Healthy Living: Striding forward to reduce child obesity

Children in Sheffield taking the Walking Bus to school
Children in Sheffield taking the Walking Bus to school
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Parents told to exercise their authority to stop youngsters being overweight

IN 1990 one in ten Sheffield children were considered overweight or very overweight (obese).

Today, that figure has jumped to one in three.

The mass emergence of computer games, internet-based entertainment and the proliferation of processed, easy-to-prepare foods has resulted in a generation of kids significantly plumper than their forbearers.

Gone are the days of playing out with your mates after school, burning off the sweets you’d bought on the way home. Today computer-generated images do the running for us. Kids don’t need to kick a football, a computer-screen Ronaldo will do it for them.

But this phenomenon has taken its toll.

In as short a time as three years the number of overweight and obese children has increased from 31.7 per cent in 2006-2007 to 33.3 per cent in 2011. Doctors have warned parents that they are treating 15 year-olds with early signs of heart disease, a result of too little exercise and too much fat.

And it’s a touchy subject.

Using the term ‘obese’ when referring to children is controversial. In 2008 Whitehall health officials issued guidance to health authorities about how to refer to children’s weight between the ages of five and eleven, suggesting that obese children should be instead referred to as ‘very overweight’.

But whether we call children overweight, very overweight or obese, the fundamental health problems with carrying too much weight still persist.

Last year a US study of 16,000 children showed that the fattest children already had signs of an inflammatory marker, known as the ‘C reactive protein’, which indicates inflammation in the body and is believed to be linked with future heart disease, which is a result of inflammation of the artery walls. As many as 40 per cent of the obese children had the protein compared with 17 per cent of children with a healthy weight. The research - conducted by the University of North Carolina - showed that the CRP of 83 per cent of the obese children had increased by the time they were between 15 and 17 years old.

But more alarming is the fact that we think it’s completely normal.

The sheer number of overweight children means our perception of what a healthy, average-sized child looks like has shifted. And not for the better.

Many parents don’t recognise that their youngster has a weight problem simply because their child is the same size as all their friends and classmates.

And it’s this issue that Sheffield’s health workers are working hard to counter. Not only is the health of thousands of Sheffield children at risk - we’re not even noticing their size in the first place.

So, as part of the National Child Measurement Programme (NCMP), health specialists in Sheffield are measuring and weighing four to five year-olds and ten to eleven year-olds across the city (with the consent of their parents) to assess their size in comparison to the measurements of children of the same age group taken in 1990. The results are then sent to parents with details as to how their child’s measurements compare to those taken in 1990.

Health improvement specialist Gilly Brenner, who works for the Children and Young People’s public health team, said: “Parents don’t notice when their child is overweight because they’ve adjusted to the fact that overweight is actually normal now. It was 20 years ago since we last had a large-scale measuring project like this.

“Since then children have just got bigger and bigger.”

But while it’s tempting to blame parents, the causes of excess weight in children are beyond the family home: “Modern society makes it so difficult to have a healthy lifestyle - now it’s all about watching TV, playing on a games console or the internet. And it’s easy to get hold of food that’s high in fat and food portions are much bigger too. These habits are easy to develop. The programme is not trying to blame parents - we’re only telling them what they probably would want to know.”

There are numerous ways in which parents can prevent their children from becoming overweight. “There are lots of ways of cutting down on fat and encouraging a healthier lifestyle. Children should have 60 minutes’ exercise a day, which sounds a lot, but that can include walking to and from school and playing out with their friends - these can really burn off the calories. It also helps to have three set meals each day, rather than continual snacking.”

Even sleep can help, according to experts. “A recent study concluded that short sleep duration is associated with increased obesity in children, especially among younger age groups,” says Gilly. “And lots of schools across Sheffield are trying to promote healthy living in children as part of the Sheffield Change4Life campaign, which is part of the national scheme to promote healthy lifestyles. Many schools are encouraging children to grow their own vegetables, take part in physical activities and eat healthy lunches, with at least two of their five recommended portions of fruit and vegetables a day.”

More than half of overweight or obese children grow up to be obese adults, and as a result they are often vulnerable to conditions such as heart disease, cancer and Type 2 diabetes. If action isn’t taken to reduce a child’s weight the issue becomes much harder to tackle as they get older. “It’s like leaving your washing up,” said Gilly. “The longer you leave it - the harder it gets.”

OBESITY AT A GLANCE

OBESITY is when a person is carrying too much body fat for their height and sex. In adults this is measured as a Body Mass Index (BMI) which indicates whether a person is a healthy weight.

A BMI below 18.5 means an adult is underweight; a BMI of 18.5 to 24.9 represents a healthy weight and a BMI of more than 25 means an adult is overweight and at increased risk of heart disease or diabetes.

Other effects of obesity include problems with the joints and bones (such as bow legs), a condition known as benign intracranial hypertension, which results in headaches and affects vision, hypoventilation, gall bladder disease, polycystic ovary syndrome and high blood pressure.

HOW EXPERTS MEASURE CHILD OBESITY

BMI centile is an effective way of determining whether a child is a healthy weight and is used by health care professionals nationwide. By comparing a child’s weight with their height, age and sex, health professionals can tell whether they are growing as expected. Once a child’s BMI centile has been calculated, they will be in one of four categories:

Underweight (below second BMI centile); healthy weight (between second and 90th BMI centile); overweight (between 91st up to 97th BMI centile) and very overweight (which refer to as ‘clinically obese’, which is at or above 98th BMI centile).

BMI centile is calculated by comparing a child’s BMI with growth charts based on the measurements of thousands of four to 20 year olds taken in 1990. This chart shows most children should fall in the healthy weight range, with fewer than one in ten in the overweight or very overweight range. Currently one in three children are overweight or obese in the UK. For more information about BMI centiles, visit www.nhs.uk/tools/pages/healthyweightcalculator.aspx.