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The Star Online: Lifestyle: Health

Weight issues: Fighting flab from young

Posted: 12 Apr 2014 09:00 AM PDT

Childhood obesity is a potential time-bomb that threatens our nation's future. Learn what steps you can take to address this issue.

Alvin is 14 years old and he weighs 89kg. He injured his leg during a PE (Physical Education) lesson at school recently and his doctors informed him that he is severely obese and they need to do further tests.

The next day, his blood test results showed that Alvin's blood cholesterol and sugar levels were above normal, a sign that he may develop diabetes and early heart disease at this young age. His parents were shocked.

Childhood obesity affects one in seven children in Malaysia, according to recent statistics from the National Health and Morbidity Survey (NHMS) carried out in 2006 and 2011.

The survey reported an alarming rising trend from one-in-19 in 2006 to the current status. The Malaysian figures are not too far away from the United States, where one in five children are overweight or obese.

These obese children, like Alvin, are at high risk of becoming obese adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life.

They are also more prone to develop stress, sadness and low self-esteem.

Causes of childhood obesity

Alvin's parents had always thought his chubbiness as a toddler was cute and no cause for concern. Their boy has always had a big appetite and enjoyed food since his younger days.

In fact, both his mum and dad are obese as well. Although weight problems run in families, not all children with a family history of obesity will be overweight.

Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviours such as eating and activity habits.

A boy poses with a chicken burger at a fast food outlet in Taipei January 29, 2010. The Taiwan Department of Health on Thursday proposed a ban on junk food advertisements aired around children's television programmes, to tackle the growing child obesity rate, said officials.    REUTERS/Nicky Loh (TAIWAN - Tags: SOCIETY FOOD HEALTH MEDIA)

There may be times when it is easier to 'bribe' children by offering them a cookie or ice cream or some other unhealthy snack for good behaviour. You have to resist this temptation. – Reuters

Children can become overweight or obese due to many reasons. The most common causes are lack of physical activity, unhealthy eating patterns, or a combination of these factors.

It is possible that being overweight can be caused by a medical condition such as a hormonal problem. However, such cases are usually rare. A physical examination and some blood tests by the doctor can usually rule out medical causes of obesity.

Is your child overweight or obese?

Bring your child to see the doctor to determine if your child is overweight. The doctor will measure your child's weight and height, and calculate his BMI or body mass index, to compare to standard values. The doctor will also consider your child's age and growth patterns.

If your child is overweight or obese, the doctor will usually provide some advice on lifestyle and dietary changes, and refer your child (and possibly the family) to a dietitian. The dietitian will be able to provide specific guidance in helping you and your family adopt a healthier diet and lifestyle.

BMI is a measure derived from your weight and height, and can be used fairly reliably to indicate body fat.

BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems. Although the BMI number is calculated the same way for children and adults, the criteria used to interpret the meaning of the number for children are different to account for their growth and development.

Thus, BMI-to-age readings are used for children instead.

Obesity is associated with significant health problems including cardiovascular, respiratory, gastrointestinal, endocrine and psychosocial morbidities.

In the recently released Malaysian Dietary Guidelines for Children and Adolescents 2013 (MDGCA), emphasis is placed on developing good dietary habits in children as lifelong dietary habits are formed during childhood and adolescence.

To achieve this, the MDGCA has several key messages that highlight the importance of good dietary habits, such as the need to eat a variety of foods within the recommended intake, attaining (and maintaining) a healthy weight, limiting the intake of salt and sugar, and drinking plenty of water daily.

Start 'em young

Another point to note is that children are heavily influenced by their family's eating habits. Make every effort to build healthy habits from a young age. Your child's diet is an extremely important aspect that should never be neglected.

How, what and where the family eats are all factors that will affect how children form their own eating habits.

As most children tend to mimic their parents' behaviours, you will also need to adjust your own eating habits and lifestyle.

If children are exposed to situations where the family goes for buffets regularly, or orders large portions every time they eat out, then the children will form these same habits. This means that the lifestyle and eating habits of the whole family must be changed.

