Food 4 Life - Obesity

Obesity

Over 30,000 deaths a year are caused by obesity in England alone. A study by the National Audit Office in 2002 estimated the condition costs the NHS £500 million a year. The overall cost to the country is estimated at up to £7.4 billion a year.

People are classed as obese if they have a body mass index over 30. They are overweight if it is 25-30. Your 'body mass index' or BMI is a measure of body fat based on height and weight.

A BMI of:

• under 20 = underweight
• 20-25 = normal
• 25-30 = overweight
• 30+ = obese

However, BMI alone is not an appropriate measure for children - it has to be used alongside charts that take into account the child's rate of growth, sex and age - and is best interpreted with the help of a GP, health visitor, practice nurse or dietician.

Children have high energy requirements because they are growing. These requirements are relative to their size.  A varied and nutritious diet is essential for their development. However, like adults, if they take in more energy in the form of food than they use up, the extra energy is stored in their bodies as fat.

It is possible to measure the proportion of a child's weight that is made up of fat. Generally speaking, a child's weight is classed as obese when their body weight is more than 25% fat in boys and 32% in girls.

Adult obesity rates have almost quadrupled in the last 25 years. Now 22% of Britons are obese and three-quarters are overweight

The number of obese children has tripled in 20 years. 10% of six year olds are obese, rising to 17% of 15 year olds. On present trends half of all children in England in 2020 could be obese.

Obesity can lead to health problems, including arthritis, heart disease and diabetes.

The National Diet and Nutrition Survey (2000) found that 40-69% of children over the age of six spend less than the recommended minimum of one hour a day doing moderate intensity physical activity.

Children are more likely to be overweight if their parents are obese. But genetic factors are thought to be less significant than the fact that families tend to share eating and activity habits.

Most children put on excess weight because their lifestyles include an unhealthy diet and a lack of physical activity. Very few children become overweight because of an underlying medical problem.

It is increasingly easier for children to become overweight. High- calorie foods, such as fast food and confectionery, are readily available, relatively cheap and extensively advertised aimed specifically at children.

Exercise is no longer a regular part of everyone's day - some children never walk or cycle to school, or play any kind of sport.  It is also common for children to spend hours in front of a television or computer.

Health problems

Obese children may develop conditions that cause problems later in life, such as high blood pressure.

They may also suffer from 'sleep apnoea'. When this happens, soft tissue in the throat blocks the airways during sleep. This can stop their breathing for up to a minute. This process can happen hundreds of times a night, leading to cardiovascular disease, memory problems, headaches and fatigue.

Children who are overweight tend to grow up into adults who are overweight. They therefore have a higher risk of developing serious health problems in later life, including heart attack and stroke, type 2 diabetes, bowel cancer, and high blood pressure. The risk of health problems increases the more overweight a person becomes.

Being overweight as a child can also cause psychological distress. Teasing about their appearance affects children's confidence and self-esteem and can lead to isolation and depression.

Maintaining a healthy weight

Expert advice is that most children who are overweight should not be encouraged to actually lose weight. Instead they are encouraged to maintain their weight, so they gradually "grow into it" as they get taller.

Children should never be put on a weight-loss diet without medical advice as this can affect their growth. Unsupervised dieting especially amongst teenage girls, is thought to lead to the development of eating disorders.  Drug treatments have not been proven effective in the treatment of weight problems in children. Instead helping children to achieve and maintain a healthy weight involves three areas:

• eating a healthy, well-balanced diet
• making changes to eating habits
• increasing physical activity

However, the evidence shows that it is much easier to change a child's eating and exercise habits than it is to alter an adult's.

A healthy well-balanced diet

The following tips are for parents who are concerned about their children's health and body weight.

• Starchy foods, which are rich in "complex carbohydrates", are bulky relative to the amount of calories they contain. This makes them filling and nutritious. Sources such as bread, potatoes, pasta, rice and chapatti should provide half the energy in a child's diet.
• Replace high-fat foods like chocolate, biscuits, cakes and crisps, with healthier alternatives such as fresh fruit, crusty bread or crackers.
• Try to grill or bake foods instead of frying.
• Substitute sugary fizzy drinks with fresh juices diluted with water or sugar-free alternatives.
• Encourage a healthy breakfast of a low-sugar cereal (eg wholemeal wheat biscuits) with milk, plus a piece of fruit.
• Dried fruit or tinned fruit in natural juice could be eaten instead of sweets. Frozen yoghurt is an alternative to ice cream.
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Changes to eating habits
Parents should:

• Try to set a good example with their own eating habits.
• Provide meals and snacks at regular times to prevent "grazing" throughout the day.
• Not allow their children to eat while watching TV or doing homework.
• Make mealtimes an occasion by eating as a family group as often as possible.
• Encourage children to eat when they are hungry rather than out of habit.
• Teach children to chew food more slowly as they will feel fuller more quickly and be less likely to overeat at mealtimes.
• Not keep lots of high-fat, high-sugar snack foods in the house.
• Not make outings for fast foods part of the weekly routine.
• Try to get children involved in preparing food as this will make them more aware of what they are eating.
• When children who need to improve their eating habits are old enough, it may help to encourage them to keep a food diary, recording what and when they eat in order to establish the problem areas in their daily diets.

Exercise

Doctors recommend a gradual increase in physical activity, such as brisk walking, to at least an hour a day. Children could:

• Walk to places such as school and the shops, rather than always going by car.
• Go to the park with a football, or for a game of rounders, cricket or frisbee.
• Visit a local leisure centre to investigate sports and team activities to become apart of.
• Enjoy special trips to an adventure play park, an ice skating rink, swimming or bike rides involving the whole family.
• Reducing sedentary hobbies.  'Sedentary hobbies' include pastimes such as watching TV or playing computer games where the child is sitting stationary. These should be reduced to no more than two hours a day or an average of 14 hours a week.

The emotional factors

Food can take on emotional significance when used to comfort or reward children. Therefore food should not be used to comfort a child. Attention, listening and hugs should be given instead. Instead of having a fast-food meal to celebrate a good school report, for example, buy a gift, go to the cinema, or have a friend to stay overnight.