Here are some facts about diet and obesity:
- Much of the decline in diet quality for children occurs between the age groups two to three and four to six. During this period, the percentage of children having a good diet falls from 35 to 16 percent, and the percentage having a diet that needs improvement rises from 60 to 75 percent.
- For young children, an extra 50 calories a day of unburned calories (not used for growth, activity or metabolism) can create five extra pounds of fat a year.
- Between one and two years of age, normal weight gain is about 2 to 3 pounds a year. Between three and eight years old, expected weight gain is about 5 pounds a year. So those extra 50 unburned calories a day can double the expected weight gain.
- Currently 22% of the US Adult population has a body mass index (BMI) greater than 30 and 3% have a BMI greater than 40 – about 100 pounds overweight. See Health Trends.
- If a baby between 6 months and 5 years of age is overweight, he has a 20% chance of being overweight as an adult. An overweight 7 year old has a 41% chance of being overweight as an adult. If the child is between 10 and 13 years of age and overweight, the chances are 70% he/she will be overweight as an adult.
- Children who were overweight at age seven were more likely to have multiple risk factors for heart disease as an adult. There was more risk for having increased insulin levels, high blood pressure, and high cholesterol. Reduction in the rate of weight gain during childhood or adolescence had the potential to reduce the levels of young adult cardiovascular risk.
- Children may think they are being active, but a research study showed that when kids (ages 11 to 13) were electronically monitored they were spending far more time sitting around than they thought. Children who said they played vigorously for one hour a day, actually had spent about 2 minutes being vigorously active.
- Soft drinks contribute significantly to the increased sugar load in our diets.
- Americans are eating more processed snack foods a day than ever. There are about 12,000 new foods introduced annually each year.
What is a parent to do when faced with the challenge of a child who is overweight?
What is overweight?
First we need to define what it means to be overweight. Growth charts need to be used; you can’t always tell by looking. Sometimes an overly concerned parent, may assess their truly normal-weighted child as being overweight. On the other hand, studies have shown that many parents tend to overlook their child’s obesity. New growth charts have been released by the Center for Disease Control and you can download the “Individual charts with all percentiles” at http://www.cdc.gov/growthcharts. Especially important are the “weight-for-length,” “weight-for-stature,” and “body mass index for age” charts for your child’s age group. Body mass index (BMI) has advantages over other methods of monitoring obesity in children and adolescents and the charts can be downloaded for children 2 to 20 years of age. It correlates closer to actual body fat measurements.
Here is how to calculate Body Mass Index:
BMI = (Weight in pounds ÷ [Height in inches ]2) x 703
Example: A 33 pound child is 37 inches tall
(33 ÷ [37 x 37]) x 703 = (33 ÷ 1369) x 703 = 0.024105 x 703 = 16.9
BMI = Weight in kilograms ÷ [Height in meters]2
Example: A 17 kg child is 106 cm tall (NOTE: 1 meter = 100 cm)
17 kg ÷ (1.06 m x 1.06 m) = 17 ÷ 1.1236 = 15.1
Here is how we can interpret BMI percentiles:
Underweight: BMI-for-age 5th percentile
At risk of overweight: BMI-for-age 85th percentile
Overweight: BMI-for-age 95th percentile
Now let’s say you have identified your child as being overweight or at risk for being overweight. Maybe you have just started to notice a recent trend of increasing BMI. First, check with your health care professional to make sure that there may not be a medical cause for weight gain. Occasionally, hormone disorders like hypothyroidism, may cause subtle weight gain without the child appearing ill. Once you are comfortable with a medical examination, think about changes in eating habits or caretakers that may be contributing to weight gain. Sometimes a change in the child’s lifestyle can be identified as a contributor to overeating or just eating more unhealthy food choices. Here are some questions to ask yourself:
- Is there a daycare provider, nanny, or relative that allows constant snacking or frequent, unhealthy snack choices?
- Have family activities or busy schedules allowed more fast food on the run to creep into the family menu?
- Has there been environmental changes that don’t allow exercise – new neighborhood without playmates or the convenience of outdoor areas to play, family stress, more sedentary activities around like Nintendo, Game Boy, computers, TV in the bedroom of the child, off season for your child’s usual sport activity?
- Does your child have a physical problem that may limit activity, like asthma, orthopedic problem?
- Are other family members also struggling with weight issues or more recent weight gain because of family lifestyle and eating habits?