There are several key aspects that you will need to be aware of and pay attention to, namely:

· Parenting style – There may be times when it is easier to "bribe" children by offering them a cookie or ice cream or some other unhealthy snack for good behaviour.

However, this practice may backfire into making them think that good behaviour must be "paid" for. Instead of using food, let them know in advance that there will be consequences for any misbehaviour.

A better reward alternative is to spend quality one-on-one time to connect with them every day. During this time, you can do something he enjoys and shower him with the love and attention he needs, instead of using food as a reward.

· Eating healthy meals – It is absolutely critical to begin developing good eating habits from childhood. This will reduce the likelihood of obesity and all its negative consequences.

With a good foundation, children will form healthy eating habits that will serve them well in the future. Helping children develop good eating habits will go a long way towards good health over their lifetime.

· Be alert to your child's eating habits – Parents need to be vigilant as we are constantly bombarded with advertisements and promotions on fast foods, soft drinks, junk food, and all sorts of other less healthy foods.

To counteract this, we should encourage children and adolescents to consume healthier foods in the right amount. Efforts should be made to inculcate the principles of balance, moderation and variety in your children.

Every meal should comprise:

· A balanced diet consisting of foods from all five food groups in the Malaysian Food Pyramid.

· Moderate portions served according to the recommended number of servings for each group.

· A variety of foods to ensure that all nutrient needs are met.

It's never too late

It was not too late for Alvin and his parents to get back on the road to health. Consultations with the dietitian assisting them to focus on gradual changes to their family's physical activity and eating habits finally made a difference.

The whole family had to go through a "lifestyle transformation". The family started enjoying healthier balanced meals cooked with less fat and oil, preparing food at home more frequently, and exercising together on weekends.

Alvin started becoming more active playing badminton with friends, and spent less time watching television and video games.

Obese children are encouraged to do a variety of aerobic activity for at least three to five days a week (moderate to vigorous intensity) and around 30-40 minutes.

Their perseverance has paid off, as Alvin is now 70kg and his last medical check-up showed that his blood cholesterol and blood sugar levels have returned to normal.

While he may not have reached the normal weight for a teenager his age, the positive changes improved his self-confidence. His mum and dad have also benefited from the change towards a healthier lifestyle.

Hence, if your child is obese, it is still not too late to start taking action.

Follow the steps outlined above. Remember that for it to be truly effective, your strategy must involve the whole family. Look at improving the diet and exercise habits of the entire family.

Other than focusing on healthy eating, you should also make sure that physical activity is a daily part of your life. It is a necessity, thus you need to be a role model as children tend to emulate their parents' habits.

Remember, to prevent or treat childhood obesity is to help protect the health of your child both now and in the future.

> The author of this article is a member of the National Steering Committee of the Nutrition Month Malaysia Programme (NMM). NMM is an annual initiative jointly organised by the Nutrition Society of Malaysia, Malaysian Dietitians' Association and Malaysian Association for the Study Obesity. NMM 2014 is supported by Gardenia Bakeries (KL) Sdn Bhd, Legosan Sdn Bhd (OatBg22), Malaysia Milk Sdn Bhd (Vitagen), Nestle Products Sdn Bhd and Yakult (M) Sdn Bhd. To learn more about preventing obesity and other interesting nutrition information, drop by the Nutrition Month Malaysia Facebook page or visit www.nutritionmonthmalaysia.org.my.

Go ahead and daydream away

Posted: 12 Apr 2014 09:00 AM PDT

Experts say that daydreaming is invaluable for important psychological attributes such as creativity, happiness and planning our future.

Tips on "resting your mind" are increasingly prominent in Western culture's non-stop barrage of lifestyle instructions. We are exhorted to give our brains downtime, and reminded of the benefits of yoga, mindfulness and transcendental meditation.

In an economic system preoccupied with squeezing value from employees' minds as well as bodies, rest, we are told, can promote creative insights rather than be purely a sign of lost productivity.

