he said. He added that their research showed even children can suffer from fatty liver disease. “If it begins too early, it can lead to fibrosis and cirrhosis, significantly raising the risk of hepatocellular carcinoma or liver cancer,” he explained. He said excessive obesity increases the risk of other cancers, such as colon, breast and gynaecological cancers. “Obese children may also develop sleep apnoea, a condition where breathing (repeatedly) stops (and starts) while sleeping. This can cause the right side of the heart to enlarge or thicken, increase pressure in the lungs and potentially lead to death during sleep,” he said, adding children also risk developing bow legs due to the stress of supporting their excess weight.

Lifelong obesity risk The 2019 National Health and Morbidity Survey (NHMS) found 29.8% of children, aged five to 17, fall into the categories of overweight (15%) and obese (14.8%). On May 24, Deputy Health Minister Datuk Lukanisman Awang Sauni was quoted by the media as saying, based on the NHMS data, the prevalence of overweight and obesity among children is continuing to rise. “For children under the age of five, the rate increased from 5.6% in 2019 to 6% in 2022. “For adolescents aged 13 to 17, the prevalence rose from 28.5% in 2017 to 30.5% in 2022, indicating one in three children is experiencing overweight or obesity issues,” he said. Pointing to the rising number of overweight and obese children in Malaysia, Yazid said if the issue is not controlled, they will add to the nation’s overall obesity statistics in adulthood. “Statistics show 70–80% of children, aged six to eight, who are overweight or obese will remain obese as adults. Out of 10 obese seven-year-olds, only three will achieve a normal weight in adulthood,” he said. Excess weight results from consuming more calories than needed, often due to unhealthy eating and lack of exercise and physical activity, he said, adding that

just order and it’s delivered to your door,” he said, adding that another study has shown Malaysian teenagers are generally not physically active. He also pointed out a lack of awareness about the importance of Physical and Health Education classes in schools. “(Physical and Health Education) is often sidelined, seen as unimportant and frequently sacrificed for other academic activities. But that short session is the only chance some students have to exercise and sweat, which is vital for their health. “After school, many kids just spend time on their gadgets and (online) games, staying indoors instead of going to the park or playing football or cycling. When we talk about this issue, (parents) will raise concerns about safety, unpredictable weather and other things. “This is where local authorities and the government must play a role by providing safe and well maintained recreational areas where local communities can exercise and participate in physical activities, thus fostering a healthier lifestyle,” he said. While the medical challenges of obesity are daunting, treatment options are available – though not without their own limitations. Metformin Rejecting claims that childhood obesity in Malaysia is only an urban issue caused by busy parents, financial status and access to food, Yazid said the situation has changed. “In the US, many obese persons come from low-income groups because healthy, nutritious and high quality food is expensive. “In contrast, in China, it’s the wealthy who tend to be obese due to access to a wide variety of food. In Malaysia today, those with money can afford to eat a lot, while those without money eat whatever is available, regardless of whether it’s healthy, high in sugar, salt or otherwise,” he said. Regarding appropriate weight-loss medications for

sleeping late or insufficient sleep can also contribute to obesity as tired children tend to feel hungrier during the day. “When children lack sleep or have poor sleep quality, they eat more the next day due to fatigue. Like adults, they tend to choose sugary, high calorie and fatty foods to regain energy. “Even if they know the food is unhealthy, their brain is already wired to crave such food,” he explained. Sedentary lifestyle impact While genetics plays a role, Yazid noted environment and habits matter more. He said studies show if one parent is obese, the child’s risk of obesity increases fivefold, and if both parents are obese, the risk goes up 13 times. “Only a very small number – less than 2% – of obesity cases are due to genetic syndromes. Most cases are due to the environment (they live in) as obese parents tend to eat more and exercise less, and their children follow suit. “In a study (‘MyHeART’) we did, we assessed the fitness levels of teens aged 13, 15 and 17. Fewer than 10% were genuinely fit and less than 30% engaged in useful physical activities daily. “Our calorie intake far outweighs calorie burn due to our sedentary lifestyle. Food is easily accessible…

children, Yazid said currently, no drug has been specifically approved for those under 12.

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Excess weight results from consuming more calories than needed. – MASRY CHE ANI/THESUN

Eating habits are the main causes of child obesity. – PICS FROM BERNAMA