Why Indian Kids Are Getting Adult Diseases Before They Turn 20

There is something that has been bothering me for some time.

When we talk about diseases like diabetes, high blood pressure, fatty liver, high cholesterol and heart disease, we usually imagine adults. Someone in their 40s. Maybe 50s. We don't immediately think about a 12 year old or a 17 year old.

But that picture is changing. I am increasingly concerned about what we are creating around our children. Not because Indian children are somehow destined to become unhealthy, but because many of the lifestyle patterns that drive adult disease are now becoming part of childhood.

And the uncomfortable part is that many of these things look completely normal. 

A child who spends hours sitting is normal.

A child who sleeps late because of school, tuition and screens is normal.

A child who has a packaged snack after school is normal.

A sugary drink at a birthday party is normal.

Not playing outside because there is homework is normal.

But when all of these things start adding up, we cannot look at them individually anymore.

Now, we have to start looking at the whole picture. 

Recently, I found some data from the Indian Academy of Pediatrics and this made the issue more pressing. The IAP has suggested making relevant recommendations with regard to monitoring BMI and waist circumference in kids with obesity and the associated risks for such problems as elevated blood pressure, problems with cholesterol, increased blood sugar levels, and fatty liver disease.

Here parents should get the important point that being overweight does not mean looking good or bad.

It is not about having a chubby look. 

The issue is much deeper than that.

There were cases when patients’ parents said that “He has gained some weight.”

And my first question is not, “How does he look?”

My question is, “What has happened to his growth pattern over the last few years?” 

Because one photograph tells me very little. A growth chart can tell me much more.

A child whose weight is steadily moving upwards deserves attention even if everyone around them keeps saying, “Don't worry, they'll grow out of it.”

Sometimes they do. Many times they don't. 

And Indian children have another important consideration. We tend to develop metabolic complications at lower levels of BMI compared with many Western populations. This is one reason India specific growth charts and proper assessment are so important.

So don't wait until your child looks visibly obese before you start thinking about metabolic health. 

Sometimes the first thing you notice is simply a little more fat around the waist.

The trousers are becoming tighter.

There is a little tummy.

The child is getting less active.

They are getting tired more easily.

These things are easy to dismiss.

But abdominal fat is metabolically important. And when insulin resistance starts developing, one possible sign is acanthosis nigricans - those darker, thicker patches of skin that can appear around the neck or in skin folds.

I am not saying parents should diagnose insulin resistance by looking at their child's neck. I am saying that when you notice changes like these, don't simply brush them off.

Talk to your pediatrician. Because by the time a child develops diabetes, the process that led there may have been developing for years. And this is where I think we have made a mistake in the way we talk about children's health.

We keep looking for one culprit.

Is it sugar?

Is it screens?

Is it junk food?

Is it lack of exercise?

Is it stress?

The answer is usually much less exciting. It is all of it working together.

• Think about a typical Indian school going child today.

• They wake up early.

• They rush to school.

• They sit for several hours.

• They come home and have tuition or homework.

• They spend some time on a phone or tablet.

• They may not play outside.

• Dinner happens late.

• They stay awake because they don't want to miss something on the screen.

• Then they wake up early again.

Now take a high-sugar diet full of refined carbohydrates and pre-packaged goods along with sugary drinks and constant snacking.

In isolation each of them doesn't seem too alarming. Together they form a lifestyle that is quite different from the needs of a growing organism.

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Now let's address the issue of movement. It’s not necessary for every child to become an athlete, but the need for movement is not more important than for a toddler – the children must be in movement, they must run, hop, climb, cycle and swim, play soccer and cricket, dance and simply be in motion.

According to the World Health Organization, children and teenagers aged 5-17 years old need at least 60 minutes every day of average activity, which should include muscle- and bone-strengthening activities at least three times a week.

But look at what has happened to childhood. We have become very good at making children productive.

• Coding classes.

• Olympiads.

• Tuition.

• Music classes.

• Homework.

• More classes.

• More exams.

• More achievements.

But somewhere along the way, play became something that happens only after everything “important” is finished.

I think we have got that backwards.

Play is important.

Physical activity is important.

Rest is important.

Social interaction is important.

A child doesn't need every minute of the day optimized.

They need a childhood.

And then there is food.

This is where I would ask parents to stop thinking in terms of “good food” and “bad food”.

One birthday cake isn't going to cause diabetes.

One pizza isn't going to destroy your child's health.

One packet of chips isn't the problem.

The problem is when these foods become the foundation of the diet.

If breakfast is refined cereal, the school snack is a packaged product, the after-school snack is another packaged food, the drink is sugary and dinner is mostly refined carbohydrates, we have to ask what is missing.

Where are the vegetables?

Where are the fruits?

Where are the pulses?

Where are the protein sources?

Where is the fiber?

Where are the minimally processed foods?

I am not urging parents to serve the ideal plate for every meal. What I want them to do is observe the overall diet pattern across a week. If your kid gets a balanced home-cooked meal throughout the week and happens to eat some cake at a party, I am not concerned about it. But if your kid has cake every day along with some other snacks, it is not the cake that is the problem here. It's the pattern. 

And please don't put a child on an extreme diet because you are worried about their weight. A growing child has different nutritional needs from an adult.

This is where a pediatrician or qualified nutrition professional can help you understand what actually needs to change.

Sometimes it may simply be reducing sugary drinks.

Sometimes it may be increasing physical activity.

Sometimes it may be improving sleep.

