Advising your clients on childhood obesity
by Susie Burrell
Childhood obesity is a significant and increasing problem in Australia. Recent data indicates that at least one in four Australian children is overweight, meaning that every one of us will know a child with a weight problem. Fitness professionals are in a powerful position to help in the management of childhood obesity, both directly through programs that target children’s health and fitness, and indirectly via the education of parents and carers who use fitness services. Fitness professionals need a clear understanding of proven, effective strategies for managing weight problems in children in order to effectively communicate these with clients.
The increasing rate of childhood obesity is the result of two simple factors: the significant reduction in physical activity children participate in on a daily basis and the increasing caloric content of the food they eat. A number of key intervention points have the potential to positively impact on a child’s long term weight status.
Emphasise the need to eat breakfast
A number of studies have now shown that children who do not eat breakfast have lower levels of concentration, eat higher calorie food and are more likely to be overweight than children who eat breakfast. Breakfast is the most important meal of the day as it kick starts metabolism, provides a number of key vitamins, minerals and fibre, and prevents kids snacking on high calorie foods during the day. The best breakfast choices combine wholegrain carbohydrates with lean protein for slow, sustained energy release. Encourage the eating of nutritionally balanced options such as wholegrain toast with an egg or reduced fat cheese, wholegrain cereal and low fat milk or fruit and low fat yoghurt.
Recommend reduced fat dairy foods
The National Dietary Guidelines for Children and Adolescents recommend that all children over the age of two in Australia consume reduced fat dairy foods. In most cases, reduced fat milks and yoghurts actually contain more calcium than the full cream variety so it is perfectly safe for children, particularly overweight children, to consume ‘light’ milk, yoghurt and cheese.
Cut fruit juice, soft drinks, cordial and sports drinks
Fruit juice, even varieties which contain one hundred per cent fruit juice, soft drinks and cordials are all concentrated forms of carbohydrate with few other nutritional benefits – a can of soft drink can contain up to nine teaspoons of sugar. Cutting out all forms of sweetened beverages is a key step in weight management for children.
Water and reduced fat milks should be the day to day drink choices for children. Sports drinks are specially formulated sports foods and should only be given to children in specific circumstances, preferably on the recommendation of a qualified sports dietitian. Children participating in recreational activities do not require sports drinks for energy.
Watch the snack choices
Muesli bars, fruit sticks, cheese dips and snack bars are all heavily marketed to children for inclusion in school lunchboxes, but are usually calorie-high, energy-dense snacks with few nutritional benefits. Many of these snack foods also have a high glycaemic index, meaning they are digested quickly and don’t keep children full for long. The best snack choices for children contain a mix of low glycaemic index carbohydrates and protein for slow, sustained energy release. Good choices include crackers and cheese, flavoured reduced fat milks and dairy snacks, nut based muesli bars, yoghurts and low fat ice creams.
Limit screen time
Reducing the amount of time kids spend sitting down watching television and DVDs, playing computer games and using the internet is a vital step for effective weight management. It is recommended that children spend no more than two hours each day engaged in these sedentary pursuits. An active child will always burn more calories than one sitting zombie-like in front of the box.
Aim for at least an hour of activity a day Children need to participate in at least an hour of physical activity such as running, team sports, swimming, or active playing every single day. It is important to remind parents that this amount of activity does not define an active child; it is simply what all children should be doing on a day to day basis for optimal health and weight control.
Add in the incidentals
Increasing the amount of day-to-day activity in a child’s life is another important step in weight control. Suggest parents park the car further away from the shops, and encourage children to walk at least some of the way to school. Encourage children’s use of stairs instead of lifts, participation in household chores and playing with the family pet on a daily basis to significantly increase caloric output.
When working with overweight and obese children, remember that their condition is a sensitive issue for both them and their parents. While fitness professionals are in a powerful position to influence parents’ behaviour in relation to physical activity and food intake, any specific recommendations or assessment of a child’s weight status should be done by the family’s general practitioner, paediatrician or dietitian who is qualified to manage childhood weight problems and then able to refer on to the appropriate health care professional for any specific issues that may arise.
Susie Burrell BNutr & Diet (Hons), BSc (psych) (Hons)
Susie is a sports and paediatric dietitian who specialises in fat loss, childhood obesity and sports nutrition. Susie is the obesity dietitian at The Children’s Hospital at Westmead, where she specialises in weight management for children and adolescents. Susie is also the consultant sports dietitian to a number of elite sporting teams including the St George Illawarra Dragons, Parramatta Eels, Illawarra Hawks Basketball, Sydney University Sport, and Randwick Rugby Club. For more information visit www.susieburrell.com.au
NETWORK MAGAZINE • SPRING 2006 • PP22-23