How fat is your child?
It’s getting harder to tell, as the latest research from obesity experts shows. Simon Crompton reports
“What do you mean my child’s fat?” When you have always regarded your child as simply cuddly, little different from most of his or her peers at school, it’s a bolt from the blue to be confronted with the fact that they’re overweight. But that’s what may soon be happening to many of us – and not just those who frequent fast food outlets – as a new scheme to routinely weigh and measure schoolchildren rolls into its third year.
Over the next few weeks, local health bodies will start contacting schools to make arrangements to weigh and measure every child in reception class (age 4 to 5) and Year 6 (age 10-11), categorising each as normal, overweight or obese. Currently, data about individual children’s weight is available to parents only on request, but the Government is considering making it routine for parents to be informed if their child is overweight or obese.
Researchers at University College London (UCL) are already working with the Department of Health to see what happens when the results of the school weighings are fed back to parents. A pilot scheme with six London schools has just finished. “When we told some parents that their child was overweight they were shocked,” says Helen Croker, the research dietitian at UCL, who led the research. “Deep down some suspected that their children were, but because so many children are now overweight, it’s harder to tell. It’s no longer the case that the overweight ones stand out from the others.”
Many of us have overweight children and don’t realise it, and experts are increasingly emphatic that it is wrong to believe that obesity is just a problem among certain social classes. The reason is that the nation’s idea of what is a “normal” weight has now become totally skewed. Recent UCL research found that among 500 children in nursery and reception classes in the outer London area, only 6 per cent of parents with overweight or obese children described their child as overweight.
The same applies in older age groups. A GfK/ NOP survey of 1,000 parents, with children aged 4 to 7, found that only 14 per cent of parents with an obese child considered their child overweight. It’s a problem because there is evidence that tubby kids will become overweight adults, having to deal with diabetes and heart disease.
It’s not that parents are stupid or deluded, it’s just that everyone looks around them to see what is normal. If everyone else looks the same and does the same, then it can’t be that bad, can it? According to the obesity expert Dr Susan Jebb, this applies to eating and exercise, too. In a previously unpublicised report for the Department of Health, published in March, she says that many parents are not embracing healthy lifestyles because everyone else isn’t. “Studies indicate that people are very sensitive to social norms for food consumption and use these to judge what they should be eating,” she says.
She fears these parental misconceptions of what is normal will result in obesity. With food abundant and cheap, and society placing a high value on cars, sedentary occupations and labour-saving devices, the default condition for mankind is obesity. If you want to avoid it, you need to do something to prevent it.
There is another difficulty. “Overweight” and “obese” are notoriously difficult to define because children are growing and their weight fluctuates. It’s only this year that reference curves have become available in the UK by which health professionals can chart whether a child’s weight is “normal”. And all the means of identifying obesity – measuring waist, fat fold, body mass index – have their weaknesses.
“If you don’t believe that obesity affects your child, the inclination is to turn your ears off to the messages about obesity and children,” says Dr Jebb, the head of nutrition and health research at MRC Human Nutrition Research, in Cambridge. “Even if we’re a normal weight, the nature of the world we live in means that most of us are at risk of gaining weight and we need to take active steps to avoid that.”
Parents, she says, should limit TV viewing, encourage kids to go to the park, limit their intake of crisps, sweets, chocolate and soft drinks, and promote fruit and vegetable consumption.
The secret, says Croker, is making parents aware, without stigmatising them and their overweight child. The first year of the Government’s school-weighing programme was far from a success. Only half of the eligible children were weighed, largely because parents opted out of the scheme. It seems to have been the parents of larger children who refused to take part, and the reason, according to Croker, may be that they saw it as possibly casting them in a bad light.
She believes that the way forward may be to make fat a future issue. If all parents understand that everyone, whatever their age and weight, is likely to become overweight unless healthy eating and exercise become a priority, it won’t seem so dreadful to be regularly consulting BMI guides to see how your child is shaping up (see box). “A blame culture doesn’t help,” she says. “There isn’t a family in the country that’s perfect.”
Weighing up the evidence
It is more difficult to gauge whether a child is overweight or obese than an adult because they are growing anyway, and do so at different rates.
The fit of a child’s clothes is a rough measure. If clothes for their age are right for their height but too tight round the waist, they could be overweight.
You can track your child’s weight using an online body mass index (BMI) calculator which is one of the more reliable ways to judge your child's weight. Try the one from the Weight Concern website at
http://www.weightconcern.org.uk/ by entering your child's age, sex, weight and height, and clicking on "calculate", you can get an indication of whether your child is normal, overweight, or very overweight.
The words obese and overweight have specific definitions according to specific BMIs for adults, but not for children. Generally, they describe the accumulation of sufficient body fat to potentially affect health.
Another way of judging whether your child is overweight is using centile BMI charts for children, similar to those used to check whether a child’s growth is in the normal range. These are not yet widely available but your GP or health visitor should be able to show you them. They show what a healthy BMI would be for a child of a particular age and sex.
RECOMMENDED DAILY BREAKDOWN OF FOOD GROUPS FOR OVER FIVES
33% fruit and veg
33% carbs: breads, cereals, potatoes, rice
12% protein: meat, fish, alternatives (eg. beans)
7% fats and sugars
15% dairy products
DAILY NEEDS
Exercise
At least one hour of moderate intensity exercise (eg swimming, cycling) every day.
Energy
Boys aged 4-6 1,715 calories
Girls aged 4-6 1,545 calories
Boys aged 7-10 1,970 calories
Girls aged 7-10 1,740 calories
How fat is your child? - Times Online