Medical Content

Quarantine Lifestyle: Obesity Scare in Children

Speakers

Dr. Grace R. Battad, MD

Pediatric Gastroenterologist

Obese in Malnutrition — Its underlying causes and modifiable risk factors [03:50]
Pre COVID-19 Quarantine Lifestyle — How we feed our kids with the “Deadly Trio” [05:24]
On the Deadly Trio — Sugar, salt, and saturated fat [07:06]
Why are added sugars deadly? — They pose a 60% risk for childhood obesity [08:43]
Why is excess salt deadly? — The increased risk for stroke and cardiovascular disease [11:38]
Why are saturated fats deadly? — Cholesterol excess increases CVD risk to five times [12:20]
Obesity as Global Epidemic — [14:04]
Obesity and its Impact on COVID-19 — [19:50]
Lifestyle Suggestions during COVID-19 Quarantine — [24:04]

Docquity Intro

Docquity 00:09 Please note that the audience may experience technical difficulties and internet connectivity issues during the webinar, which are beyond the control of the organizer and Docquity. If you encounter any connectivity issues or technical problems which will result in partial completion of the webinar, you may view the on-demand video, which will be available at the organizer's Docquity channel and Docquity application and website.

Docquity 00:37 Welcome to Docquity, Asia's largest professional network built exclusively for doctors. At Docquity, we are reimagining what a doctor community is. Today, being a doctor does not stop when you step out of the hospital or after you have attended a webinar or medical conference. Being a doctor means you will always be connecting, learning, and growing.

Docquity 01:06 Being a part of Docquity means being able to connect with doctors from all over the country. On this platform, you can connect with colleagues and use your secure one-on-one or group chat to start discussions. You can discuss cases and post your own and connect with others through channels dedicated to your hospital or medical associations. You can even attend online conferences and symposiums.

Docquity 01:37 At Docquity, we know that learning is one of the most important parts of being a doctor. Continue your education on Docquity with a wide range of resources, including webinars, educational doc talks, CPD modules, guideline updates, expert articles including medical news and journal summaries, and unique case reports. With over 260,000 members from all over Southeast Asia, Docquity is continuing to grow with new features like patient access programs, telemedicine, and teleconsulting. Welcome to Asia's largest online community for doctors. Welcome to Docquity.

Opening: on Childhood Obesity During Pandemic

Host 02:43 Good day, dearest doctors. We are very pleased to welcome you to today's webinar, where we will discuss the “COVID-19 Quarantine Lifestyle: Obesity Scare in Children.” At this point, let me introduce to you our speaker. She is a graduate of the University of East Ramon Magsaysay College of Medicine. She had residency training in Pediatrics at UERMMMCI, where she was the Chief Resident. She had her fellowship training in Pediatric Gastroenterology, Hepatology, and Nutrition at UP Philippine General Hospital. She is a Past President and Fellow of the Philippine Society for Pediatric Gastroenterology, Hepatology, and Nutrition. She is currently an Associate Professor at UERMMMCI, and she is an Active Consultant at UERMMMCI and Dr. Jesus C. Delgado Memorial Hospital. Dearest doctors, to talk about “COVID-19 Quarantine Lifestyle: Obesity Scare in Children” during this pandemic, let us all welcome Dr. Grace R. Battad.

Obese in Malnutrition

Dr. Grace R. Battad 03:50 Good evening, everybody, we are going to talk about food eating. Malnutrition, whether over or under, depends on one's food intake. Besides that, it also depends on food security and food accessibility, which comes from the community and society as well because these are actually the underlying and basic causes of it all. Therefore, the nutritional state depends not only on food, it depends all on food intake, food security, and food accessibility.

Dr. Grace R. Battad 04:31 When food intake is over and above food expenditure, it means that there is going to be an imbalance of caloric intake because it means that we are eating food a lot, but we are not burning a lot. Therefore this would lead to excess adiposity, and we will be depositing fat a lot, not only in the subcutaneous tissue but also in the visceral organs as well. Then we have a bloating of our body mass index, which would lead to the condition which we call obesity. The environment, World Health Organization, has already identified two modifiable risk factors for obesity. And when we talk about modifiable risk factors, it means that they can still be changed, and these are unhealthy diets and sedentary activity.

Pre-COVID-19 Quarantine Lifestyle

Dr. Grace R. Battad 05:24 Now, how was the Filipino child before? How active was he? Already, pre-COVID-19 quarantine, he is already about 86% inactive. Most of them are already glued to their gadgets, and only about 14% are going to their moderate activity. Here, our data on adolescents will show that about 75-85% of them are also physically insufficiently active.

Dr. Grace R. Battad 05:55 What about our food intake? How did we handle them last year? Oh, all of us, we enjoyed "Buy One Take One: Pizzas and Burgers." We loved "Eat-All-You-Can," we loved "Unlimited Rice," and also we loved having the "Buffets." Now, how did we feed our kids? We did it with a lot of rice, we are giving a lot of sweets and this is according to FITS' study, which is Feeding Infants and Toddlers Study. There is a lot of sugar intake in children higher than that of adults. And this is also sitting even across all socioeconomic states.