But what are the criteria for judging if a mind is at rest? What accounts for the unevenness in people's experiences of mental "rest"?

And can we broaden the repertoire of practices that people use – beyond mindfulness training and yoga – to find rest in their everyday lives?

One arena in which debates over what "rest" means for the mind have been particularly lively is neuroscience.

Until recently, if you were to volunteer for a cognitive neuroscience experiment, the chances are you would be slid, supine, into a magnetic resonance imaging (MRI) scanner, would come face to face with a simple cross-hair – and would be told to "do nothing" in between the psychological tasks you would be asked to carry out.

Filename : shutterstock_71.59507094625.original.jpg - To go with

Current models of the resting mind need to incorporate insights from people's multifaceted experiences of rest, which undoubtedly extend well beyond currently
favoured practices for 'stilling the mind', such as meditation. – AFP

This cross-hair is the way that cognitive neuroscientists traditionally access the brain and mind's state of rest.

Little over a decade ago, mental activity during a phase of cross-hair fixation was treated simply as the baseline.

The assumption was that the mind would rev up and out of its idling state in order to complete the tasks it was being set, and its activity could then be measured against this dormant "baseline" state.

But in the past decade, this view of the resting state has been transformed.

Neuroscientists have demonstrated that different parts of the brain display remarkably co-ordinated patterns of activity "at rest", and that disparate regions in the brain are consistently more active when people are told to "do nothing".

Data and visualisation techniques from resting-state cognitive neuroscientists, such as my collaborator, Daniel Margulies, have allowed the slow rhythms of these brain dynamics to be displayed as maps of connectivity.

In a few short years, a brain that is "doing nothing" has become, for neuroscientists, a whole lot more complicated.

Rest, at least in relation to the space inside our skulls, isn't what it used to be.

As you might observe, your own mental experiences while "doing nothing" give the lie to the assumption that the mind shuts up shop when not focused on the world outside. The mind in so-called states of rest might be described as doing a whole host of complex things – whether engaged in "a meal at which images are eaten" (to use WH Auden's description of the daydream) or building "air castles undisturbed" (to use Washington Irving's account of reverie).

But it has been hard to incorporate these rich subjective accounts of the mind's activity when unengaged by the outside world into scientific models.

After all, as soon as one attempts to probe the activity of mind-wandering or daydreaming, one has disturbed the very thing one is trying to study.

But psychological research on "spontaneous cognition" has in the past decade been reinvigorated.

At the heart of these efforts are researchers such as Jonathan Smallwood, who has attempted to bring order to the fuzzy chaos of daydreaming.

For Smallwood, the daydreaming state – far from being a lapse of attention – allows our species to transcend the here and now. It is therefore invaluable for important psychological attributes such as creativity, happiness and planning our future.

In the space of a few years, then, understandings of what the brain is and does "at rest" have been transformed.

Gone are connotations of idleness and stasis, to be replaced by an emphasis on industry, productivity and forward planning.

But there remain at least two big challenges if we are to understand the complex neurological and psychic attributes of mental states of "rest".

First, to understand the relationship between brain dynamics and corresponding inner experience – a scientific effort that is nothing less than an attempt to characterise the fugitive movements and mechanisms of thought.

Second, to figure out what the relationship is between the state of rest that characterises the strange, constricted experience of being inside an MRI scanner, and people's everyday, varied and unequal experiences of mental and bodily rest.

To make progress on either of these questions, we need far richer descriptions and models of what actually goes on in minds – and bodies – during states of rest.

Are the new "busier" models of mental rest that are being advanced in neuroscience and psychology drawing from changing experiences of "rest" in people's everyday lives?

Current models of the resting mind need to incorporate insights from people's multifaceted experiences of rest, which undoubtedly extend well beyond currently favoured practices for "stilling the mind" such as meditation. Rest is commonly defined by what it isn't.

In a dictionary, you'll find it defined as the absence of activity, labour, exertion, disturbance and movement.

