Childhood obesity prevention

IMPORTANT

Under no circumstances should Slim & Save products be given to children. The following article focuses on suitable methods to help avoid and cure childhood obesity.

Latest figures from the National Child Measurement Programme in 2015/16¹ suggest that 9.3% of children aged 4-5 are obese with a further 12.8% being overweight. As children progress through their primary school years, obesity and overweight increases. By year 6, a staggering 19.8% of children are obese, with a further 14.3% overweight. These worrying statistics mean that a third of 10-11 year olds are overweight or obese.

Being overweight or obese is a big cause for concern in children; not only is it likely to affect a child’s self-esteem and social interaction, but it increases their risk of developing health conditions such as type 2 diabetes and heart disease which are affecting people at much younger ages than before.

Interestingly, our perceptions of what a child with a healthy weight looks like has changed over the years, as we have got used to seeing bigger sizes. A London-based study in 2015 surveyed 3000 families about whether they thought their child was obese, overweight or a healthy weight. Results showed that nearly a third of parents underestimated the weight of their child². The researchers suggested that as a society we have become so used to obesity that we have lost our sense of a healthy weight.

If you’re overweight or obese yourself, you may be particularly interested in helping your children make healthier choices when it comes to food and lifestyle, to help prevent your children struggling with their weight as adults. If you’ve never done it before (or not reviewed it for a while), you could check your child’s weight status by using the ‘healthy weight calculator’ on the NHS Choices website (www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx). This will give you an indication of where your child is (underweight, healthy, overweight, obese), and whether you should consider making more changes or seeking professional advice.

If you want to take stock, review and consider what you can do to support your children to help them become healthy and active adults, here are our top 10 tips.

1. Start young – babies and toddlers

Don’t underestimate the importance of starting young. Exposing babies to lots of textures and flavours from an early age is really important. It’s also important to remember that studies have estimated that a baby needs to try a new food over 15 times before he/she can decide if they really don’t like it.

When it comes to feeding your baby, it’s best to steer clear of the special ‘baby foods’ and give them ‘normal’ healthy, home-cooked family food (without the addition or salt or sugar). For example, many of the flavoured baby porridges are sweetened; normal porridge oats or plain instant oats with mashed fresh fruit is a much better alternative.

Many snack foods marketed for babies actually contain added sugar in the form of fruit juice, e.g. apple juice concentrate. For example, apple rice cakes aimed at 7+ month babies consist of rice cakes coated in apple juice. We know that eating an apple whole or in chunks is great, as the sugars naturally inside the cells of the apple are released slowly during digestion. However, when juiced, the natural sugar (fructose) is quickly absorbed in a similar way to normal sugar. Sweet tasting snacks also gets babies used to expecting a sweet taste, which could affect their diet and weight as children and adults.

2. Role modelling & family mealtimes

Your children will pick up on your fruit and veggie likes and dislikes early on, and it’s great to try and talk about all fruits and veggies with positivity. Your children will naturally model many of your habits around eating, so try to stay positive and model healthy eating and healthy snacks to your children. Doing physical activity as a family also helps to model a healthy lifestyle and show that it can be fun! Studies have also found that eating together as a family can have significant benefits, perhaps due to role modelling. One study found that when eating together as a family, a child may be 35% less likely to engage in disordered eating, 24% more likely to eat healthier foods and 12% less likely to be overweight³. In addition, one study found that regular family mealtimes were a more predictor of academic achievement than time spent in school!⁴.

3. Cut back on sugary drinks

We’ve all heard the news recently about the new ‘sugar tax’ which aims to reduce consumption of sugary drinks. Dietary surveys have found that sugary drinks are one of the biggest contributors of sugar intake for children. When we hear ‘sugary drinks’, we often think about non-diet fizzy drinks, energy drinks and milkshakes – we may not think about fruit juices and smoothies. The blending or juicing process to make fruit juices and smoothies releases the sugar to the outside of the cell, meaning the ‘natural’ sugar in the fruit is readily absorbed in a similar way to the sugar found in regular coke. Children over 5 should have no more than 150ml a day of fruit juice or smoothie. In children under 5, fruit juices should be watered down (1 part juice to 10 parts water), and consumed at mealtimes only to protect dental health.

4. Snack attack

Sweet snacks are often not only convenient, but they’re what our kids are demanding. However sugary snacks can be harmful for both their weight and their teeth. Healthy snack options to try include oatcakes, rice cakes, dry cereal (cornflakes and rice crispies are fairly low in sugar), small sandwiches or pitta pockets, fruit, veggie sticks, nuts and seeds. Also be aware of hidden sugars found in seemingly healthy products. For example - cereals bars often contain more than 40% sugar, and even those marketed as ‘healthy’ are often laden with added sugar; dried fruit (especially those marketed for kids lunchboxes) can often be sweetened with extra sugar.

