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Junior high

Tummy fat and inactivity has pushed up hypertension in city children five-fold in as many years.

health and fitness Updated: Aug 22, 2010 00:47 IST
Suhas Munshi

Raging hypertension is something you associate with adults in urgent need of a lifestyle overhaul. It now appears similar life-altering choices need to be made much earlier, as an increasing number of children —especially teens — are being diagnosed with high blood pressure.

One in 15 — 6.4 per cent — students in both public and government schools in Delhi have high blood pressure, reported a study in the Archives of Disease in Childhood, a British Medical Journal publication, last week.

"Five years ago, barely one per cent children had hypertension (sustained high blood pressure), now it's 6.4 per cent. Current obesity levels and lifestyle trends indicate that the number will cross 10 per cent children in another two years,” said lead author Dr Anoop Misra, director and head, department of diabetes and metabolic diseases, Fortis Group of Hospitals.

The study found that the strongest predictors of high blood pressure in teens are high waist circumference, high triglycerides (blood fats) and a family predisposition to hypertension. A large waist was a stronger risk factor than overall obesity, said the study that tracked a thousand 13 to 18-year-olds from 2004 to 2008.

This study tracked teenagers, but the problem often starts much younger, especially in overweight children. "Children with high blood pressure were an anomaly a decade ago, but now I routinely measure their blood pressure during a physical examination, even if they are not overweight,” said Dr Subhash Arya, chairman, department of paediatrics and adolescent medicine at BLK Memorial Hospital in Central Delhi.

Last year, a five-city survey of obesity showed that children in India have fat deposits where it hurts their health the most: their belly. A Diabetes Foundation of India study of 12,872 children in five cities — New Delhi, Mumbai, Agra, Jaipur and Allahabad — has found that one in five children had waists that were too wide for their health.

Unfit metros
Teens in Mumbai (31.3 per cent) and Delhi (28.8 per cent) were well over twice as unfit as their counterparts in Jaipur (13.7 per cent) and Agra (13.9 per cent), reported the study in International Journal of Paediatric Obesity.

"Even without abdominal fat, Indsians are genetically at a two to three times higher risk of developing heart and diabetes risk factors as compared to Caucasians. You can do little about genes but necessary lifestyle changes must be made," said Rekha Sharma, chief dietitian, Medanta — The Medicity.

Like adults, children with bellies have more heart disease and type-2 diabetes risk factors. They are more likely to develop these diseases at a younger age, sometimes in their 20s and 30s.

Road to recovery

Young people however can reverse the situation by increasing physical activity, improving their diet and losing weight. Medicines generally aren't needed to treat children and teenagers.

The only way to lose belly fat, said Sharma, is to go easy on processed food and get more active.

"Two periods of physical activity a week at school is not enough, children need to play team sports at least five times a week. When that's not possible, they should walk, run, swim or cycle for at least an hour a day," said Sharma.

Another way to cut pressure is to switch loyalties to groups that play slow and steady rhythms. An Italian study found that breathing while listening to slow music helped people lower their systolic blood pressure (the top number in a reading) by four points.

"An unhealthy child makes an unhealthy adult. Wrong choices made in adolescence (inactivity, smoking, drinking etc) may haunt you two decades later, so make the right choices right from the start," said Dr Arya.