Sometimes the entire family needs to change its eating pattern.

And very often, the child should not be the only person changing.

Because children watch us.

• We tell them to put the phone away while we are scrolling through ours.

• We tell them to eat healthy while we order takeout.

• We tell them to exercise while we spend the weekend sitting.

• We tell them to sleep early while we stay awake until midnight.

Children don't just learn from what we tell them.

They learn from what they see

So if you want your child to develop healthy habits, make those habits normal in the house.

• Go for a walk together.

• Eat together.

• Keep fruit visible.

• Cook together.

• Spend time without screens.

• Make physical activity part of family life. Don't make health feel like punishment.

The same thing applies to screens. I don't believe we should treat screens like poison.

Technology is part of childhood now. Children use screens for education, communication and entertainment. The more useful question is what the screen is replacing.

Is it replacing sleep?

Is it replacing outdoor play?

Is it replacing reading?

Is it replacing family interaction?

Is it replacing socialization?

That is where I become concerned.

WHO recommends limiting sedentary behavior, particularly recreational screen time, because excessive sedentary behavior in children is associated with poorer health outcomes.

And I think parents can ask themselves one very simple question:

If I take the screen away, what does my child do instead?

If the answer is nothing, we have a bigger problem than screen time. We need to rebuild the rest of the child's routine.

Sleep is another area where I think we underestimate the problem. A child who sleeps five or six hours because they have school, tuition, homework and screen time is not simply “busy”.

Indian kids are sleep deprived. Sleep is important for growth, learning, behavior, emotional health and overall physical health. And when a child consistently sleeps late but still has to wake up early for school, the body doesn't magically adjust.

The schedule needs to change.

Sometimes that means reducing evening activities.

Sometimes it means putting the phone away earlier.

Sometimes it means changing when homework is done.

And sometimes it means the adults in the house need to change their own routine. Because a child cannot build a good sleep schedule in a household where everything happens at midnight.

Then there is stress. This is something I see parents underestimate.

A little stress is not necessarily bad.

An exam can create positive stress.

A sports competition can create positive stress.

Trying something difficult can create positive stress.

That kind of challenge can teach a child something very valuable: “I can struggle and still keep going.”

The problem is chronic stress.

A child who constantly feels that love, approval or attention depends on performance is living under a different kind of pressure. If every conversation is about marks, rankings, Olympiads, coding classes and future careers, the child may start believing that their value depends on what they achieve.

And I think that is dangerous. Your child is not a résumé. Your child is not a project.

Your child does not need to be optimized for the next 20 years.

• They need to feel loved.

• They need boundaries.

• They need responsibility.

• They need opportunities to fail.

• They need opportunities to try again.

• They need to know that getting 65 instead of 95 does not change the fact that they are your child. 

Because resilience is built when children experience difficulty and learn that they can handle it.

If we remove every obstacle from their path, they never learn how to deal with obstacles.

If we solve every problem for them, they never learn to solve problems.

If we never allow them to fail, they may become terrified of failure. And this has implications for health too.

Mental health and physical health are not separate compartments. A child who is constantly stressed, sleeping poorly, sitting all day and eating poorly is not dealing with four separate problems. It is one interconnected system.

There is another environmental issue we cannot ignore in India: air pollution.

As a parent, you can control what goes into your child's lunchbox. You can influence how much they exercise and when they sleep. But you cannot completely control the air outside. Children are particularly vulnerable to air pollution because their lungs and other systems are still developing. WHO identifies air pollution as an important risk factor for children's health, including respiratory problems and impaired lung development.

So when we talk about the health of the next generation, we need to think beyond food.

Food matters.

Exercise matters.

Sleep matters.

Stress matters.

Pollution matters.

The home environment matters.

The school environment matters.

And they all interact.

That is why I don't want parents reading this article and becoming anxious. I don't want you going home tonight and putting your child on a strict diet.

I don't want you taking away every sweet. I don't want you throwing away the television.

And I certainly don't want your child to start believing that something is wrong with their body.

Instead, start with the basics.

• Look at their growth trajectory.

• Look at their waist circumference if their pediatrician recommends it.

• Look at their food pattern.

• Look at their sleep.

• Look at how much they move.

• Look at how much time they spend sitting.

• Look at how much pressure they are carrying.

And if something concerns you, speak to a qualified pediatrician. The good news is that childhood is also a huge opportunity.

Muscle can be built.

Fitness can improve.

Food preferences can change.

Sleep habits can change.

Physical activity can become normal.

The family environment can change.

And metabolic risk can be addressed before it becomes a serious disease. So when we talk about Indian children developing “adult diseases” before they turn 20, I don't want the takeaway to be fear.

I want it to be awareness. Because the goal isn't to make our children live like adults. The goal is to give them a childhood that builds the foundation for a healthy adulthood.

Let them play.

Let them run.

Let them occasionally eat cake.

Let them fail.

Let them sleep.

Let them talk to you.

Let them spend time away from screens.

Feed them nourishing food most of the time. And don't make their body a source of shame. As parents, we don't need to create perfect children. 

We need to create an environment where children have the best possible chance to become healthy, confident and resilient adults.

Don't wait for an adult disease to become an adult problem. Start building the foundation while they are still children.

A qualified dietitian or nutritionist can look at your child's health, lifestyle, food preferences, sleep goals and nutritional needs and help build a plan around your child, rather than asking him or her to fit into a generic diet.

Start Your Personalised Diet Plan: click here