Chen Szu-ta (陳思達) is the least popular physician in Yunlin County — or so it seemed last weekend.
At a local health fair, Chen was offering free ultrasounds to test children for fatty liver disease, a symptom of juvenile obesity. For 30-minute and even hour-long stretches, nobody brought in their child for a test, while nurses stood outside the booth and smiled at passersby.
“We haven’t managed to test many kids,” said Chen, a pediatrician at National Taiwan University Hospital’s branch in Yunlin County. “But I wanted to offer something that the community needs.”
Overweight and obese children are at higher risk for fatty liver, cardiovascular diseases and the early onset of diabetes. According to Chen’s unpublished study, at least 23 percent of Yunlin children are either overweight or obese.
“That’s higher than Taipei’s rate,” said Chen, referring to the capital city’s 18.36 percent. “Most people think urban children should weigh more because they have richer food and less space and live more sedentary lifestyles. But actually, children in Taipei these days are savvy about correct nutrition.”
In contrast, children in rural areas are far less versed in the how and why of eating right.
“They won’t eat rice if there’s a McDonald’s,” said Chiou Shu-yuan (邱淑媛), a researcher at the Hualien District Agricultural Research and Extension Station (花蓮區農業改良場).
Hualien County has its own problems with child obesity. In the latest available study, Buddhist Tzu Chi General Hospital found that 27 percent of boys and 23 percent of girls in the county are overweight or obese. This year, Chiou’s research center and a local company are preparing to mass produce Colored Rice — white rice that has been treated with natural dyes that come in four clown-like colors.
“This rice gets the child interested. We have shown kids some photographs of Colored Rice and they’ve told us, ‘Oh! I want that!’” said Chiou.
But even if rice were more fun, mitigating rural child obesity requires change to a legion of deeper issues.
“Parents and grandparents see round children and they are not too troubled,” said Chen at his deserted clinic.
Down the street from Chen, one local said his son is thin, but that he wouldn’t mind if the boy were not. “People are at different weights at different stages of their life. I was fat when I was younger. After I started working, I became much skinnier,” said Chang Hsiang (張向).
Chang is warden of the tiny Gancuo Village (甘厝), population 1,000.
Like its neighbors, Gancuo is economically depressed and home mostly to seniors, who make a living growing water spinach, cabbage and bell peppers.
Every day, the locals — Chang included — rise at 4am to work the land. At daybreak, Chang clocks in as the village warden, an elected office he has held for over 20 years.
For him, a variable contributing to child obesity could be the local makeup of families, which are rarely nuclear.
“I do see big children,” said Chang. “One reason is the grandparents. Parents provide the meals and grandparents dote on the kids with snacks. Lots of households here are multi-generational.”
Other households of Gancuo Village are cross-generational — grandparents raise the child in the absence of parents. For Chang, that’s another reason why local children eat French fries for lunch and sweets for dinner.
“Kids in Taipei probably don’t eat like this. I think maybe they have different nutritional values, enforced by their parents.”
He nods toward the street, which is devoid of people and cars, the way it has been for the duration he’s been speaking. “You see. Most adults have already left.”