Battling the bulge

Eat well, move well, play well…and be healthy for life!

Countering overweight and obesity in our children

Today, one in every five school-age children is overweight or obese. This figure has doubled in the last 10 years. The health and wellbeing of our children is vital but modern Australian society threatens children’s health. Eating habits have changed so that these days children’s diets are high in fat, salt and sugar. In addition, increased time spent in front of the computer or television or playing video games (often while snacking on ‘junk food’ and soft drinks) means that children spend less time being physically active. These changes have produced an increasing number of children who are overweight or obese.

Recognising the problem

Before we can deal with weight issues in childhood we must recognise the problem in the first place. Although most families are aware that Australian children are getting fatter and that this situation is of concern, parents often believe that childhood overweight and obesity affects other people’s children – their own children are just ‘a little overweight’, or have ‘puppy fat’. Children can develop different shapes at different ages as part of their growth and development and sometimes it can be hard to determine if they are overweight. However if a child is ‘huffing and puffing’ or going red in the face when walking up a hill, if they cannot fit into age-sized clothes and/or if extra rolls of fat can be seen around their waist, then that child is likely to be overweight and to need help. A health professional (such as your GP, a community nurse or a paediatric dietitian) can help you determine if your child is overweight.

Many people believe that fat children will ‘grow out of it’ – unfortunately, this is generally not the case. There is a high risk that problems with weight in childhood will persist into adulthood. Children do not usually grow out of their ‘puppy fat’ and ‘chubbiness’ – the weight problems remain and the longer a child is overweight or obese the higher the likelihood that weight problems will persist.

The vicious cycles

Most people understand the link between over-eating or poor nutrition and weight problems, but the link between decreased physical activity and overweight is less well appreciated. In simple terms, the food eaten each day needs to be matched by a level of physical activity that uses the energy provided by the food. Maintaining a balance between energy input and energy output is the key to healthy weight and good health. Overeating or excessive eating of junk food and/or too little physical activity leads to an unhealthy nutritional state. Children with weight problems are often unfit and not well co-ordinated, and this makes it harder for them to be active; there is a vicious cycle of further sedentary behaviour, decreased physical activity, and worsening states of fitness. A paediatric physiotherapist can help here as they have training and experience in assessing motor skills and exercise fitness, and in advising suitable activity/exercise programs.

Children who are overweight or obese frequently have poor self-esteem as a result of being teased, bullied and ostracised. And there is the risk of other serious health problems. Lack of exercise, poor nutrition and resultant weight problems in childhood have serious health consequences both in the short term and the long term. This may include joint pain, asthma, sleep apnoea, raised blood pressure, high cholesterol, fatty liver disease and non-insulin dependent (Type II) diabetes. Some of these health problems, such as Type II diabetes, previously seen only in adults, are now being seen in children. It has been suggested that unless we reverse the weight problems in our children we run the risk that the next generation will have such serious health problems that their life expectancy will be less than that of their parents.

Some families believe that as long as their child seems a normal weight then poor diet habits and a preference for sedentary behaviour does not really matter. Physical activity is an important part of good health. Being active every day can protect against disease later in life and can help your child improve concentration, boost self-esteem and confidence, and maintain a healthy weight. Establishing healthy diet habits and engaging in regular physical activity from early childhood is a means of maximising health for life!

How can I change undesirable habits?

Encouraging children to eat healthy food and be physically active can be a challenge. It requires patience, practice, and time. Start slowly. It is best to introduce one or two small changes successfully before moving on to the next idea.

A paediatric dietitian can provide ideas on how to introduce and maintain healthy food choices into your child’s diet. To increase the level of physical activity and to maintain your child’s interest in being active, try to introduce a variety of activities. Being involved in organised physical activity (sports and hobbies) is great, but remember that there are simple and cheap ways to be active too. Build up activity levels gradually and set goals – start by aiming to increase activity by 15–30 minutes a day, and each month increase the goal time until your child is physically active for an hour per day (up to 90 minutes is even better!). Being active for 10–15 minute periods a few times a day is fine and may make achieving total daily goals more manageable. Doing things together as a family is a motivating way to set up healthy habits – so get out and about with your children.

Remember the motto: eat well, move well, play well…and be healthy for life!

Q: I had a weight problem as a teenager and I want to prevent my own children from going through the teasing that I faced. I often read that children should be active and eat the right food but exactly what does this mean? My children are in primary school – what should they be doing?

A:The following healthy habits are recommended not only for your children but for everyone in your household – remember that what you model for your children is very important and establishing and maintaining healthy choices is crucial throughout childhood and adolescence.

Your children should be encouraged to:

• Have at least an hour of physical activity/active play each day – and even more is better.
• Limit time in front of the TV or computer to less than 2 hours per day.
• Eat at least 2 fruit and 5 serves of vegetables each day.
• Drink water instead of fruit juice or soft drinks.
• Avoid snack foods that are high in saturated fats or have added salt and/or sugar.

Be savvy about food advertising and packaging – read food labels to ensure you have made a healthy choice.

Q: My child is a fussy eater and I battle to get him to eat fruit or vegetables. I also feel that he watches too much TV and plays his computer games more than I like – but he is a normal weight so do I need to be concerned?

A: Your child may seem a normal weight now, but his restricted diet and sedentary habits put him at risk of developing health problems, even if these do not emerge until later in adulthood. A balanced, healthy diet and being physically active for at least an hour a day is a good way of protecting against lifestyle health problems such as cardiovascular (heart disease, stroke) and respiratory problems, and diabetes. Habits entrenched in childhood are much harder to change as an adult, so the earlier healthy habits are established the better. A paediatric (children’s) dietitian can advise you on how to introduce healthier food choices into your child’s diet. Limit his time in front of the TV or computer to less than 2 hours a day and try to create more active play opportunities (walking or riding around the neighbourhood, ball games, playing in the park etc). Children are more likely to be active in the company of friends or family so try to work out times when you can invite his friend(s) over to play or when you can get out and about as a family.

How to foster physical activity

• Talk with your child about how physical activity is an important part of being healthy
• Provide simple equipment for your child to play with (balls, rope, ‘Frisbee’ etc)
• Encourage your child to try new activities and be patient as they learn
  • Play ball games in the backyard-kick, hit and catch
  • Ride a trike, scooter or bike
  • Take your child for a swim
• Build physical activity into your child’s daily routine
  • Walk rather than drive to get around
  • Walk to and from school. If neighbourhood safety is a concern, think about setting up a ‘walking bus’ in which a couple of adults walk a group of children to and from the school
  • If the distance to the school, shops or park is too great then consider parking the car a couple of blocks from your destination, or getting off the bus one stop early, and walking the rest of the distance
  • Use the stairs rather than the lift or escalator
• Be a role model by being physically active yourself
  • Take your child when you walk the dog
  • Go to the park with your child – encourage them to climb, swing and run
  • Walk along the beach with your child, slide down sand hills
  • Involve your child in helping around the house and doing things like gardening
• Encourage any interest in neighbourhood or school sports and recreational activities – check out what community activities are on offer e.g. at the YMCA
• You do not have to be outdoors to be active – be imaginative with indoor activities
  • Dance to music
  • Adapt ball games using a balloon (balloon tennis or balloon soccer) or ping pong ball (indoor cricket)
  • Jump up the stairs
  • Use a hula hoop
  • Play ‘Simon Says’ or ‘Hide and Seek’