Everyone continues to talk about under-nutrition, starvation, malnutrition and lack of food supplies in developing nations and regions in conflict. However, there is little or no conversation around the exponential increase in the number of obese children. This is not much of a surprise as overweight is the other face of the nutrition problem common in developing nations like Canada and the US particularly in minority groups. Just to give you an insight into the depth of this problem; the number of overweight and obese children has quadrupled since the 90s in Canada and little has been done about it as the situation is even worse in the US with 1 in 4 children currently overweight. As if this is not enough, many of these children continue into adulthood remaining overweight and obese worsening the obesity epidemic. As we know, obesity whether in childhood or adulthood is not a disease in itself however, it predisposes a child to a whole lot of problems including NCDs like:

• Hypertension and cardiovascular diseases
• Diabetes mellitus and it’s complications
• COPD, obstructive sleep panda and other respiratory issues
• Arthritis and other musculoskeletal problems

In addition to the above health risks, there are social implications of childhood obesity. Most times, these children tend to be mocked, bullied and teased a lot leading to psychosocial problems such as depression, poor self-esteem and anxiety disorders. And of course, those with poor coping mechanisms and weak support systems can engage in violence, drug addiction and even more overfeeding detrimental to themselves and the society. The natural question that follows is: What can be done to address this problem? Well, there’s a lot but we have to first understand the factors that are responsible. It is not difficult to see why diet is an important factor; the more you eat, the more likely you are to grow fatter though this is rather too simplistic as some diets like high energy, carbohydrate and trans fat diet are more likely to make one fat than fruits and vegetables. The increase in snacks, sweet and sugary products partly account for the increasing rate of obesity in children. However, that is not full piece of the puzzle; the increasing sedentary lifestyle due to technological advancements is another important factor. Children spend most of their time on TV, video games or with their mobile phones or laptops surfing the internet, they don’t burn off their extra calories which leads to weight gain. These two factors, diet and physical inactivity remain the major focus of most interventions in childhood overweight and obesity.

There are three groups of interventions:  government, population and community based interventions. Government interventions can include dedicated investment in health promotion by using food policies like import tariffs and taxes on unhealthy foods and subsidies on healthy foods. Additionally, policies to incorporate teaching the importance of good diet and physical activity on health are effective. Population wide policies include traffic light labelling of products, restriction in television advertising of snacks, drinks rich in sugar and trans-fat as exemplified by Denmark, increased provision of fruits and vegetables to school canteens, provision of school playgrounds and incorporating exercise in daily school schedule. These interventions should involve key stakeholders in the community and tailored to fit into the culture and organisation of the community to ensure high level of participation and success.

Finally, there’s actually so much parents can do for their overweight or obese children, although it still revolves around better diet and physical activity. Parents may have to restrict their child’s intake of sugary or high carb foods. It is also important to start at an early age to always make fruits and vegetables available as well as keep snacks away from the house since feeding habits are formed at an early age. Also you may want to go for a walk on evenings or on weekends if you’re busy which not only increases physical activity but also gives you enough bonding time. Children should be encouraged to engage in other forms of leisure aside from watching TV and playing video games. Outdoor sports like football, running and some time out with friends are great ways to pass time and would help in better social development for your child.

When you say the word addiction, people tend to think alcohol, marijuana, crack, opioids and the like; of course, they’ve caused a lot of deaths; opioids alone account for over 40,000 deaths (50% of all overdose deaths).However, to think that drug addiction is the only form of addiction is nothing further from the truth. The fact is that there are a lot of things one can get addicted to… thinking of it scientifically, one actually gets addicted to the reward system in the brain not the substance or action itself. These substances cause addiction because they cause a potent rise in the dopamine level in the brain; hence, the likelihood of a substance to cause addiction depends on the level of dopamine rise in the brain. This is why we don’t get addicted to other things like washing clothes or cooking. What this means in essence is that if something gives you as much or even greater dopamine rush as marijuana, it would probably lead to an addiction. Such is the case with internet addiction, the 21st century wave of behavioural addiction gradually eating into the lives of our youth particularly the adolescents and teenagers.

