Are there more children overweight than a decade ago? In Bermuda ‘yes’, would seem to be the answer.Paediatrician Sylvanus Nawab, of Edgewood Paediatric Services, estimates that more than a third of his clients are overweight or obese.“I’m seeing children from the age of three, four and five years old that are overweight and some obese,” he said.Fortunately he doesn’t see the disturbing trend in the weight of babies and children under two. “There are no such problems here,” he said.In an interview with Body & Soul Dr Nawab said he’s noticed a correlation between the time children are weaned off milk and their weight gain."When they are weaned off milk many parents start giving their infants and toddlers, inappropriate foods," he said. "Many toddlers are given cakes and cookies. They eat bread and fried food. Many parents don't know that they should never give infants fried foods," he added.He believes it's a problem that can easily be rectified if local doctors take action. "It makes a big difference when I as the primary care provider, push parents to make changes to benefit their children," he said. "When parents realise the problem, they are willing and want it to be solved. As physicians we have to be the people spearheading the change because most parents don't know what they need to give their children," he added.He said parents cause their children to develop a taste for high sugar, high fat and flour based products by feeding them such foods from infancy. "Most of the parents that come to our practice don't do that because we explain that they should give the children vegetables and fruits and stay clear of breads and sweets."We see that parents that do this tend to have children with a more varied palate. They don't crave sugar and high fat foods," he said.In contrast to children who get cookies and other sweets as snacks, Dr Nawab said children given fruits and vegetables, learn how to enjoy these types of foods as snacks.Although food plays a major role in the children being overweight and obese Dr Nawab said lack of activity is also a factor."Weight gain starts when the children become less active. When they are babies and up to the age of two they are very active, they are always moving around after two things tend to change," he said.Recognising that social and environmental factors like poverty and violence are often at the root of why children are less active, Dr Nawab believes the problem doesn't rest entirely on parents."It's a socio-economic problem so everyone has to pitch in," he said. "Children can't play outside if there's a problem of violence in their neighbourhoods. Parents may not be able to afford healthy lunches so the schools should provide healthy lunches," he added.For his part, he educates parents on feeding their children and explains the body mass index scale. He points out that conditions including diabetes, high blood pressure and ultimately heart disease are in the cards for children who are overweight and obese. Dr Nawab sees all his clients at least once a year and always records their weight and height."I plot it on a graph where I can easily see if a weight problem is starting to develop," he said. In this way he is able to work with the family to arrest the problem.As a paediatrician he sees children from the time they are babies until they are leaving high school at 16 and 17. He said seeing them annually gives him a pretty clear picture of any weight problem.So when do local children tend to start having problem with weight gain?According to Dr Nawab it can happen at any time. "There are lots of changes in the lives of children and lots of new things happening. It's like a tree, if you are planting it from seed there are many things that can go wrong before it reaches maturity. You want to detect these problems early and deal with them so that the tree reaches maturity disease free."It's the same with our children, that's why we want to see them annually," he said. "When we start looking at them early we can try and correct these things early."