AS a working mum, I constantly worry whether my child is eating right.
Eating a balanced diet is important for children and physical activity is crucial, but making this work on a daily basis is easier said than done.
I aim for a healthy meal on most days (whenever possible) and ensure desserts, sweets and carbonated drinks are not a daily occurrence.
The sad truth is that what our children are eating is impacting their health in a huge way as Malaysia grapples with both adult and adolescent obesity.
Half of all adults in Malaysia are already overweight or obese and adolescents are catching up fast.
The National Health and Morbidity Survey 2022 (Adolescent Health Survey) indicates that 1 in 3 adolescents are overweight or obese.
This essentially means that we will be seeing an increasing number of children, not just adults struggling with type 2 diabetes in the years to come.
Most children who develop type 2 diabetes are usually diagnosed between the ages of 13-14 says Sunway Medical Centre paediatric endocrinologist Dr Ch'ng Tong Wooi.
These children are usually obese and their parents start to notice unusual signs which indicate a problem, leading to screening and diagnosis.
Dr Ch'ng says the signs include drinking way too much water, peeing a lot and being very hungry and consequently eating a lot too.
"They may be drinking water every 30 minutes to an hour, or waking up in the middle of the night to pee. This may not be their usual pattern of behaviour."
If the child is already overweight or obese or has a family history of diabetes, screening is crucial to ensure the condition is picked up early and properly managed, says Dr Ch'ng.
The first step in addressing childhood type 2 diabetes is putting in place diet and lifestyle modifications, she adds.
Parents may need to work with a dietitian to ensure the child eats balanced meals and is able to maintain a healthy weight.
These lifestyle changes need to be introduced gradually so the child is able to accept them.
"We cannot expect a child who eats nasi lemak for breakfast every day to suddenly turn to oatmeal. We have to gradually make these changes and encourage the child to stick to them."
Teaching the child about healthy food and portion control also helps them to better understand and manage their condition.
Exercise or physical activity would also have to be incorporated into the child's life with one hour recommended daily.
"As parents, we can set an example too. Put down our phones and go outdoors as a family every evening to fulfil that commitment to being active."
If the child's diabetes is at a severe stage, he or she may need to be put on medication, explains Dr Ch'ng.
With lifestyle modifications and medication, childhood type 2 diabetes can be properly managed and kept under control as children grow.
With the right approach, their diabetes may even go into remission and they can lead normal lives, but if control is not maintained, they will face a variety of health issues as they grow.
Dr Ch'ng says most parents are shocked when told their child has type 2 diabetes.
"They don't realise that children can get the disease too. They assume it only affects older people."
Many people also mistakenly assume that sugar directly causes diabetes, adds Dr Ch'ng. In fact, it's obesity which fuels insulin resistance.
This is why portion control is important so children can maintain a healthy weight.
They don't have to be denied sweets or treats, but parents must keep portion control in mind.
Dr Ch'ng says the Ministry of Health's "Quarter Quarter Half" healthy plate concept is a good guide for parents wanting to serve balanced meals in the right portions.
Another crucial step is to help children understand that they should stop eating when they feel full.
Parents often force children to clear their plates when it actually sends the wrong message about food intake.
"It's a very Asian thing to do, but it doesn't teach children that they should stop eating when they're full."
Similarly, when mothers serve food, they tend to put larger portions, so it's better if children serve themselves.
Ultimately, the goal is to help children cultivate a healthy relationship with food, one that will carry them well into adulthood.
EAT RIGHT, BE HEALTHY
*Involve your child in meal planning/preparation.
*Allow them to choose fruits/vegetables when grocery shopping.
*Set an example by eating fruits/vegetables yourself.
*Give encouragement when your child tries fruits/vegetables.
*Make mealtimes colourful with a variety of fruit/vegetables on the table.
*Start young so children are more likely to cultivate a taste for fruits/vegetables.
WHERE DO OUR CHILDREN STAND?
*1 in 3 are overweight/obese
*4 in 5 are physically inactive
*4 in 5 do not eat enough fruits and vegetables
*1 in 3 drink carbonated drinks every day
*1 in 10 eat fast food at least three days a week
Source: National Health and Morbidity Survey 2022 (Adolescent Health Survey)