That minds "at rest" are now, at least in certain quarters, characterised precisely by their activity, labour, exertion and movement, poses important scientific and social questions about this commonly hidden but vital aspect of our lives. – Guardian News & Media

> Felicity Callard is a senior lecturer in geography and medical humanities at Durham University, Britain.

Eczema triggers: Find out what they are to reduce chances of flaring up

Posted: 12 Apr 2014 09:00 AM PDT

Identify the various types of eczema triggers in and around the house, as well as the environment children are exposed to on a daily basis.

Eczema is a condition characterised by inflamed skin after exposure to certain trigger factors.

These triggers are often defined as external substances that irritate the skin and cause flare-ups.

The most common type of eczema is known as atopic dermatitis, or atopic eczema, where the condition is linked to other allergic-related problems such as asthma.

Triggers are not causes of eczema. Rather, these are substances that initiate symptoms.

Similarly, the exact cause of eczema, atopic or otherwise, is unknown.

The closest explanation to why eczema transpires within a person is that external factors (i.e. cold or hot weather, dust, dander, etc) prompt an overactive defensive response from the body's immune system.

Eczema triggers can be divided into a few different categories, namely, physical irritants, allergens and microbes.

Physical irritants can worsen the symptoms of eczema and may vary from one child to another. They include:

· Soaps and detergents

· Cosmetics and perfume

· Shampoos, dish-washing liquids

· Bubble baths

· Disinfectants like chlorine

· Coarse clothing (Wear it loose, and wear cotton!)

Ensure all cleaning products are kept from the reach of children and choose suitable toiletries for your child (soap, towel etc). It's always good to prepare a small bag of products you already know works for your child that won't cause irritation or flare-ups.

Remember, sharing isn't always caring, especially when it's itchy.

Allergens are what trigger allergic reactions, besides eczema symptoms. They may also lead to other complications such as asthma and hay fever.

These allergens can be divided into:

· Environmental – house dust mites, dander, pollen, mold, dandruff, etc.

· Food – eggs, nuts, dairy products, soy products, wheat, fresh fruit juice, meats, vegetables, etc.

Your child may have inherited an allergic response to a specific substance from you or your spouse. You may want to assess the extent of the allergy by seeking further medical advice.

Microbes can also trigger eczemic reactions. Some commonly known ones are:

· Bacteria such as the staphylococcus and streptococcal strains.

· The Molluscum contagiosum virus thrives in warm, humid climates and in areas where people live very close to each other.

· Malassezia and candida fungal strains colonising a child's skin can initiate an inflammatory response.

Although not considered to be triggers, stress and climate conditions can intensify symptoms of eczema.

Adults, and even children, can experience physical, mental or social stresses that can lead to the worsening of eczemic symptoms.

The reason for this remains a mystery, but some experts suggest that certain hormones released during stress, or a reduced immune response of the body may be responsible.

Other illnesses such as the common cold can also cause stress and initiate an eczemic response.

Eczema outbreaks can be avoided, or the severity lessened or managed. Consider these takeaway tips:

· Moisturise frequently with a good choice of moisturiser or cream.

· Avoid sudden changes in temperature or humidity.

· Avoid sweating or overheating; regular baths can help cool down your child.

· Reduce stress and provide good emotional support.

· Avoid scratchy materials, such as wool.

· Avoid harsh soaps, detergents and solvents.

· Be aware of any foods that may cause an outbreak and avoid these foods.

Familiarise yourself with your child's condition to avoid conditions that may cause a flare-up. You'll need to know his sensitivities intimately if you are to avoid aggravating his condition.

If you're sending him to day care or have a caregiver taking care of your child, it's best to keep them informed as well.

It's also recommended that you get advice from a paediatrician on managing your child's eczema.

> This article is published in conjunction with National Eczema Awareness Month 2014, supported by a grant from A. Menarini Sdn Bhd. Part of this initiative includes running a 'My Eczema Journey' 30-Day Challenge. Visit https://www.facebook.com/myeczemajourney, email myeczemajourney@gmail.com or call/text 012-6609681.

Kredit: www.thestar.com.my

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