Obesity and sedentary lifestyle: Growing problem among youth

Today, children and youth across Lebanon are facing an unprecedented and growing obesity problem which is the precursor to non-communicable diseases, such as diabetes later on. The sedentary lifestyle coupled with high consumption of junk food has contributed to this alarming trend which can have grave life-long consequences if left unchecked.

Sedentary lifestyle trend

Not too far back most kids and youth would be playing games or engaging in activities that involved some form of physical exercise or movement. Unfortunately, when there are playdates today, you will often see children sitting together busy playing with each other’s electronic gadgets. Similarly, teenagers are frequently seen seated and gaming with each other and typically for hours on end. This widespread use of electronic devices has led to a major increase in sedentary screen time, usually accompanied by increased snacking and consumption of high-calorie foods. Additionally, Lebanese students are faced with increasing academic pressure, which means longer school hours and homework, leaving little time for after school sports. Moreover, Lebanon lacks accessible spacious public parks or other safe outdoor spaces which further minimizes outdoor activity.

Obesity and health problems

Lack of movement is one culprit but equally so is what children are ingesting, as food plays a crucial role. While Lebanon prides itself in the healthy Mediterranean diet, much of the average daily calorie intake is now being made up of ultra-processed food (UPF), such as packaged snacks, sugary breakfast cereals, soft drinks and sweet desserts. A national cross-sectional study of children in Lebanon aged 6 months to 4.9 years found that UPFs contributed to 47% of daily energy intake (in Japan it is 27%). Additionally, studies have shown that a significant portion of children in Lebanon aged 6-19 are clinically overweight or obese today.

According to Dr. Carole Saba, an endocrinologist who specializes in children and young adults, Covid was a major catalyst for the sudden rise in obesity. “The prolonged periods sitting at home encouraged lack of movement and frequent snacking,” she says.  Lockdown may have ended but the popular trend of fast food deliveries among the youth has not. In her practice she is seeing increasing overweight children with insulin resistance conditions. One of the telltale signs is acanthosis nigricans - a common condition in overweight children where the skin appears dark around skin folds, especially the neck and arm pit area. “This is an indication of high levels on insulin in the blood. These patients also tend to be very fatigued and have a big appetite, especially a high craving for sweets, “ explains Saba.

These patients also have a high-risk factor of developing type 2 diabetes (especially if there is a family history), in addition to other health issues, such as high blood pressure and high cholesterol. It is worth noting that a 2024 report from the International Diabetes Federation estimates that the adult-diabetes prevalence in Lebanon is at 12.3%, which is considered high on a global scale.

Eating right – dietician’s recommendations

UPF is considered unhealthy because it is often high in bad fats, salt and very low in essential nutrients like fiber, vitamins and minerals. It usually has preservatives, hydrogenated oils, refined sugar and food colouring. In Lebanon, the economic crisis and resulting food insecurity have also made cheaper, longer-shelf-life processed food more accessible and convenient for families, particularly those living below the poverty lines. There are also more working mothers today, leaving kids to be on their own longer which contributes to poor food choices and lack of surveillance to their diet. 

Dietitian Nagham Tannous, who regularly helps children and teenagers, has noticed the increase in obesity particularly due to the exponentially high sugar content in today’s treats. “In the past we worried about cakes and crepes being sweet, but they pale in comparison to what is available today,” she stresses. She is referring to desserts with mega sweet toppings or the extreme sugary drinks, like the trending bubble tea drink. “The youth are seeing these treats on social media or in the mall when they are with friends. So the temptations are stronger than ever before.” She also stressed the negative impact of late-night screen time; it results in less sleep, more snacking late into the night, affecting their hormones and leads to quick weight gain.

Tannous wants parents to be mindful of their children’s eating habits. Bad treats can be easily replaced with healthy and tasty alternatives. For Savory snacks she suggests edamame, turmous (lupin beans) and homemade popcorn (microwave ones must be avoided). She also recommends making a yoghurt dip with crushed garlic and dried mint eaten with cucumber sticks or wholewheat crackers served with humous or labneh. She stresses on more homemade ‘tabikh’ meals along with a serving of salad made with a dressing of apple cider vinegar and a modest amount of olive oil. For sweet snacks, she suggests more fruits, dates with nut butters or dipped in dark chocolate, and homemade pancakes made with wholewheat flour and mashed ripe bananas (added in the batter) for sweetness. “Greek yoghurt with a teaspoon of natural honey topped with fresh berries and nuts is another healthy desert,” advises Tannous. “I also suggest baking cakes with dates or ripe bananas as an alternative to sugar. I don’t recommend deserts with artificial sweeteners. While studies deem them safe, we don’t know the long-term effects.” 

Calorie deficit (cutting calories) is not usually recommended as quantity of food is important for the exponential growth of children and teens explains Tannous. “However, eating the right foods allows overweight children to lose the fat while preserving their muscle density and height, “she adds. Finally, Tannous encourages her young clients do regular sports as it reduces inflammation in the body. “I suggest cardio, strength training or resistance training, such as planks or push-ups. They do not need to lift weights. Additionally, drink lots of water, sleep well and in complete darkness. If children dislike darkness, red indirect light is a healthy night light option.”

Bad habits in youth can continue into adulthood if left unchecked, therefore, it is important to introduce healthy lifestyle choices during the critical period in our children’s development. This is why regular exercise; less screen time and healthy eating habits goes a long way.