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Childhood obesity- a bad sign of what might follow

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by Randima Attygalle

‘All work and no play makes Jack a dull boy’ calls for rephrasing today into ‘Bad food and screen time make Jack an obese boy’. Childhood obesity is increasing rapidly in Sri Lanka and the present COVID-19 pandemic is a double whammy, with children being home-bound with no physical activity. The increased screen time spent on virtual learning adds fuel to the fire.

“Although we did see more obese and overweight children in high income settings in the past, today the incidence of obesity is rising among the urban middle class,” observes the Consultant Paediatrician and Professor of Paediatrics from General Sir John Kotelawala Defence University, Prof. Ishani Rodrigo. She cites a recent survey among 5-18 year olds in urban Sri Lanka which showed an obesity prevalence of 10.3% and overweight prevalence of 11.3%. Studies in the Colombo, Gampaha and Jaffna Districts reflect a higher prevalence of childhood obesity says Dr. Rodrigo. “We are yet to unearth island-wide data on the problem,” she adds.

In 2019, according to the WHO, an estimated 38.2 million children worldwide, under the age of five years were overweight or obese. Once considered a high-income country problem, excess weight and obesity are now on the rise in low- and middle-income countries, particularly in urban settings. In Africa, the number of overweight children under five has increased by nearly 24% percent since 2000. Almost half of the children under five who were overweight or obese in 2019 lived in Asia.

The etiology of obesity is multi-factorial and complex. Although at a basic level it is about more ‘calories in’ than ‘calories out’, there is a genetic contribution as well, says the paediatrician. “Although pathological obesity is attributed to medical conditions such as Cushings Syndrome and hypothyroidism what is more often seen is simple obesity. It is often the food and lifestyle which contribute to it.”

Increased intake of food high in simple carbohydrates, sugars and fats, convenience food such as pastries and kottu high in energy, fast food, sweetened beverages, flavoured milk, fizzy drinks, large portion sizes and frequent snacking are among the major triggers of obesity in children. Poor intake of vegetables and fruit in the diet, less outdoor play, increased screen time, less household chores for children and dependence on electrical appliances as opposed to doing tasks manually have made the situation worse.

Food advertising aimed at children, enabling availability of sugary beverages at affordable prices and lack of healthy food choices in school canteens/tuck shops (the choices largely being starchy and sugary food) have also accelerated this national health dilemma. “In the UK, the school meal policy was revised, adopting the healthy school lunches which were promoted by the famous master chef Jamie Oliver. The country also imposed a sugar tax on beverages depending on the amount of sugar they contain,” explains Prof. Rodrigo who calls for a similar shift in the local policy. “Although the Ministry of Health had issues dietary guidelines, they have not yet filtered to communities and there are no national level programmes to have a dialogue with parents, teachers and school authorities on this national health crisis.”

COVID pandemic has also led to an alarming increase in the weight of children across all age groups. “Children have lost most opportunities for physical activities including walking to school, playing with friends and organized sports. With virtual classrooms replacing real classrooms, children spend a considerable time before screens. Most of the entertaining is also afforded by screens. With very little to do at home, children eat often to relieve their boredom and mothers too tend to make more treats at home and feed their children which could go against them.”

Once obesity is established, managing of it becomes very challenging, warns Dr. Rodrigo who urges parents to encourage healthy eating and living. “Children usually eat the family diet, hence if the family diet is rich in starchy, fatty and sugary food and low in vegetables and fruit, they will automatically follow this.”

The long term repercussions of childhood obesity are multiple: adult obesity, the increased risk of cardiovascular disease, hypertension, heart disease, strokes and orthopaedic complications including joint pains and early osteoarthritis, increased levels of cholesterol, Type 2 diabetes and fatty liver are among these. The condition can also trigger skin problems such as thickening and discolouration of skin and stretch marks and also cause breathing problems including obstructive sleep apnea (stopping breathing during sleep), obstruction to airway and snoring. Childhood obesity also increases risk of fractures and certain cancers in adulthood including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon cancers.

Addressing childhood obesity requires a multidisciplinary approach with collective inputs of paediatricians, nutritionists, physical training instructors, psychologists etc. “Motivation of the child and family or motivational counseling is the key in intervention which if often very intensive,” remarks the Professor. Following the initial assessment involving physical markers and other necessary medical tests, the psychological assessment involving the child and his/her family would follow. “Family history of obesity, family perception and understanding of the problem and motivation to achieve a healthy weight is important in this process,” she notes. Regular monitoring of children and motivational therapy sessions help keep children and their families on track, she says.

The ‘Nutri-Fit Programme’ at the University Hospital of the Kotelawala Defence University manages overweight and obese children. Conducted through the Paediatric Clinic of the hospital, the programme emphasizes on becoming healthier and more fit rather than losing weight. “Weight loss inevitably happens as a result of this approach,” explains the professor who goes on to note that this facility is extended to healthy cooking demonstrations for children, exercise and yoga sessions.

