Guilt relief: how families can fight childhood obesity

Forget feeling guilty and do something: parents can help kids learn healthier habits. www.shutterstock.com/Aleksei Potov

As a dietitian and nutritionist for more than 15 years, the most common emotion I encounter in parents is guilt. And it’s little wonder - if you’re an Australian parent, you have a one-in-four chance of raising a child outside the healthy weight range.

The latest figures show that 25.1% of Australian kids aged 2-17 years are overweight or obese. The biggest “growth” in this statistic is in the obese category. That means that more children who were overweight are now obese, and those who were obese children are now more obese.

So why is this happening? It’s not that we’ve all suddenly become dodgy parents. Instead, the odds are increasingly stacked against us as parents trying to do the right thing by our kids.

Would you like fries with that?

Researchers, including the team I work with, describe the society we live in as “obesogenic”. That means that our environment makes it much easier to gain weight than stay healthy.

Unhealthy food is cheaper and more easily available than healthy food, leisure activities are increasingly about sitting in front of a screen, and our towns and cities are built more for cars than for pedestrians or cyclists.

You only have to look at the sponsorship at a sporting club sign-on day to see how directly junk food companies market to children. My 10-year-old daughter gets a McDonalds voucher with each of her swimming certificates. Those are just a few examples of many small things that add up to make it harder to keep kids within a healthy weight range.

How do I know if my child’s a healthy weight?

For children, healthy weight is defined as being below the 85th percentile for body mass index (BMI) for age. BMI for children is calculated the same way as it is for adults: weight (measured in kilograms) divided by height squared (measured in metres).

For example, let’s take a nine-year-old girl, who weighs 33kg and is 1.3m tall. The calculation is 33 divided by 1.69 (1.3 x 1.3 = 1.69). That equals 19.52. For a girl aged nine, that’s considered overweight.

For adults, there are set cut-offs for a healthy or unhealthy BMI. But for children, the bands or percentiles change according to age to account for growing bodies.

In most Australian states, those BMI charts would be in the Personal Health Record book you get when your child is born. (You can also calculate your child’s BMI based on their gender, age, height and weight here.

You probably haven’t checked up on their growth since they were a baby - but checking growth, just like checking teeth, vision, hearing etc, is good to do on a regular basis. We’re not used to thinking about weight in this way but for most health professionals, we think of it as just another health indicator that needs regular monitoring. There are tips on how to accurately measure your child here.

You are what you eat

Healthy eating and being physically active are the cornerstones of healthy weight. So the main tips for trying to keep a lid on unhealthy growth are to firstly try to keep to eating only the food serves recommended in this Australian Guide to Healthy Eating brochure. (You can read more at the federal government’s Eat for Health website.)

A sample meal plan for a 9-11 year old child. www.eatforhealth.gov.au

The right serving sizes vary by gender and age, but for primary schoolers it’s around 5 serves of vegetables, 2 serves fruit, 4 serves grains and cereals, 2½ serves of the meat group and 2½ serves of the dairy group. Try to stick to just eating this as much as you can, and your child will get all of the nutrients they need in the right amounts.

The brochure gives equivalents of what you can swap for what and still get roughly the same calorie and nutrient intake. “Discretionary foods” that are not in those main food group categories - such as cakes, biscuits, soft drinks and fast foods - are what will put on extra weight, and they’re easy to over-eat, so try to keep them to a minimum.

A recent survey showed that on average, Australian children get around 40% of their calories from those discretionary foods, which means they’re seriously missing out on food that’s better for them.

Try to make water and milk the only drinks. Drinking is a really quick way of taking in a lot of calories without feeling full and without knowing it. Low-fat milks are recommended for children over two, as they still have all the nutrients, but with less of the fat.

Aim to keep kids active for around 60 minutes a day and spend no more than two hours in front of a screen. Try to make the time you spend together active, such as swapping couch time for a pre-dinner family walk. And buy a bike for the next Christmas present instead of an Xbox.

Off the couch and into fun runs

In the late 1990s, Flinders University dietitians and researchers developed a healthy lifestyle program for families of overweight primary school aged kids, which they called PEACH (Parenting, Eating and Activity for Child Health).

Over the past 15 years, around 300 families in South Australia, New South Wales, and most recently Queensland have taken part in a PEACH program. A research trial, published in Pediatrics, found that participating in PEACH produced a relative weight loss of 10% in moderately obese children aged 5-9, which was maintained over a period of two years.

There have been some great individual success stories. For instance, the Innes family from Adelaide say they still eat healthier and lead more active lives than before they took part in the program three years ago. Last weekend, mother Fiona Innes and her son completed the 6km run/walk in a local city to bay fun run.

The program is run over a six-month period to help change behaviours of the whole family, with 10 group sessions where the parents and carers meet while their kids play, as well as three support phone calls and a handbook with tips and recipes. The idea is to give parents the skills they need to recognise the risks in our obesogenic society, and how to plan ahead to avoid them.

With funding from the Queensland and federal governments, our team from QUT is now rolling out the PEACH program across Queensland. It’s available free to Queensland families with a child 5-11 years old above a healthy weight for their age and gender, and over the next three years we hope to help 1400 children across the state.

Starting off life overweight is pretty uncomfortable as a child. But research also tells us that children who are above a healthy weight while young have a really high chance of staying that way as adults.

There are countless reasons why more of our kids are growing up overweight and obese, many of which are out of our control as parents. But as the Innes family show, the choices we make can make a crucial difference to our kids’ futures.

If you’re part of a Queensland family that wants to be part of the free program, you can register here.