Sometimes, in examining these questions honestly, we can identify risk factors or changes in our lifestyle that may be contributing to our child’s weight gain.
Fats for Toddlers
Toddlers should not be restricted in their fat intake. There brain is laying down lots of new neuronal cells that need fat. See Essential Fatty Acids for more information on this concept. It does not mean allowing unlimited high-fat, high-sugar foods. Here are some guidelines for toddlers:
- Make sure you are offering whole milk, not two percent, one percent or non-fat until after two years of age. Toddlers need the extra fat for brain development. They may receive more than 40 percent of their daily calories as fat.
- This does not mean allowing unlimited fat and butter.
- Once children have reached two years of age, decrease milk to one percent or two percent. If you feel your toddler is overweight, talk to your pediatrician to see if this is really the case. Many toddlers appear chubby, but are proportional on the growth curves. If your toddler is on the heavy side, you may want to use one percent milk.
- The American Society for Nutritional Sciences and the American Society for Clinical Nutrition are looking to give children their own dietary guidelines. Rather than insisting that children consume a low fat diet (less than 30 percent of calories derived from fat) after age two, the 1995 Dietary Guidelines Advisory Committee recommended that there be a gradual change in dietary fat intake between the ages of two and five towards the heart-healthy diet.
Practical Tips of Controlling Weight Issues
Remember, that prevention is the key. If your child is at risk according to BMI calculations and over two years of age, you can start to take some simple steps to intervene. Being overly concerned about a child’s weight may lead to the development of eating disorders. If your child is slightly chubby and worried about their weight, try to make him feel comfortable about his image. Even if he is markedly overweight, let him know he is still special!
Having family members accuse a child of being fat is destructive to the his self-esteem. The key with overweight children is, not making them go on a diet or go hungry, but by offering them healthy food choices, cutting out high fat snacks, and encouraging exercise. Nagging, criticizing, and pressuring them is not the way to handle the overweight child.
It also has to be a family-oriented issue and not just directed at the overweight child. Most often, it is about the family lifestyle or eating habits. If dad is allowed to eat candy and sweets in front of the child and the child is told, “No,” resentment and battles will most likely follow. The most successful weight-loss programs for children are those that are also directed to an overweight parent losing weight, also.
Children have the advantage over adults in that they are still gaining height. Usually, the goal is not necessarily weight loss, but a slow up in the rate of gain. This is often enough to create a thinning effect as they age.
Here are some practical tips for controlling weight problems and overeating in children:
- Prevention is the key. Following growth throughout childhood can identify children at risk. If children are overweight before adolescence, the goal is to try to maintain the same weight. This way, as children gain in height, they will thin out.
- Have the whole family model healthy eating patterns. If the child is discouraged from certain food choices, but other family members are allowed those choices, the child will feel singled out as having a problem. Make healthy eating a family choice.
- Add a family physical activity, like walking or biking.
- Don’t calorie-restrict children. Don’t take the message of dieting or low fat or no fat eating to the extreme. Don’t obsess with your child over every fat gram and sugar calorie. The goal is to make better choices, but still fulfill a normal eating pattern.
- Decrease fat intake. With many lower fat choices of foods available, this is getting easier. However, don’t be fooled. Even low fat foods in excess quantities can lead to weight gain, and some low fat foods are high in sugar.
- Don’t forbid junk food and the less healthy foods, just use them less often.
- Limit fast foods.
- Cook at home with low fat cooking techniques.
- Share meals when eating out. Pick healthier choices off the adult menu, rather than limiting their choices to the Kids Menu.
- Use more grains, soy (like tofu), and beans instead of meats.
- Use a snack plan. See Get Kids to Eat Great and Love It!
- Make water the beverage of choice over juice and soda.
- Use one percent or non-fat milk. (REMEMBER: Children under two years of age are encouraged to drink whole milk to obtain the extra fat they need for brain development.)
- Encourage and find physical activities that the child enjoys.
- Limit television, computer, and video game time.
- Don’t allow snacking in the car, in front of the television, or while doing homework. Studies have shown that eating in front of the television is a large factor in creating weight problems.
- Do not use food to punish or reward children.
- Monitor the school lunch program and encourage more packed lunches if the school lunch is not a good example.
- Seek professional help with your pediatrician or nutritionist if you are having difficulty.
- Love and appreciate your children no matter what their size.