Obese children need to be empowered to overcome psychological trauma the condition entails, remarks the Consultant. Destigmatizing obesity, motivational counseling, removing the guilt stigma, making them partners in achieving the target, emphasizing health rather than obesity, identifying their strengths and encouraging them and early involvement of a clinical psychologist in addressing these issues are among the tools of empowerment. Severe cases of obesity may need certain medications.



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Dr. Sarah Fazy wins Outstanding Business Woman Award 2022

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Recognition of self-made success and dedication

Sri Lanka’s leading Cosmetic and Aesthetic Physician Dr. Sarah Fazy, also fondly known as Dr. Cherry was awarded the Outstanding Business Woman Award 2022 by CEO Magazine’s CEO Awards.

Dedicated to honouring leadership in the business world, the CEO Magazine provides a platform for all genres of corporate icons. At the recently held awards night, Dr. Fazy was honoured for her dedication and for being a self-made woman of success. Her clinic, 360 Wellness, was founded on the principle that the technology reshaping skincare today must be available to all people aiming to improve and maintain their skin and well-being.

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King Charles’s Coronation guest list: who’s who of everyone expected to attend

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The Royal family last appeared on the balcony of Buckingham Palace for Queen Elizabeth's Platinum Jubilee in June. They are expected to appear again for a fly-past following the Coronation ceremony in May

From foreign royals to charity leaders, the invitees are expected to reflect a modern and multicultural Britain

Save-the-date emails have been sent and preparations are underway as the countdown to King Charles’s Coronation in May begins. The final guest list is yet to be confirmed, but the attendees are certain to include an array of foreign royals, heads of state and politicians.

Charles is also understood to want a diverse congregation to reflect modern, multicultural society and ensure that his ceremony is inclusive.Representatives from his many charity affiliations and a large cross section from the voluntary sector will consequently be in attendance.

In contrast, only a small minority of politicians and peers are expected to be invited and far fewer members of the aristocracy than the vast numbers that attended Queen Elizabeth II’s coronation in 1953.While 8,000 guests crammed into Westminster Abbey for the late Queen’s investiture, the guest list this year has reportedly been cut to around 2,000.

Here, we detail all the guests who are likely to attend the May 6 ceremony.
British Royal family

While King Charles’s Coronation will be a slimmed-down event in comparison to 1953, nearly the entire Royal family will be out in force.Members from across the family, including extended cousins and grandchildren, are expected to attend the ceremony at Westminster Abbey.

Even the youngest members of the family – including Prince Louis – are expected to be involved, posing a challenge for their parents about how to rein them in.The big question that remains is whether the Duke and Duchess of Sussex will attend.

While the couple have stated that they have been in correspondence with the King’s office regarding the Coronation, they have not confirmed for certain whether they will attend.A spokesman said: “An immediate decision on whether the Duke and Duchess will attend will not be disclosed by us at this time.”

If either of them does attend, it is understood the visit will be brief. It is not thought that either Archie or his sister, one-year-old Lilibet, will travel to London for the ceremony.Meanwhile, the Duchess of York also revealed at an event in New York earlier this month that she had not yet received an invitation.

“I’m travelling at the moment, so maybe it [invitation] has gone to another place,” she said.

While many members of the family will attend the ceremony, just senior royals are expected to appear on the balcony of Buckingham Palace for a fly-past, in line with King Charles’s wish for a more streamlined monarchy.

Queen Consort’s family and friends

Camilla’s family is set to get equal billing at the Coronation, with her five teenage grandchildren expected to be thrust into the limelight for the first time with official duties. It has not yet been confirmed what roles they will carry out, but The Sunday Times reported that the Queen wanted her grandchildren to hold the canopy over her while she is anointed with holy oil. But Palace sources suggested that no such role would be given.

Meanwhile, it is likely that the Queen Consort’s six companions – her replacement to the former ladies-in-waiting – will also attend the event. They were appointed to support and accompany Her Majesty on key occasions.

Foreign royals 

Members of foreign royal families are also expected to be invited to the ceremony in an historic break with tradition. Convention dating back centuries stated that a coronation should be a sacred ceremony between a monarch and their people in the presence of God.

But King Charles is set to do away with the tradition and invite his counterparts from around the world. A source told The Mail on Sunday: “I believe the rule began because a Coronation is meant to be a monarch’s private event with God.

“At the Queen’s Coronation there were no crowned monarchs, only the protectorate rulers like the Queen of Tonga. It’s been a tradition for centuries.”

The source added: “Inviting the King of Jordan, the Sultan of Brunei, the Sultan of Oman and the Scandinavian royals – who are all friends of Charles – will be a good bit of soft power and diplomacy.”

Some international royals have already indicated that they will attend the ceremony, including Prince Albert of Monaco.Speaking to People magazine, the monegasque head of state said: “I’m certain that it’s going to be an incredible ceremony and a very moving one. We’ve maintained contact since His Majesty became King, but I haven’t talked to him personally since the Queen’s funeral.

“I’m certain His Majesty will add his own personal touches to the ceremonies, but what those will be, I’m sure I don’t know.”

