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Healthy childhood weights
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The rate of obesity has risen among children. In Canada, obesity in children ages 7-12 years has increased by more than 50% between 1981 - 1988
(Limbert, Crawford, & McCarger, 1994). In the U.S., approximately 1 in 5 children is now overweight
(Troiano, Flegal, Kuczmarski, Campbell, Johnson, 1995). Obesity that is not related to an underlying medical condition is caused by an imbalance between energy intake and energy expenditure - whatever is eaten that is not burned off will be stored in the body, some of it as fat. The concern with children who have excess body fat is the potential contribution to their current health as well as their health as adults.
The consequences of childhood obesity include medical complications in childhood (in addition to future complications in adulthood). Some of these risks include increased heart rate and cardiac output, hypertension, sleep apnea,
hyperlipidemia, insulin resistance, and early menarche. It is also important to consider the psychological and social complications of childhood obesity, which include poor self-esteem and prejudiced reception
(Naaso, 2000).
When presented with a child who is considered obese, try exploring these issues:
- Physical activity - What kinds of physical activity does the child do? how many hours spent watching TV, playing video games, or using the internet versus hours spent doing active things such as playing outside, being on a sports team, etc
Sedentary activities like these replace time available for physical activity.
- Eating Habits - How is the child's fruit and vegetable intake? How much fruit juice do they drink? (if in excess, this could be providing unnecessary calories). What types of snack foods does the child eat - high fat, empty calorie foods?
- Family Perceptions - What is the family's perception of the child's weight? How do the parents view the child's health? Does the family have concerns about the child's weight and/or eating and physical activity?
It is important to remember that we never want to recommend going on a "diet" to children of any age, even those who are considered overweight or obese according to growth charts. Children need fat and calories to grow and develop. Recommending "diet" foods and cutting down portion sizes is not the solution to any child's or adult's health risks. Rather than recommending restrictive "diets", the best approach is to encourage children to eat at least the minimum number of servings from the four food groups as outlined in Canada's Food Guide. Excessive restriction of foods in children leads to increased snacking, often on high fat processed foods. High fat and highly processed foods should be limited and some form of physical activity should be done by the child every day.
Physicians and other health care professionals have an important role in promoting preventive measures and encouraging positive lifestyle behaviours that can contribute to healthy weights, both for adults and for children.
For more information on healthy childhood weights, or for resources that you may offer to your patients, please contact the Leeds,
Grenville, & Lanark District Health Unit's Health Action Line at 1-800-660-5853
or 613-345-5685 and ask to speak to a registered dietitian.
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