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Family Health Magazine - CHILDHOOD

Not Just Baby Fat
The risks of childhood obesity

Children love the simple joy of jumping, climbing, running and chasing. These activities are more than just plain fun – they help keep kids healthy. All children need at least one hour of moderate activity each day (such as playing outside or biking). Unfortunately, today’s children often do not get enough physical activity. They also tend to eat more processed and high-energy food than in the past. Combining less physical activity with more unhealthy food choices means that more children are overweight or obese more than ever before.

Unfortunately, today’s children often do not get enough physical activity. They also tend to eat more processed and high-energy food than in the past. Combining less physical activity with more unhealthy food choices means that more children are overweight or obese more than ever before.

What’s the problem with a little extra weight?

Children who are overweight have a body mass index (BMI) that is more than 85 per cent compared to most children their own age and gender. Children are considered obese if their BMI is more than 95 per cent compared to children their own age and gender. The BMI is measured using a child’s height and weight. Often this is done at least once each year in the doctor’s office.

Even as kids, overweight or obese children can have serious health problems. Medical problems arising from childhood obesity include high blood pressure, sleep apnea, fatty liver, and joint pain. Overweight or obese children are also in danger of becoming overweight or obese adults. Obese adults are at risk for diabetes, heart disease and other hard-to-treat chronic illnesses. There are no easy ways to manage these diseases.

Often, the more urgent issue for obese children is social reaction to the extra weight. Unfortunately, the discrimination and abuse that overweight adults experience starts in childhood. We all know how unkind children can be to kids who are overweight. An obese child is often ridiculed and left out. Being teased and bullied can result in poor self-esteem and body image, depression and anxiety. Teens who are obese are more likely to be depressed as adults. The psychological pain of obesity can cause frustration, sadness and actually lead to more overeating.

It can be hard for parents to accept that their child is too heavy. They do not want to face how their decisions about the child’s food and activity may lead to bullying and poor health. Accepting that your child needs help with weight may also mean accepting that you do too.

Why are more children overweight now?

How do children and families reach that point in the first place? Understanding how children become overweight or obese is sometimes thought of as a simple math problem. On one side of the equation is energy that a child consumes (food and beverage calories), and on the other side is the energy that a child uses (physical activity).

However, this simple equation does not have a simple answer. North American families eat more prepared and calorie-dense food at home or in restaurants than they did 20 years ago. Portion sizes are much bigger. (See Portion Distortion below.) People of all ages commonly drink more beverages loaded with sugar, like soda and fruit juice. Screen time in front of the television, tablets, computers and gaming consoles has pushed aside active play. Schools have less structured physical activity. The media presents confusing information about how to live and eat more healthily.

What can I do to help my child?

Parents can support their families in eating well, being active and avoiding the health dangers of being overweight or obese. Take a good look at your family’s eating patterns. This would include the following.

• Where do the children eat?
• When do they eat?
• What types of food are eaten?
• What is the amount of food eaten?
• How often are snacks offered?
• What kind of snacks are eaten?

Any food choices in the house are the responsibility of the adults who buy the groceries. Taking a pass on a sugary treat may cause some short-term conflict at home. However, if it is not in the house, it cannot be eaten!

Busy families often grab food on the go. These food choices are convenient, but usually high in calories and low in nutrition. Fast food, drive-through coffee and doughnut shops and convenience stores do not offer many healthy choices for growing children.

It may seem like healthier fresh food is more expensive than quick, processed food. However, this does not have to be the case. Frozen and canned vegetables are an inexpensive source of good nutrition. Looking for sales in flyers or online can greatly cut the cost of fresh fruit. Consider buying in larger quantities and dividing food with another family. For those lucky enough to live near farms or in agricultural areas, u-pick businesses tend to be very reasonably priced. You also increase your family’s activity by picking the produce!

Cheap convenience foods tend to come in larger portions than what a child of three, eight or even 15 needs. Canada’s Food Guide is a good resource that shows the type and amount of food growing children need. Remember, children need five or more servings of fruits and vegetables each day.

