Helping families find their way to a healthier lifestyle
A healthy lifestyle is essential in childhood to support growth and development and allow children to carry out their day-to-day activities. Diet and physical activity are the two main components of a healthy lifestyle. Balance is key; energy or calories taken in from food and drink must be enough to meet needs but not excessive. If more energy is taken in than is needed, it is converted to fat to be stored on the body for future use when food is scarce. In our modern world, and especially in wealthy countries like the UK, there is rarely a shortage of food. Foods that are high in energy (energy-dense) are readily available, but we need to ensure that children eat a balanced diet that provides the right amount of energy and essential nutrients (carbs, protein, fat, vitamins and minerals).
The UK National Diet and Nutrition Survey show that children are eating too many foods that are high in fat, salt, and sugar (HFSS) and not enough fruit and vegetables. As a result, more children than ever before are starting school carrying excess weight. Once gained, excess weight is hard to shift and is often carried through childhood and into adult life. So how can we help turn the tide on this modern problem and ensure our children grow at a healthy rate without gaining excess weight?
An ounce of prevention is worth a pound of cure as the saying goes. When it comes to excess weight gain this is very true. The costs of carrying excess weight can be high in terms of health. Having overweight or obesity as an adult is linked to an increased risk of serious diseases including those affecting the heart and blood vessels (cardiovascular disease) and some cancers. Children who have overweight have higher levels of risk factors for cardiovascular disease even at a very young age. They may also suffer more from certain diseases including asthma and sleep apnoea (irregular breathing at night) and are more likely to be bullied.
The best way of preventing excess weight gain is to help children find a healthy growth pathway right from the start. Human milk is the ideal source of nutrition for infants and provides the best start in life. In general, infants who are breastfed have a slower growth pattern than those fed infant formulas. It is thought that this is because human milk has the best balance of nutrients to support healthy growth. Not all parents are able to breastfeed their babies though and formula feeding can also support healthy growth provided it is done responsively. Responsive feeding happens when the parent responds in the right way to a baby’s hunger signals. It is important not to override signals of fullness (satiety) in a baby to prevent overfeeding. Starting life on a healthy growth path can help protect against excess weight gain and lower the risk of having overweight in later childhood.
Weaning is a term used to describe the gradual introduction of foods to the infant sole milk diet. The definition varies from culture to culture. In an ideal world, most infants would receive only breastmilk for the first 6 months but in reality, many receive infant formula during this time, either alone or as a ‘top up’ to breastmilk. Early weaning (before 4 months of age) has been linked to a higher risk of being overweight in later childhood. Evidence is not strong, but parents are advised not to introduce solid foods early to avoid this risk. Weaning is an important milestone in an infant’s life and is needed because breastfeeding alone is not able to support growth from around 6 months of age onwards. This period is an opportunity to introduce infants to a wide range of foods from all the main groups to encourage a diverse diet that is balanced in energy and nutrients.
During the second year of life, toddlers progress towards a family diet. Once they are established on a healthy diet and growing at a steady rate the focus is on expanding the diet to include foods from all the main groups. Energy providing foods, carbs, fats and proteins, should be offered in portion sizes suitable for a child’s age and size. Foods high in fat, sugar and salt should only be offered occasionally, once a week is enough. Try to encourage fruit as a healthy snack, plain biscuits and cakes with not too much added sugar or savoury options.
The best way to ensure your child has a healthy diet is to give unprocessed foods as much as possible. In the real world, many parents need to include convenience foods in their children’s diets. This is perfectly acceptable provided the whole diet is kept within guidelines for calories, fat, salt and sugar.
In summary, to reduce your child’s risk of excess weight gain, try to breastfeed, exclusively for at least 4 months and ideally up to 6 months or ensure responsive feeding if using replacement milk. Weaning is an opportunity to introduce a wide range of foods and establish a healthy diet. Include foods from all the main groups in the correct proportions. Toddlerhood is an important time when a healthy dietary pattern is established. Use unprocessed foods as much as you can, read labels to check calories and amounts of fat, salt and added sugars when using packaged foods. Throughout childhood, encourage healthy eating principles laid down in early life. Keep an eye on your child’s growth pattern. Encourage healthy dietary intake and physical activity to avoid excess weight gain and protect health.
Nutrition is a complex landscape to navigate. It is impossible to teach families everything there is to know about a healthy diet in one short article or a single clinic session. That’s why we have worked to produce a portfolio of healthy living programmes, suitable for all ages that aim to teach the principles of a healthy lifestyle and reduce the risk of overweight and obesity. Planet Munch is a healthy lifestyle programme designed for preschool children and their families. This fun interactive programme has shown success in the prevention of overweight and is well-liked by children, families and health and social care workers. More information can be found at www.trimtots.com FABFams is a healthy lifestyle programme for the whole family that accommodates all age groups. This 8-week programme is available in person or online from StepbyStepKidz Nutrition Ltd. Group packages for Planet Munch and FABFams are also available. Contact Dr Julie Lanigan, Paediatric Dietitian here: julie@rosan-paediatricdietitian.com for more information.
Useful resources are available at:
https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/ https://www.bda.uk.com/specialist-groups-and-branches/paediatric-specialist-group/patient-resources.html
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