5. Perfect portions

Due to the fact that children generally have such a wide range of calorie requirements (e.g. due to their varying physical activity levels), there are no set portion sizes which can be recommended for your child. However, guidance does exist and may be that reducing portion sizes of certain foods is required. The Caroline Walker Trust ‘CHEW’ resource contains some good information for children aged 5-11 (available to download from here). For toddlers, check out the ‘perfect portions for toddler tums’ from the British Nutrition Foundation (available to download from here ).

6. Cut the screen time

Setting time limits with your children on time in front of the TV or on computer games or phones is really important to reduce their time spent sitting down, being ‘sedentary’. If you’ve never addressed this before, involve your children in deciding what is reasonable, and start from there. By involving your kids and explaining the benefits to them, you’re more likely to get buy-in from them.

7. Get active as a family

Spending time being active as a family can really help burn excess energy and encourage a healthier lifestyle. It could be something as simple as bike rides at the weekend, regular trips to the park after school, or challenging the whole family to a race by taking part in the junior⁵ (or adult⁶) park runs as a family.

8. Perfect packed lunches

If your child is at school or nursery, packing a healthy packed lunch which varies across the week is an important contributor to their daily nutritional intake. The ‘perfect’ packed lunch consists of the following:

• A starchy food – e.g. bread, pitta bread, wrap, bagel, pasta, noodles or couscous. Rice cakes, breadsticks and oatcakes are other alternatives
• A dairy product – e.g. yoghurt, fromage frais, cheese. Choose reduced fat versions where available
• A serving of protein-rich food – e.g. lean meat (chicken, ham, roast beef fillings to sandwiches), fish, egg, beans, lentils and pulses. You could try including kidney beans or chickpeas into a pasta salad, or hummus as a dip for veggie sticks
• At least one serving of fruit – this could be fresh fruit, dried fruit, or tinned fruit in natural juice (drained). If your child doesn’t like fresh fruit, try grating some apple into a pasta salad, or add some tinned/fresh fruit into some custard or whip to make a tasty dessert. Grapes, clementines (peeled and segmented for them) and berries work nicely in packed lunches – invest in some little pots to portion them up and avoid mess
• At least one serving of vegetable or salad item – this could be salad or vegetables in a sandwich, wrap or bagel, a side salad to accompany the lunch, an addition to a pasta salad, or some pre-prepared carrot, pepper, celery, spring onion and cucumber sticks
• A drink – it’s best to stick to water or milk - or if your child is over 5, a small carton of pure unsweetened fruit juice (from concentrate). Check labels on fruit juice cartons to ensure no added sugar

9. Get them cooking (and growing)

Food related activities are a great way to get kids interested in eating healthily. Often when children do food-related activities at school or preschool, it is sweet baking (think chocolate cornflake cakes and cookies!) Children generally get less opportunities to be involved in savoury food preparation and cooking in the home. Food activities like making fresh fruit kebabs, making soup from scratch, making cheese scones and pitta-bread-pizza are fun and easy things to try. Activities around growing foods can also help children get involved and interested in eating healthily. f you have the space in your garden, why not buy some planters and grow some vegetables? Things like lettuce and runner beans are easy ones to try. If you don’t have the space in a garden, a window herb box is a great alternative.

10. Involve the children

Family based approach is best. If your children are old enough (primary age and up), try to involve them in decisions around changing diet and lifestyle. Having a complete overhaul of your child’s lunchbox is likely to be met with a negative reaction. However, having a discussion about how healthy they feel their current packed lunch is, and making some small changes with their consent is likely to be a better way to approach change. This will help them make more informed decisions and empower them to be more independent with food choice. The ‘Be Food Smart’ app from Change 4 Life has proved very popular with school-aged children⁷. It enables you to scan in your food and see how much sugar, saturated fat and salt is in the produce. You may even find your children can teach you some new facts about the sugar content of foods in your cupboard!

Where to go for more support

If you are concerned about your child, their GP or school nurse is the best person to see as a starting point. There may be additional support or services available that they could refer you to, such as a dietitian or psychologist. The child’s age and growth pattern will often determine whether the focus would be to keep a child’s weight stable or actively try to lose weight. If you would like to look at some more information, including healthy recipes and fun physical activity ideas, you can visit the Change 4 Life website.

References:

¹ https://www.noo.org.uk/NCMP
² Summary of the key points of the original paper available from here.
³ Hammons and Fiese, 2011
⁴ For more information on this, visit The Family Dinner Project.
⁵ Park Run Events.
⁶ Park Run.
⁷ Change 4 Life.

Written by Annemarie Aburrow RD BSc (Hons) PGDip, Slim & Save Dietitian.