It is really difficult to comprehend the effects of internet addiction since it has not been recognised by the DSM or ICD as a distinct condition; however it is quite easy to see its impacts on the society. Why is internet addiction becoming an increasing problem? possibly the dramatic shift in social life of recent times in addition to the anonymity, affordability and accessibility of internet makes it very available and consequently, addicting. There are various forms of internet addiction including:

• Online pornography: It is very easy to see why pornography can be very addictive knowing that sex is a primitive human drive. Individuals easily browse through videos of inappropriate sexual content eventually leading sexual problems like premature ejaculation and erectile dysfunction
• Online video gaming: A long recognised problem particularly in Asian countries- here, individuals immerse themselves in virtual reality where they connect with multiple players anywhere in the world. With well-known recorded deaths of people playing games days without food, some countries like China are already placing restrictions to use and including it as a psychiatric condition
• Social media: Here, individuals connect to friends via social media platforms like Facebook, Whatsapp, Twitter etc. However, due to the changing social system, individuals are relying more on social media even when there is room for tangible conversation; it is relatively common these days to see a group of individuals sit close to each other busy chatting online without exchanging a single word. There is compulsive and insatiable need to acquire more friends for their sense of ego and identity; mostly due to weak psychosocial support around the individual.

Whether its compulsive use of the internet for pornography or inappropriate sexual content, gaming, chatting etc, these behavioural addictions may actually develop as a form of escape from an uncomfortable reality, for example poor interpersonal relationships and psychosocial support system, the individual is confronted with. And of course, it makes to address this problem by building better support system in communities, in schools, religious gatherings and creating awareness of these problems to encourage parents to help their children build positive interpersonal relationships and avoid social exclusion. For individuals struggling with these addictions, there are also treatment options similar to other forms of addiction though they are not standardised as internet addiction is not yet recognised as a distinct disorder. There should be stronger advocacy to include this as a separate entity.

The human body has a remarkable ability to adapt to variable cold weather conditions because as the environmental temperature reduces, the body adjusts by increasing heat gain through shivering, reduced sweating and increased physical activity. However, if there is as little as more than 2° drop in the body temperature due to exposure to extreme cold weather conditions, the body may lose its ability to maintain the core body temperature around normal range which can cause a number of deaths that are preventable when proper measures are taken. Just as hot weather and heat related problems are not limited to hotter parts of the world like middle east and Africa, cold weather exposure and cold related problems are also not limited to very cold parts of the world .Thus, the unique and paradoxical nature of the climate change problem- everywhere is getting hotter and colder!!!Although this is a general public health concern, Canada and other colder parts of the world like Russia and Iceland face more cold related health problems.

These problems can range from lifestyle limitations to predisposition to some health conditions and injuries. If you’ve lived in Canada, for example, you would have probably woken up to find your door covered in ice, plus the weather can be so cold that the streets will be covered in snow- these can really affect movement leading to physical inactivity. Moreover, some people tend to smoke more to keep warm; this negative lifestyle modification can adversely affect health since smoking is a risk factor for many chronic health conditions. In addition to the hindrance to movement and lifestyle changes, people may feel a numbing sensation on their fingertips… something medically referred to as raynaud phenomenon, particularly common in very cold temperatures. For asthmatic or allergic people, there may be significant increase and more frequent puffs of their inhaler. There are also more common upper respiratory tract infections, mostly viral-like common cold which tend to resolve on their own. Finally, there are cold related injuries which mostly affect people that work outside. These include

• Chilblains: redness, itching, swelling due to repeated exposure to temperatures above 0° but less than 16°
• Trench foot and immersion foot: pain, swelling, tingling on the legs or rarely the hands due to prolonged exposure to wet and cold conditions
• Frost nip and frost bites: these are freezing cold injuries that result in pain, stinging skin sensation, paleness and waxy skin. It usually starts on the extremities such as skin of the toes, fingers, ear lobes, nose and cheeks but in more serious cases can involve more body parts.

