The World Health Organization (WHO) 2015 Report on Obesity and Diabetes must surely be a clarion call for all nations of the world to combat the scourge caused largely by uncontrolled intake of sugar and a sedentary lifestyle . The statistics are telling, particularly among the young . 42 million children under the age of 5 were overweight or obese in 2013. Among children and adolescents, obesity  which has a direct link to diabetes, has increased substantially worldwide.  In 2013, more than 22% of girls and nearly 24% of boys living in developed countries were found to be overweight or obese.

 According to Ms Amy Khor, Singapore Senior Minister of State for Health and Manpower,  1.7 million Singaporeans are already at risk of obesity-related diseases, as they have a Body Mass Index (BMI) greater than or equal to 23. Six in 10 of these Singaporeans are either pre-diabetic, or suffer at least one chronic condition such as diabetes, high blood pressure or high cholesterol.

Obesity in schoolchildren has risen - from 11 per cent in 2013 to 12 per cent in 2014, said the Education Ministry. In 2000, it was 10 per cent. Professor Chia Kee Seng, dean of the Saw Swee Hock School of Public Health, said 34 per cent of people aged 24 to 35 this year can expect to be diabetic by the time they are 65, based on projections.

About 20 years ago, type 2 diabetes accounted for only 5 to 10 per cent of childhood diabetes. Today, that number has increased to more than 30 per cent. Dr Yvonne Lim, Associate Consultant with the Division of Paediatric Endocrinology at the National University Hospital (NUH), said the hospital has seen a rise in child patients with type 2 diabetes.  (AsiaOne report).

According to an International Diabetes Federation (IDF) report last year, Singapore has the second-highest proportion of diabetics among developed nations after the US. It said 10.53 per cent of people here aged between 20 and 79 are estimated to have the chronic disease. Locally,  a study of more than 57,000 diabetic patients at the nine National Healthcare Group (NHG) polyclinics from 2006 to 2009 found that half had diabetic kidney disease, the precursor of kidney failure. This is higher than in most other countries, including the United States, where the proportion is 32 per cent.

Children have fewer opportunities for physical activity because they spend considerable  free time on TV, Smart phones  and computers . Being overweight or obese further reduces children’s opportunities to participate in group physical activities. They then become even less physically active, which makes them likely to become more overweight over time.

A survey by the Health Promotion Board (HPB) shows that an unhealthy proportion of Singapore children and teenagers consume sugary drinks frequently. (AsiaOne, Aug 30, 2012). More than 40 per cent of students in secondary schools, junior colleges and the centralised institute consume sugary drinks daily, the survey discovered. Sugary drinks have been a constant part of the diet of Singaporean children since young. A separate HPB survey found that 28 per cent of parents and caregivers of children between four and nine years old give their kids sugary drinks more than once a week.

This percentage increases to 34 per cent for children aged 10 years and above. Research has shown that the consumption of sugary drinks is linked to poor dietary choices and obesity in children, and these health issues follow them to adulthood, HPB said.

The facts are frightening: People who consume sugary drinks regularly—1 to 2 cans a day or more—have a 26% greater risk of developing type 2 diabetes than people who rarely have such drinks.

How much sugar is in :

(source : http://www.rethinksugarydrink.org.au/contact/)

Solutions?

Obesity  and its attendant results are largely preventable. Supportive policies, environments, schools and communities are fundamental in shaping parents’ and children’s choices, making the healthier choice of foods and regular physical activity the easiest choice (accessible, available and affordable), and therefore preventing obesity.

With obesity and diabetes rates rising among children and adolescents globally, school nutrition programs can play an increasingly important public health role in supporting students’ health and well-being. Habits formed early in life influence choices made throughout adulthood. Dietary habits and preferences are no exception.

The school environment and the food served at school can influence children’s diet for better or for worse. For example, it is not unusual to see vendors selling salty or sugary snacks . Do schools monitor the nutritional value of food sold at the canteens? According to the  HPB, stallholders in school canteens have been encouraged to use healthier ingredients, and drinks have to meet the Health Promotion Board's (HPB's) reduced-sugar requirement. However  schools must mandate that cafeteria food and drinks offer healthier choices. MOE and MOH need to work together to help schools manage this proactively. Schools need to work with parents on recognizing the importance of healthy eating habits. In the short-term, nutrition programs can increase opportunities to access nutritious meals, and can help children avoid obesity, and  in the long-term by teaching them to make effective dietary choices from an early age.

In response to the obesity epidemic, many countries are redesigning policies to change norms and regulations. Policy interventions range from taxation on sugar-sweetened beverages in Mexico, Finland and recently in UK.  Globally, soft drink makers are facing severe pressure from civil society groups and governments to reduce the calories in soft drinks. It is time now to regulate and enforce stricter calorie contents in order to prevent obesity among the young in Singapore. The WHO guidelines recommend adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (6 teaspoons) per day would provide additional health benefits.