Dual approach against childhood obesity

Dual approach against childhood obesity

Melissa Southern-Garcia, Dietitian, Jakarta, SouthernDietitian@yahoo.com

Dear Melissa,
I am very concerned with my son's excess weight. He is 6 years
old and weighs 60 kilograms (132 pounds). I hope you can advise
me on how to reduce his weight in a very gentle way. Thanks.
--Rani

Dear Rani,

Your question addresses such an important topic that I would
like to focus my entire article today on the subject.

Childhood obesity is a problem of growing proportions. An
estimated 22 million children under the age of 5 are overweight
worldwide. In the United States, the number of obese children has
doubled in the past 30 years and in Britain it has doubled in the
past 10.

Countries such as Egypt, Mexico, Italy and Australia have a
rate of childhood obesity greater than 25 percent.

In many cultures an overweight child has traditionally been
equated with a healthy or happy child, however, an increasing
number of studies indicate that an overweight child has a
significantly higher risk of becoming an overweight adult, thus
increasing risks for heart disease, diabetes, some forms of
cancer and arthritis.

More and more overweight children are being diagnosed everyday
with type II diabetes, once considered a disease of the old. It
is becoming increasingly clear that childhood obesity is a
serious public health problem that needs to be addressed. So what
can we, as parents, do to help our children stay fit and healthy?

The first place to look is the energy balance equation. All
the food we eat is burned by the body either for its basic
metabolic needs or through physical activity. The rest is stored
as fat.

In order to maintain a healthy balance, we must look at both
sides of the equation: the food that goes in, and the energy that
is expended.

With children, it is especially important to remember that
"cutting back on food" is not the answer. Children are growing
and have high nutrient requirements which should not be
restricted.

However, certain changes can still be made on the food side of
the equation. When choosing a meal or snack for your child,
rather than limiting foods, provide healthy choices. Many
children will snack on what is readily available.

Stocking your shelves and refrigerator with fruits,
vegetables, and good sources of fiber such as whole wheat bread
will help take away some of the temptation to eat high-fat, high-
sugar foods.

Place ready-to-eat snacks such as carrot sticks, low-fat
yogurt, or watermelon cubes on refrigerator shelves at your
child's eye-level. No food should be "forbidden", instead try to
encourage children to eat more of the healthy foods and smaller
portions of the high-calorie, low-nutrient choices that are often
marketed to children.

Several studies have indicated that an adequate intake of
calcium may also be helpful in reducing fat deposition in
childhood. Make sure your child is getting enough calcium by
offering good sources such as low-fat milk, tofu or green leafy
vegetables.

It is also important to get everyone involved in the
commitment to healthy eating. If the whole family is making
healthier choices, the child will have a good parental role model
to follow and will not feel singled-out or left out by having to
eat different foods.

Talk to baby-sitters or family members such as grandparents or
aunts that may spend time with the child. Explain that food
should not be offered as a reward, prize or comfort and ask them
to help encourage your child with positive messages to boost
self-esteem.

Many overweight children may have problems with self-esteem
and may even be tempted to try dieting on their own. Talk to your
child and explain the importance of a healthy, well-balanced diet
and warn of the consequences to health and growth of unsafe
dieting.

Now onto the other side of the equation: physical activity.
Since it is not wise to limit the caloric intake of a growing
child, an important part of the weight loss approach is to
increase the amount of calories burned through physical activity.

As we have become more urbanized, and technology has presented
us with more computer games and movies for entertainment,
children have become more sedentary.

Multiple studies have shown a direct correlation between
obesity and the amount of hours of television that a child
watches. It is not television itself that is a problem, but what
watching TV implies: inactivity and mindless snacking.

In our modern society, children need to be encouraged to
participate in physical activity. Provide your child with age-
appropriate toys that encourage activity such as skates,
bicycles, balls or jump ropes.

The whole family should become involved in physical activities
such as swimming, soccer or just running around in the park.
Make physical activity something fun and enjoyable for your
child.

Of course, your child will still want time to watch television
or play video games. Try to set reasonable time limits for these
activities. Always encourage your child to turn off the
television and sit at the table when eating so that he is aware
of when he is full and does not continue eating just because he
is distracted by the television.

Children should learn to listen to the body's natural hunger
cues instead of eating as a distraction or as a response to
schedules, emotions or pressures which can lead to further eating
problems.

Remember that you will have to be patient. Healthy weight loss
should be accomplished slowly in a child. Your main goals should
be to teach your child life-long skills of healthy eating and
exercise within a positive context.

Finally, if you detect any unusual changes in your child's
weight, slowed growth, fatigue, dry skin or other unusual
symptoms accompanied with weight gain, make sure to consult your
pediatrician.