These injuries can be prevented by staying indoors and going out only when necessary. Also, dressing warm before going out and keeping up with daily weather advice are essential to protecting oneself from extreme cold. Unfortunately, if you’re ever affected or happen to be around an individual affected by these cold injuries, carefully follow the following first aid tips by CCOHS:

• Never ignore numbness. If you feel numb or tingly, take steps to warm the area immediately. (e.g., put your hands under your armpits, or pull your arms into the inside of your jacket for more direct contact with the body)
• If possible, move the victim to a warm area.
• Remove wet clothing, and gently loosen or remove constricting clothing or jewellery that may restrict circulation.
• Warm the person by wrapping them in blankets or by putting them on dry clothing. Cover the head and neck. Warm the person slowly. Avoid direct heat which can burn the skin.
• Loosely cover the affected area with a sterile dressing. Place some gauze between fingers and toes to absorb moisture and prevent them from sticking together.
• If the person is alert, give them liquids to drink.
• Check for signs of hypothermia and seek medical attention. If necessary quickly transport the victim to an emergency care facility
• Treat the person gently and monitor breathing
• DO NOT attempt to rewarm any affected frostbite area
• DO NOT thaw the area if it could freeze again
• DO NOT rub area or apply snow
• DO NOT permit victim to drink alcohol or smoke

Conclusively, prolonged exposure to cold with complete loss of the body’s thermoregulatory system can result in hypothermia-the most serious condition of cold exposure and a medical emergency. Hence, if a victim progresses from vigorous shivering, complaining of cold, impaired judgement and lack of coordination to unresponsiveness, reduced or no shivering and no pulse, quickly separate the victim from cold when you recognize the symptoms, do a CPR and seek medical help immediately.

Extreme temperatures are temperatures that fluctuate plus or minus 10 degrees or more above or below the average high and low temperatures for a particular region at a particular season, and last for several weeks. In terms of extreme heat exposure, our bodies have a remarkable ability to adapt to variable hot weather conditions. This is because the body temperature increases when net heat gain from the environment and the body itself is more than heat loss. Practically, the body needs to maintain its temperature which is about 37.4° around relatively higher temperatures without more than 3°rise in its core temperature. This is necessary for survival.

Extreme hot weather conditions are seen predominantly in African countries but also exist in some European countries, some parts of the US, UK and others during a heat wave. A heat wave is 5 or more consecutive days of prolonged heat in which the daily maximum temperature is higher than the average maximum temperature by 5 °C or more as defined by the World Meteorological Association, however, this definition may differ by country. High temperatures have become an increasing public health concern not only because they cause a number of preventable deaths particularly in children, elderly and pregnant women but they are also worsening due to global warming. People that have experienced these hot conditions can attest to their negative health impacts such as an overall decrease in work performance or a gradual decline in health and wellness. These are due to the indirect psychological stress that heat can put on the human brain. Other direct health problems that can result with extreme heat and increasing temperature include;

• Heat rash: rashes that develop due to heat
• Heat cramps: severe painful muscle cramps mostly in intense exertion due to strenuous exercise
• Heat syncope: fainting spells that occur due to fluid and electrolyte loss during profuse sweating
• Heat exhaustion: loss in the body’s ability to regulate heat leading to marked derangement in most body systems.
• Heat stroke: the most extreme case known as hyperthermia where there is severe dehydration and impaired neurological functions (loss of consciousness, seizures and possibly death)

In addition to its effects on the body, extreme heat can put pressure on electricity and power distribution due to increased air conditioner use. Heat waves can also cause other problems like damage to roads and railway. Finally, it has largely contributed to the increased frequency and severity of wildfires such as the amazon fires. The outlook would continue to worsen if we fold our arms because global warming would keep increasing the temperature of our environment. Therefore, there has to be more serious commitment to our global action on climate change if we are serious at all about these public health problems. For individual problems, some of these tips may help:

• Stay hydrated with water not alcohol or caffeine as most health effects are due to fluid and electrolyte loss
• Reduce exposure by removing clothing to create room for heat loss
• Stop or reduce exercise or physical activity because they work the muscles and increase core body temperature
• Take cold baths and rest on a light bed linen not cushion
• Wear loose fitting clothes, wide hats and sunglasses to protect oneself when going out
• Reduce heat load in the house by turning off as much electrical appliances as possible
• Hang wet towels in airy places and close the windows directly facing the sun during the day
• Spend the most time in the coolest parts of the house
• Avoid going out in very hot periods and use shades when out
• Check on family especially children and elderly
• Do not stay or leave people in confined areas like cars, particularly children
• Contact a health professional if you experience any problems