by Suzanne Williams

There is no doubt that obesity, and related diseases such as diabetes, heart attack, stroke, high blood pressure and certain types of cancer (eg bowel cancer), are increasing in the Britain and in the Western World in general at an alarming rate. In the 1980's 6% of  men and 8% of women in the British Isles were classified as obese.  However by 2003 the figures had leapt to 25% of men and 20% of women and they are still increasing! Even more alarming is the trend of growing childhood obesity.  It has been estimated that up to 15% of children in the UK are overweight or obese. Why?

This article will try to explain the reasons for this increase and attempt to provide some guidelines to help families suffering with this problem. Firstly let's look at the reasons why obesity is such a serious problem.

The Reasons Why Obesity Is Such A Serious Problem in Children.

1) Children who are overweight are more likely to grow up to be overweight adults.

2) Overweight people have a higher risk of serious health problems such as heart attack and stroke, bowel cancer and high blood pressure.

3) Children have suffered a threefold increase in Type II Diabetes in the last thirty years. This is directly linked to diet and the reliance on highly processed, sugar laden fast foods.

4) Being overweight can also cause psychological distress, as teasing can affect a child's confidence and self-esteem and can lead to isolation and depression.

If you're still not convinced that we need to change our eating habits, we are seeing increasing cases of rickets (caused by vitamin D deficiency) in children, additives found in many foods cause behavioural problems such as ADHD, 1 out of 8 toddlers have anaemia and some children never eat any vegetables at all let alone the recommended guideline of 5 a day!

Maintaining a normal bodyweight is essential for good health.
So how do we determine what is normal?

Obesity is calculated using Body Mass Index (BMI), which is a measure of body fat based on height and weight. To calculate your BMI just follow these three steps.

1) Work out your height in metres AND square it (multiply the figure by itself).
2) Measure your weight in kilograms.
3) Divide the weight by the height squared.

For example you might be 1.6m (5 feet 3 inches) tall and weigh 65kg (10 stone).
The calculation would then be:
height squared =1.6 x 1.6 = 2.56.
weight divided by height squared = 65 / 2.56 = 25.39.
BMI = 25.39

· A BMI of less than 19 - underweight

· A BMI of 19-24.9 - normal weight.

· A BMI of 25-29.9 - overweight.

· A BMI of 30+ - denotes obesity.

Reasons for Increased Childhood Obesity.

Everyone can understand the equation that eating more calories than your body needs to go about it's everyday activities will lead to the excess being laid down as fat. However if we simply needed to eat less and exercise more, surely everyone could be thin! But it isn't that simple. Our bodies are excellent at adapting to exercise and calorific intake and when it does, any weight loss experienced will stop.

Today's reliance on cheap convenience and fast foods make it easy to consume large amounts of calories and they are well advertised to children. Sweets and chocolate are relatively cheap and difficult to avoid! Only a very few children are overweight due to  medical problems.  Genetics, whilst playing a part, is less likely to be the cause than the eating and activity habits children share with their parents.

Figures for physical activity also show a marked decrease. In schools, especially primary schools, the amount of time allocated to physical education has dropped. Fewer children now walk to school and it is not unusual for children to spend hours sitting at a computer or watching TV. In 2000, The National Diet and Nutrition Survey found 40-69% of children over six years old spend less than the recommended minimum of 1 hour per day doing moderate intensity physical activity. In short an increase in high sugar and fatty foods and a decrease in exercise have been responsible for our children's increasing obesity.

How can we help?

Firstly a child should never be put on a restrictive diet without proper medical supervision as this could affect their growth and it is important not to start them on the yo-yo dieting cycle which almost inevitably leads to gaining the weight back with extra unwanted pounds once the diet has 'finished.' Encouraging 'dieting' can also lead to eating disorders such as anorexia and bulimia which are also on the increase. Instead children should be encouraged to maintain their weight so that they will 'grow into it' as they get taller.

Secondly parents should lead by example - changing their own eating and exercise patterns at the same time will have the greatest impact on their child - and of course they'll feel the benefit too!

What is healthy eating?

Healthy eating means including a wide variety of foods from the major food groups.

Protein foods include meat, poultry, fish, eggs and dairy products, beans/legumes, grains (eg wheat, rye, oats, barley, rice, maize, millet) and nuts.

Carbohydrate foods include grains, such as oats, wheat, rye etc. It is important when choosing carbohydrates to eat whole grains rather than the highly processed 'white' forms ie choose wholemeal bread and brown rice. This will maximize the nutrients they contain and provide more fibre. If your child doesn't care for brown rice try serving white rice coloured yellow with cumin. When they are used to this, switch to brown rice coloured with cumin, chances are they won't notice because they now look the same! Many children refuse brown bread, but there are now several loaves that include both white and brown flour which again makes them a halfway house between white and brown until they can make the switch completely.

Carbohydrates also include vegetables. Many children do not like vegetables but they can often be 'hidden' in foods that they will eat. For example cauliflower disappears in mashed potatoes, pizza toppings can hide extra cooked mixed vegetables such as sweetcorn (maize) and peas under grated cheese. Also try raw, grated carrots or carrot sticks rather than the boiled versions. Many children will prefer vegetables raw, and it's better for them as cooking can destroy many of the vital vitamins and minerals they contain. A good resource full of ideas for disguising vegetables is "The Art of Hiding Vegetables" by Karen Bali and Sally Childs.

