Leanne Cooper is a Sydney based registered nutritionist, mother of two and author. Heading up her own successful nutrition business, Cadence Health, Leanne is consultant nutritionist to numerous parenting organisations and magazines and a number of expert panels such as CareforKids.com.au and Huggies Baby Club feature her advice.
Leanne believes that 'getting nutrition right' early in life is the cornerstone to community health. For free childhood nutrition tip sheets for your parents and staff and other childhood nutrition resources go to Leanne's website www.sneakys.com.au.
from Cadence Health
Weight, health and the role of child care organisations
By Leanne Cooper
Whereas once it was thought that the bigger the baby the better, many parents are now asking: 'Is my baby too fat?' or 'Is my child overweight?' In most cases, it's unlikely there's anything to worry about as growth and development are still the most important indicators of a child's health.
Still, there is no denying that with figures showing around 20-25 per cent of Australian children are either overweight or obese, there is good reason for concern. The most common consequences of obesity in childhood (and adolescence) are poor body image and self-esteem. The health impacts of childhood obesity include high blood pressure and blood cholesterol, raised blood sugar levels, Type II diabetes, joint problems, sleep apnoea, asthma, and fatty liver.
This may be a good point to remind you that young children who are plump don't necessarily become overweight adults, but if they continue this trend into school age then there may be an increased likelihood.
How are children diagnosed as being overweight?
Classing a child as being overweight is a big call and something that even the professionals don't do lightly. Body mass index (BMI), is the standard measure used for assessing body weight in children and adults (although there are different charts for each). BMI is simply your weight-height ratio. For children aged two-20 years there are a set of BMI charts related to age.
The NSW Health Department website has an excellent Children and Youth BMI calculator. See also the useful links at the end of this page.
What are some of the reasons a child becomes overweight?
There are many reasons; some factors are genetic, while others are environmental, even illnesses and medications can cause a child to become overweight. Often it is not a single reason but a combination of factors. Every child is different and no two situations are the same.
Risk factors may include:
Early infant feeding
- Breastfeeding may be protective against the development of obesity.
- Infants of obese parents have more than double the chance of becoming obese adults.
- The tendency for some parents and caregivers to encourage a child to eat more than is necessary can, in some cases, lead to weight gain.
- Parenting styles and attitudes towards food restriction or permission can influence overeating.
- Most parents understand the desire to soothe a child, especially one who is unwell, by offering them a 'happy food' such as chocolate.
- Restricting food intake can cause children to ignore their own natural cues of hunger in favour of eating whenever food is offered, encouraging a pattern of overeating later in life (or as soon as food is no longer restricted).
- Children from wealthy countries but poor regions, rural areas and indigenous backgrounds seem most at risk of obesity.
- A diet that is high in fat (saturated fat) and added sugar, low in healthy carbohydrate or low in protein can alter hunger signals to the brain, potentially causing overeating. Looking carefully at the nutrient breakdown of a meal can be useful. Ensuring adequate protein-rich foods is a newly emerging factor in weight issues.
Fast fact: Does sugar turn to fat? No, not in humans. Sugar can contribute to increased body fat in a few ways. Firstly, excessive sugar encourages 'fat storage' hormones and discourages 'fat releasing' hormones. Secondly, simple sugars are the body's preferred fuel so if you eat a lot of sugar your body will use that for energy rather than its fat stores. So, excessive sugar can contribute to weight gain by reducing the use of stored fat as a fuel and encouraging fat storage.
Issues of ill-health, such as being overweight, are not just an individual or even simply a family concern, they are a community concern. The future of our community depends on the health and well-being of its young.
Currently in Australia more than 350,000 children attend some form of daycare. Children can receive a significant amount of their nourishment from sources outside the home, so the nutritional knowledge and attitudes of the staff is of great importance in the health of children attending such centres.
Research shows that some 95 per cent of centres provide nutrition information to staff and parents, for example in the form of newsletters. Staff at child care centres are regularly called upon by parents and carers for information, support and advice. It's not about diagnosing the problem; rather it is about providing support, information and direction.
Ways forward
Some ways that centres can assist staff and parents reduce the risk of children being overweight or obese
- Provide a detailed nutrition policy; about 78 per cent of centres now have a nutrition policy. Review the Dietary Guidelines for Children and Adolescents from the National Health and Medical Research Council.