Dr. Grace R. Battad 06:40 Let us take a look at the sugar-sweetened beverages. Here, we see the one in red, which is the FNRI recommendation for sugar intake across all preschools, school ages, and adolescents; and the intake for juice: the one in yellow. And the one intake for soft drinks: the one in blue, has gone sky-high.

On the Deadly Trio

Dr. Grace R. Battad 07:06 Or, how about salt intake? The one in red, the red line that is the WHO recommendation for salt intake. And here we see again, across all age groups and socioeconomic statuses, salt intake was very excessive. So we do have what they call the deadly trio: added sugar, added salt, added saturated fats.

Dr. Grace R. Battad 07:32 Let us go to sugar, free sugars. Free sugars are added sugars during the process of food preparation. For example, if you are going to make a cup of coffee, and you add about five teaspoons of sugar, that is added sugar. And added sugar was there to satisfy your palate and not to satisfy a need. Table sugar or sucrose comes from sugarcane, but mostly globally, the predominant product would be corn. Sucrose or table sugar gives rise to simple sugars, fructose, and glucose.

Dr. Grace R. Battad 08:11 Fructose is sweeter than glucose. In the process, the food manufacturing business went into enzymatic processing to increase fructose concentration. And now we have high fructose corn syrup, which is the main sweetener of the food industry. So these are the main ingredients, you know, sugar-sweetened beverages: in juices, in soft drinks, in desserts, in ice creams, etc.

Why are added sugars deadly?

Dr. Grace R. Battad 08:43 Now, why are added sugars deadly? Because they pose a 60% risk for childhood obesity. If you take one can have regular soft drinks for a day, it is about 200 calories per day, accumulating about five pounds per year.

Dr. Grace R. Battad 09:02 Let us raise the pathway of glucose and fructose. As glucose enters the human body, it gets stored as muscle glycogen and paper glycogen. There are a lot of glucose receptors in the body. Because we need glucose for our fuel, there are more glucose receptors in the brain because the brain wants to have that glucose as its fuel. Therefore, we have continuous glycogenolysis, and we have continuous glucose utilization.

Dr. Grace R. Battad 09:34 Let us go to the fructose pathway. As it enters the body, it is another pathway, the Glucose Transport-5 (GLUT 5). But, there are very few fructose receptors in the body. Because we do not need fructose as our glucose, the brain does not need fructose. There are a lot of fructose receptors in the liver. So, as fructose enters the liver, it provides carbon precursors for triacylglycerol. Therefore, it enters the fatty acid synthesis, we have a lot of VLDL secretion, and since you do not need them, they get to be stored as fat, and there is fat deposition in the visceral organs.

Dr. Grace R. Battad 10:19 Excess fat is actually stored in your fat cells. And this is an example of your adipose tissue in lean individuals. These are the adipose tissues in obese individuals. Fat is stored in the fat cells. If there is excess fat, the fat cells get oversized, we call that adipocyte hypertrophy, and this leads to bloating with the fat cells. Beyond storage capacity, the lipid droplets' outpour gets accumulated in ectopic tissues: heart, liver, and skeletal muscles. This would harrow the condition called dyslipidemia and metabolic disorders.

Dr. Grace R. Battad 11:04 Let us now go to the obese adipocytes. Here you have a reduced oxygen supply. The tissue hypoxia occurs here. And in adipocyte hypertrophy, there is going to be mobilization of a lot of macrophages, which leads to the release of proinflammatory cytokines. Therefore in adipocyte hypertrophy, you have chronic low-grade inflammation.

Why is excess salt deadly?

Dr. Grace R. Battad 11:38 Let us go to salt. Why is excess salt deadly? And here I just gave you a list of your favorite snacks, your children's favorite hotdogs, corned beef, and we have here our sodium content average, and here that is the limit of WHO recommendation at 500 milligrams. Salt intake beyond two grams would lead to disturbances in your blood pressure. It has been shown that beyond two grams, you already have an increased risk for stroke or death and cardiovascular disease.

Why are saturated fats deadly?

Dr. Grace R. Battad 12:20 Now, why are saturated fats deadly? And here we see again our favorite foods, rich in saturated fats because studies show that children with total cholesterol of more than 200 milligrams per deciliter have a five times risk of developing cardiovascular disease in 30 to 40 years' time.

About Docquity

Docquity has built Southeast Asia's largest community of healthcare professionals. Today, we have over 300,000 doctors spread across six countries in Asia. We started the company to connect medical practitioners while supporting them with life-long medical education. Become a part of the largest medical community in SE Asia and get up-to-date medical insights from events & webinars at your fingertip. Join today!