Childhood obesity

Childhood obesity is becoming a big problem in New Zealand, as it is in most Western countries.

The National Children’s Nutrition Survey, carried out in 2002, showed that 31% of children were either overweight or obese, so based on those statistics, you could easily be a parent of an overweight child.

Many parents are concerned about this issue. A number of the families that I see voice their concerns about how to approach such a sensitive issue. While they want to help their child they do not want the pendulum to swing the other way and start off the cycle of dieting and excessive weight loss. This concern is most apparent in parents of overweight girls.

Some studies show that if a child is put on a strict weight loss programme at a very young age, then they may battle with “yoyo” dieting later in life. They also tend to have a low self image from a young age. So it is important to avoid “diets” with kids.

The term “diet” in my mind equates to a restricted eating pattern with a long list of foods to avoid. As many long term dieters will tell you, a diet tends to be a temporary eating pattern. If, while on a diet, a person eats a food that is on their “banned list” they will then feel guilty or feel like they have little control over their eating.

We do not want to introduce children to these negative thoughts around food, so dieting for children is not recommended. In fact for children the aim is not so much weight loss, but trying to halt further weight gain and allowing them to grow in height until their weight is appropriate for their height.

So what can you do? Whilst “dieting” is not recommended it is important to start dealing with the problem sooner rather than later. The longer poor eating patterns and/or low activity levels are left unchecked, the harder they will be to correct.

It is important however that the problem is dealt with as a family rather than placing all the focus on the child. Generally speaking, it is not the child who is responsible for buying or preparing the food, so healthy options should be bought in for the whole family. The child with the weight problem should not be left to feel that they are the only one who has the problem.

It is also a positive idea to talk about improved health rather than just focusing on the child’s weight. Focus on improved energy levels or better exercise tolerance for the whole family. This may help to avoid or reduce the negative feelings that the child may have about his or her body image.

The first starting point, as for any person trying to improve their eating patterns, is to ensure that the day consists of three regular meals. While you may have a non-breakfast eater on your hands, the importance of breakfast cannot be underestimated. Breakfast helps to kickstart our metabolism for the day and studies do indicate that non-breakfasters often actually eat more during the day.

Taking stock of how many treats are had over the day is also important. They may seem small but they can have a significant impact. Often a child may have a small packet of chips in the daily lunch box – at 25 grams the packet may seem insignificant, but over 5 days this adds in an extra 45 grams of fat (this is the equivalent to an extra 9 teaspoons of a fat such as butter!). On a regular basis this has a significant impact.

No food needs to be banned, but some foods should be considered as occasional foods while the healthier foods are considered everyday foods. These occasional foods then need to be monitored.

Generally, trying to encourage less in the way of packaged and processed foods will result in a reduction in fat and added sugars. At the same time, healthy and wholesome foods such as fruit and vegetables, breads and cereals, lean meats and low fat dairy products should be encouraged.

It is interesting to note these following findings regarding body mass index (BMI) from the NZ Children’s Nutritional Survey. The BMI compares a person’s weight with their height, and a high BMI indicates that a person is overweight.

• Children who ate breakfast at home had a lower BMI than children who did not eat breakfast
• Children who usually ate lunch had lower BMI’s than children who did not eat lunch
• Children who usually ate lunch prepared from home had a lower BMI than those who usually ate lunch bought from the school tuck-shop or dairy
• Children who drank soft drinks less than once a week had lower BMIs than those who drank soft drinks at least once a day
• Children who watch less than 1 hour of television per day had a lower BMI than those who watched over 2 hours per day

While the above findings do not prove a cause in childhood obesity, they do imply a link.

Lastly, the importance of exercise cannot be underestimated. Regular exercise is a vital habit to start in childhood. Again it should be a family project not just focusing on one child. Don’t forget that if your child is quite large or if they have not done much exercise the idea of doing exercise as part of a team sport may seem very daunting for them. This is where doing things initially as a family can be very important. Things like walks, bike rides, going to the park, and kicking a ball around are all important. Setting limits on the television, computer and play station may be necessary. Considering TV-free days for the whole family may be appropriate so that the child does not feel that they are the only one with new limits imposed.

So if you are concerned about your child’s weight don’t wait to see if they will ‘grow into their weight’. The earlier you start with positive changes the better. The younger the child is when good habits are developed the more likely they are to maintain those habits and attitudes for life.

Avoid the feeling of guilt around food by talking in positive terms. Talk about how some foods will energise us and satisfy us for longer, while on the other hand some foods will leave us feeling sluggish and won’t satisfy us for very long.

Don’t forget that for the child with a weight problem it is important that the whole family tries to treat the problem – it is not just the overweight child in the family who needs to change eating and exercise habits.