- Provide regular short tips about nutrition. You are likely to find that practical information is 'eaten up', such as healthy product info, ideas for lunchboxes, reasons why apple juice isn't okay and so on.
- Provide easy access to healthy eating booklets and tip sheets for parents to grab on the way in and out of the centre. There are literally hundreds at your disposal by government agencies.
- Encourage staff training in childhood nutrition.
- Encourage regular physical activity (most effectively through leading by example, get involved and support parents in becoming active).
- Ensure a variety of foods is being offered; this is one of the best ways to achieve a balanced diet.
- Increase participation and input by parents over the food policy to encourage compliance.
- Explain how to avoid products with added sugar by checking the ingredients panel, I guarantee once you start reading panels you will be shocked!
- Provide information on how to gain a fibre-rich diet including vegetables, fruits, wholegrains, legumes and seeds. Such diets may also have additional benefits in the prevention of cardiovascular disease and Type II diabetes.
- Encourage parents to avoid junk foods such as biscuits, pastries, sausage rolls, meat pies, chips and children should not consume soft drinks (which can contain up to eight teaspoons of sugar).
- Encourage children to drink water instead of cordials, juices and flavoured milk.
- Make eating about enjoyment of food rather than healthy eating rhetoric. Early childhood experts, such as yourselves, already know about relating to children within their understanding of the world. Now we nutrition experts need to click on.
- Discourage parents from attempting to place an infant or child on a diet or restrict their dietary intake in any way. If parents are concerned, encourage them to talk to their early childhood nurse, GP or other suitably qualified healthcare professional.
The use of low-fat diets in childhood should only be carried out under strict supervision by a qualified health professional. Restricting the amount of food, total energy intake, limiting dietary fat and over-control of a child's diet can have severe impacts on physical growth and development as well as on the development of healthy eating habits and attitudes.
Physical activity has well documented benefits for health (heart, bone etc.) and development (physical, emotional and social). Children who are active develop self-confidence, social skills and have an additional outlet for emotional expression, which in turn can lead to strong self-esteem and a healthy body image. In fact, being physically active is so important that it is included on most healthy eating pyramids and in most dietary guidelines.
Keep in mind that for some children - particularly those who are overweight or obese - physical activity (let alone exercise) can be challenging, both emotionally and physically. In overweight children encourage gentle movement and be careful with activity that can place too much stress on joints, ligaments and other organs.
Simply we all need to eat good ole fashion food from nature, enjoy it more and move lots.
Child Care Nutrition Kit
On request by child care providers Leanne and the team at Cadence Health have developed a Child Care Nutrition Kit for child care centres which combines a variety of useful nutrition and diet related resources into a folder and CDRom.
For information on the kit and how to gain a copy for your centre visit www.cadencehealth.com.au
Additional Resources
Australian Canteen Association
http://www.asca.com.au/
Comprehensive list of government health agency links
http://www.betterhealth.vic.gov.au/bhcv2/bhcsite.nsf/pages/
links?open
DET physical activity information
http://www.det.wa.edu.au/education/physicalactivity/
Dietary Guidelines for Children and Adolescence (download from the site) http://www.nhmrc.gov.au/publications/index.htm
Dietitians Association of Australia
www.daa.asn.au
HealthInsite (collective of all health sheets produced by government agencies)
www.healthinsite.gov.au
NSW Health Department Multicultural Services
http://mhcs.health.nsw.gov.au/mhcs/index.html
Raising Children
http://raisingchildren.net.au/articles/packing_a_lunch_box.
html/context/217
Sneakys Nutrition Tip Sheets and Child Care Nutrition Packs http://www.sneakys.com.au
World growth charts
- http://www.cdc.gov/nchs/about/major/nhanes/
growthcharts/clinical_charts.htm - http://www.who.org and refer to WHO Child Growth Standards
- http://www.cdc.gov/growthcharts
Second Expert Report. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, 2008
World Health Organisation. The world health report 2002: Reducing risks promoting healthy life. Geneva, WHO 2002.
World Health Organisation. Diet physical activity and health - a global response (Department of NCD's) December 2002.
© 2009 - All rights reserved
Care For Kids Internet Services Pty Ltd
ABN 55 104 145 735
Level 2, 2 Bligh St Sydney NSW 2000
privacy policy contact us