British MPs and peers 

Parliamentarians have been in uproar after learning that only a minority will be invited to the ceremony itself. Members have been lobbying the Cabinet Office to argue their case, convinced that they have a right to attend.It was initially planned that just 20 MPs and 20 peers would get a ticket for Westminster Abbey.

These numbers have now been more than doubled, according to those with knowledge of the event. On top of this, there will be extra places reserved for former prime ministers, Cabinet ministers and some members of the Privy Council.An extra event for MPs and peers has also been added to the Coronation line-up – a special reception in Westminster Hall which will take place on the Tuesday before the Coronation and will be attended by the King.

The final decision about which peers and MPs will make the cut will be made by the Cabinet Office, which is keen to ensure that attendees are representative of all parties, geographical locations, ages and backgrounds.

Foreign heads of state

The heads of state and representatives from a number of key British allies and Commonwealth nations are expected to attend the ceremony.Andrzej Duda, the Polish president, is the first head of state to be confirmed as attending the event.

Meanwhile, the most noticeable abscence may be US President Joe Biden, whose attendance is reportedly in doubt. One official suggested it was “unlikely” Mr Biden would be present, while another senior administration official only said the United States would be “represented”. However, they could not yet say whether Mr Biden would go personally, or send a delegation.

Members of the public

Representatives from many of the King’s charity affiliations and a large cross section from the voluntary sector are set to be present at the ceremony. It has already been revealed that refugees and the NHS will be at the heart of the star-studded concert taking place at Windsor Castle on May 8, the day after the Coronation.

One of the highlights will be the performance of the Coronation Choir, a diverse group drawing together singers from the nation’s community choirs, including refugee choirs, NHS choirs, LGBTQ+ singing groups and deaf signing choirs.

Daily Telegtaph

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Butterflies and dinosaurs, spaceships and girl-power this avurudu

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Hold onto your hats, kiddos! The much-anticipated 2023 Avurudu Collection for kids by Tropic Of Linen has finally arrived – and it’s packed to the brim with quirky prints and playful detail.With its reputation for unique and adorable festive outfits that are a cut above the rest, Tropic Of Linen has earned a name as the go-to destination for Avurudu kids wear – outdoing themselves year after year. This year is no exception, for the 2023 Avurudu edit features not just one-of-a-kind designs, but also incorporates a ‘play’ element in all of its exclusive, two-piece sets.

For the little ladies, Tropic Of Linen has taken the classic redde and hatte designs of vintage Ceylonese tradition and spun them in to something truly unique. The result is a stunning collection of outfits that pay homage to the beauty and charm of traditional Sri Lankan fashion, while still being perfectly on-trend for today’s festivities.

The auspicious ‘multi-colour’ theme for this year was what influenced designer Minha Akram to seek inspiration from the vibrant butterfly, with its beautiful myriad of colour. “We wanted to create something different, while also bringing a sense of play to our outfits,” she said. “Butterflies are spirited, light, fun, and filled with beauty in every combination of colour. So, we created very wearable, play-centred outfits by building in beautiful 3D butterfly wings on to the backs of the tops, resulting in a cross between costume and everyday clothing.”

Girls aged 2 to 9 are in for a treat with five exciting designs to choose from. Little mermaid fans can go pretty in pastels with a seashell motif that will make them feel like a true sea princess. For the bright and bold personality types, ‘Fly High Butterfly’ is the perfect fit, with its 90s girl-power and retro pop art-inspired prints.

Heralding a changing of seasons and the essence of springtime, the lovely ‘Birds and Blossoms’ beige ensemble is for the true flower child, dancing and twirling through the festivities in style.The serene island girl, amidst sunny lemons and the blue ocean will be fresh, bright, and beaming in the Santorini-inspired vintage style set.

Tropic Of Linen has also crafted a delicate and whimsical outfit filled with old world charm and a more elegant quality -the ‘Avurudu Rose’-, featuring exquisite red roses and flowers on a dreamy soft blue background.Avurudu may only come once a year, but all girls’ tops have been designed to be worn over and over again, when paired with other shorts, skirts, or trousers.

Tropic Of Linen has not forgotten the little gents of course, with sarong-shirt sets featuring lively and contemporary prints and designs. For the toddler age group the sarongs come in fun and cutesy prints, while the older ‘big boys’ can rock more modern and edgy motifs. Blast off into unknown galaxies or astro surf to the stars with out of this world space-inspired sets. Even unleash their inner dinosaur with some rock n’ roaring outfits. Easy-to-wear expandable hidden belts come built in to each sarong, so both kids and parents feel secure in knowing the sarong will hold up to all play!

With Tropic of Linen’s attention to detail and unwavering commitment to bringing only the best and most stylish designs to the fore, it’s no wonder parents and kids alike flock to the store at #1 Wijerama Mawatha, Colombo 7 every April. Kids will love Tropic of Linen’s play centred designs and its characteristically comfortable cotton and linen wear, with also a strong chance to be the best dressed kid on the block this Avurudu season.

 

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