Off-the-shelf snacks are not only contributing to a changing lifestyle, but may also be responsible for asthamatic disorders in the young
COOKIES, colas and candies, once considered special treats by some and looked down by other as reeking of western influences, are now becoming everyday snacks, replacing fresh and dry fruits.
The Pakistani child seems to be going through a palate change with the desire for food that is fast and processed, and this is worrying paediatricians like Dr Naseeruddin Mahmood a lot.
Dr Naseeruddin is the country coordinator of a huge international study — the ISAAC (International Study of Asthma and Allergies in Children) project, being carried out in 150 countries, where so far 50,000 children have been studied.
In Karachi alone, so far 6,000 children in various age brackets from six to 14 from all localities — the posh residences of Karachi to the slums have been tested since 1998 to date with “very perturbing findings”, points out Dr Mahmood.
“In 1996 about 2,000 children were studied between ages 13 and 14. The prevalence of asthma was about nine per cent and allergic rhinitis (known commonly as nazla and runny nose) about 22 per cent.
“The same age bracket was studied in 2001 and this time 3,000 children were studied from generally the same schools, with the collaboration of an NGO called the Care and Cure.” According to Dr Mahmood the prevalence of asthma was 19 per cent and allergic rhinitis was more than 30 per cent.
The results of the first study in 1996 were published in The Lancet, a prestigious British medical journal. The results of the newest study are in the process of being collated, but Dr Mahmood seems certain that the figures will be “slightly higher”.
“We need to evaluate the causes as it is taking a toll on our young population. Hospitalization, cost of medicine, time out from work for parents — the burden of disease — these dimensions remain unmeasured,” he adds.
Asthma, commonly known as damma in Urdu, is a disease of the lungs characterized by recurrent breathing problems. The common symptoms of asthma include breathlessness, wheezing, chest tightness and coughing. During normal breathing, air flows freely in and out of the lungs, but in a patient with asthma, the airways of the lungs become thick, swollen and inflamed. In some patients, particularly in children, coughing may be the only indication of them having this condition.
But fast food is not the only cause. “It’s this whole new approach to the changed lifestyle that is to be blamed,” says Dr Mahmood.
But the fallacies and myths attached to the condition further complicate the situation with asthma considered a disease of the west. “Parents often think it’s a contagious disease and children suffering from it (are) socially unacceptable,” to the extent, says Dr Mahmood, that “it may prove a hindrance in a young woman’s potential for a good suitor”.
It is shedding these misconceptions as well as those linked to food like avoiding ice-creams, rice and bananas, that is the first step towards fighting the problem. Next comes acceptance.
Dr Syed Jamal Raza, a paediatrician at the National Institute of Child Health, Karachi, highlights the importance of an early diagnosis. He says asthma should be suspected in any child with wheezing and having a history of any of the conditions such as cough, worse particularly at night, recurrent breathing difficulty or recurrent chest tightness.
Some colouring agents and food preservatives can also cause asthma attack. Flu and common cold are by far the most common reason for the worsening of the asthma symptoms. However, Dr Raza stresses: “Smoke caused by cigarettes, burning garbage, and automobiles is the major contributing factor in the increasing the prevalence of asthma.”
Among teenagers, smoking different flavoured shisha (water- pipe), considered a great communal activity, shows no sign of abating. What is worse, it is being done in closed environment in what are known as cafes and lounges instead of out in the open. And while these young people insist that it won’t hurt their lungs, several medical studies, abroad, have concluded that smoking a hookah poses the same health risks, such as carbon dioxide and nicotine exposure, as smoking cigars or cigarettes. Thus shisha can be considered a contributing factor in increasing the prevalence of asthma.
Parents in this part of the world face another dilemma. They don’t allow their children to go out in the neighbourhood and play because of the prevalence of violence and insecurity, especially in the urban areas. Television or the computers are the best, if not the safest baby-sitter, and sports has taken a back seat. Rise in obesity due to the sedentary, couch potato-like lifestyle with computers, the Internet, round the clock television channels available with kids nibbling continually while watching television makes them less inclined to play outside.
In a lot of families, the three-meal day concept does not apply anymore because we don’t eat together as families. People eat as and when they are hungry. Gone are the days when people sat out in the courtyard to eat fruit together on a sunny winter morning or gathered around the heater in the evening consuming kilos of pine nuts, peanuts and raisins.
Gone also are weekend meals shared amidst laughter, with extended families. Everything is a big hurry. Breakfasts have become a hurried, out-of-the box processed affair instead of the family eating a wholesome meal. For a lot of teenagers, lunch time means a rushed snack while being trailed off from school to tuitions. Fruit drinks in cardboard packs have replaced fresh fruit juices. Eating at foreign fast food joints is also a fad. We don’t consume fresh fruits or dry fruits and neither do we encourage our children to do so. “It’s just not considered fashionable to be eating fruits. How many parents take their children to buy fruits, and yet almost everyone loves to go to big departmental stores with shelves packed and processed foodstuffs?” asks Dr Mahmood, warming up to a cause near to his heart.
“Parents and teachers need to identify asthma as a growing problem. They need to understand that a family history of any allergy, say allergic rhinitis or even eczema may appear as asthma in a child. But most important, we must relearn our eating habits,” explains Dr Mahmood.
Apart from changing our eating habits, the parents need to bring about a few changes in their home too. According to Dr Raza, “Wall-to-wall carpeting should be removed, at least from the bedrooms. Carpets should not be swept with a broom or a jharoo, instead vacuum it. Feather and cotton pillows need to be done away with and replaced with foam and polyester ones. Changing bed-clothes weekly, airing linen and blanket once a week are a must. Stuffed toys should be kept away from children suffering from asthma.”
In some cases indiscriminate use of mosquito repellent coils and mats, incense and the latest fad, burning perfumed candles and potpurri — can all be silent accomplices and aggravate asthma in children.
We need more exercise, more natural foods, especially fish. And we can also educate the masses through talk shows on TV, radio, symposia directed to teachers, parents and teenagers and even passively by diffusing the issue through scripts of plays, dramas and textbooks. For a vast majority, though, a proper understanding of the disease and use of medicines appropriately can control asthma symptoms.
Off-the-shelf snacks are not only contributing to a changing lifestyle, but may also be responsible for asthamatic disorders in the young 