Keep in mind – not all calories are equal. ‘Empty’ calories from sugary drinks, including juices, are a major source of extra calories with little benefit. For instance, one cup of low fat milk contains about the same amount of calories as one cup of Coke. However, Coke has no nutritional value compared to the calcium, vitamins, and protein milk offers.

Sugar content of common beverages
Beverage	Grams of sugar	Calories	Teaspoons of sugar
Coca-Cola®, 590 mL bottle	65	240	15
Rockstar® Energy Drink, 480 mL can	62	248	14
Vitamin Water®, Jackfruit-Guava, 591 mL bottle	33	125	8
Snapple® Lemon Iced Tea, 16 oz. bottle	46	200	11
Minute Maid® Orange Juice, 16 oz. bottle	48	220	11
Minute Maid® Apple Juice, 16 oz. bottle	52	240	12
Nesquik® Chocolate Milk, 16 oz. bottle	58	400	14

How many liquid calories does a child drink? Many parents underestimate the amount of useless calories in juice or another sugary drink. Drinking a glass of juice at breakfast, on the go, or with meals provides almost no nutrition but adds many calories to a child’s day. It is far better to replace the apple juice with an actual apple and a glass of water.

High-calorie energy drinks are now being marketed to teens. While these drinks have no nutritional value, they often contain large amounts of caffeine and salt. Substituting water and low-fat milk will lower the number of unnecessary calories, while improving health and nutrition.

Activity makes a difference

Next, consider how your child spends the day. How many hours are spent in front of a screen? How many doing physical activity? Does your child walk or ride a bike to school? Are other members of the family active on a daily basis? Parents can be excellent role models and champions for healthy living. There are many ways to increase a child’s activity level without the expense and commitment of organized sports. Telling children to simply go outside and play for an hour is a good starting point. Better yet, join your child at the playground or in the backyard. Set up an obstacle course, play hopscotch, throw a ball, or make up a game. As a family, take a 15 to 20 minute walk around the neighbourhood after dinner. Sledding or building a snow fort can be fun in the winter. Include children in common household tasks like raking leaves, gardening, walking the dog, and washing the car. Consider having your child walk or ride a bike to school.

Certain medical problems can contribute to being overweight or obese, although they are not common. They are more likely if weight gain appeared over a short period of time. Doctors can usually rule out these problems with lab tests. A complete physical exam can also help decide whether excess weight comes from lack of activity and too much food, or medical illness. Doctors will also look at whether one or both parents are obese. Having an obese parent makes a child more likely to be obese as an adult. If one or more parents are obese, the doctor will ask about any obesity-related diseases like diabetes, heart disease, high blood pressure or liver disease. The response will guide suggestions for long-term change.

The bottom line is that all parents want their children to be healthy and happy. Some people gain weight more easily than others. Their genetic makeup means they must work harder to maintain a healthy weight. With this in mind, families and health care providers can work together for the immediate and long-term health of children.

If your child is overweight or obese, focus on changes in behaviour that will help in growing into a healthy weight. One way to is for your child and family to self-monitor food and activity, and have a nutritionist, doctor or nurse check in regularly. Again, it helps to avoid buying certain kinds of food for the household like sodas, juices, potato chips, and candy. Remember, if it is not in the house, then it can’t be eaten! This is the responsibility of the person buying groceries.

Setting goals for nutrition or activity can be very useful. Goals need to be specific, attainable, and realistic. Begin with one goal at a time. For instance, your first goal might be playing at the playground for one hour after school. Another might be to replace a glass of orange juice with an orange and a glass of water. Once goals are achieved, reward them with small prizes and praise.

Families and children who are overweight or obese deserve non-judgmental health care. Speaking with a family doctor or pediatrician can help guide positive behavior changes. Most mid-sized to large communities have health care programs to help obese and overweight children. As well, websites can provide excellent information for children and families (see sidebar).

Simple changes can make a big difference to your child’s future health. Be physically active for at least one hour per day. Avoid sugary beverages. Eat five to six fruits or vegetables daily. Limit screen time to less than two hours per day. Modelling change for the children in your life can make their childhoods and futures healthier. Now get out there and get moving!

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While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [CH_FHa13]