Fats have a really bad reputation for causing weight gain. However fats are not all created equal, there are good, essential fats which are vital for proper function of the brain and circulatory system and the not-so-good fats which tend to clog the arteries and cause health problems. The trouble is that the current western diet is full of the bad fats and deficient in the good ones. Frying foods in fat not only increases their calorific content but also changes the molecular structure of the food making them potentially harmful to the body and should be avoided. Research by Patrick Holford shows that foods cooked at high temperatures produce acrylamide, a cancer promoting chemical. The safe limit is set at 10 parts per billion.  However chips can contain up to 12000 ppb and Pringles contain 1500!

What about drinks?

Over the last 20 years or so, consumption of soft fizzy drinks has increased by 100%. A can of Coke contains 9.14 teaspoons of sugar.  No wonder our children are putting on weight! Of course that is not to mention the extract of coca leaves it contains.  The official story is that in 1929 cocaine was finally removed from its formula. However the Coca-Cola Company continues to import some eight tons of coca leaf from South America each year -- a substance that, if carried into the country by an ordinary citizen, would result in their arrest and incarceration for "drug trafficking ".  And they still use those leaves in preparing its soft drinks.

If you want to improve health and the chances of staying at a normal weight cut out fizzy drinks altogether and change to 100% natural, unsweetened fruit juice or filtered water. Use sparkling mineral water for a treat!

When to eat

Children need regular meals in order to keep their blood sugar levels steady as they are less able to regulate it than adults. [Kathleen DesMaisons 2004] You should aim to give them three meals a day plus healthy snacks in between. Make sure they eat a breakfast that includes protein and a complex carbohydrate every day. This kick-starts the metabolism and avoids a blood sugar crash mid-morning when they may reach for a chocolate bar.

All meals should include protein. Try to choose low calorie proteins such as cottage cheese and lean meats. Snacks too should include protein which can be harder to think of. Examples could be a handful of unsalted nuts and raisins (not for children under 3), peanut butter (where tolerated) on wholewheat crackers, apples and chunks of cheese.

Taking Out The Sugar

This can seem like an impossible task but the secret here is to add things to the diet before removing them, by doing that you will balance your child's biochemistry. Sugar has the same effect on the human body as heroin, albeit not as dramatically [DesMaisons 2004] and it is highly addictive. To avoid withdrawal symptoms, it is important not to try to alter eating patterns overnight. Excess consumption of sugar can lead to diabetes; it also produces behavioural problems in sensitive children. An action plan
for changing your children's eating habits is shown below. Ideally the whole process should take 6 - 12 months.

Stage 1 - Eat breakfast with protein and complex carbohydrates every morning within an hour of waking

Stage 2 - Make connections between the foods you have eaten and how you feel.

Stage 3 - Change snacks and drinks from junk food to healthy food and from fizzy drinks to water

Stage 4 - Make sure all your meals and snacks include both proteins and carbohydrates

Stage 5 - Change all carbohydrates from to 'white' foods to wholegrains.

Stage 6 - Reduce and then eliminate sugars.

By following the above plan your child should begin to lose weight naturally without developing a 'diet head'. Further advice on changing your child's diet gradually can be found in Little Sugar Addicts by Kathleen DesMaisons.

Food Supplements

A well-balanced diet should include a wide variety of foods to ensure a good intake of essential nutrients. However supplements of vitamins can be very useful, especially if your child is a picky eater. Look for good quality supplements that can be chewed if your child doesn't like swallowing tablets.

Omega oils are essential for proper brain function and many manufacturers now offer flavoured oils for children. Be careful, however, to choose one without sugar, sweetener or artificial colouring. Alternatively the oils can be added to milkshakes, juice or yogurt where they generally become undetectable.

Exercise

There are several excellent ways to include exercise into your daily routine.

1. Try walking to school (or the shops) instead of taking the car.

2. Park at the back of the car park when shopping instead of fighting for the space nearest to the entrance!

3. Visit your local leisure centre. They usually have sports your child might like to try. Make sure they have some well-fitting clothes to minimise their size problem.

4. Judo and karate suits are great cover-ups if your child is self-conscious and learning martial arts will often help self-confidence. Look for a sympathetic teacher who will not make comments about your child's weight.

5. Swimming is excellent exercise and fun, especially if the whole family takes part.

6. Make exercise a special treat - visit skating rinks, adventure playgrounds, take bike rides, play tennis or football or simply walk in the park.

7. Limit the time spent in front of a computer or TV screen to two hours a day maximum.

8. Get a dog.  Preferably rescue one in need of a good home rather than buying one from a breeder or pet shop.

In conclusion, an overweight child generally lives with overweight adults. By changing your eating habits and getting more exercise it should be possible to improve the health and decrease the weight of the whole family. If some, or all, of these things seem impossible to you at this moment, believe me that once you start making these changes things will get easier and will be well worth the effort. You can give your child no greater gift than that of good health.

References:

Karen Bali & Sally Child (2005) - The Art of Hiding Vegetables - White Ladder Press.

Kathleen DesMaisons (2004) - Little Sugar Addicts - Three Rivers Press.

Patrick Holford (2004) - New Optimum Nutrition Bible - Piatkus Press.


Useful Websites:

http://www.nutrition.org.uk/home.asp?siteId=43&sectionId=408&subSectionId=321&parentSection=299&which=1

http://hcd2.bupa.co.uk/fact_sheets/html/child_obesity.html

http://www.statistics.gov.uk

http://www.netdoctor.co.uk/diseases/facts/diabetes.htm

http://www.sciencedaily.com/releases/2000/08/000811070339.htm

http://bjp.rcpsych.org/cgi/content/abstract/186/2/132

http://www.botanicchoice.com/hnwire1104a.asp

http://biology.clc.uc.edu/scripts/popreslt.pl

http://www.newstarget.com/003228.html