Rosalee Brown - DIETITIAN'S DESK

My child is too fat

Dear Ms Brown,

I have to write as I am having a difficulty and do hope someone can help me to control my little girl's weight. She is five years old and is overweight. At present, she eats junk like biscuits and noodles and she drinks a lot of juice and water. She eats little fruits and vegetables. Please give some advice.

Dear Reader,

Mom, let me congratulate you on being vigilant. Overweight in children can lead to overweight in the adolescent and adult years. These children, when overweight, are faced with many health challenges including that of low self-esteem. The risk for many of the adult diseases is increased and children are now being diagnosed with type two diabetes, high blood pressure and high cholesterol, problems which would formerly only be seen in adults.

Even when children are overweight, that is, they are more than the weight for the general population at their specific age, drastic weight reduction is not recommended.

Change the family's diet

The challenge faced by a child is that of continuous growth and development. They need adequate energy and a correct mix of nutrients from a wide variety of foods to ensure growth and development. If this is affected in any way, so will their growth and development. A trained medical person such as a paediatrician along with a dietitian or nutritionist should guide the necessary changes in food intake to ensure a reduction in the rate of fat increase in the child while ensuring preservation of nutritional status and proper growth and development.

The best way to help your five-year-old is to make changes in the entire family, so that whatever is required of her is the normal requirement for all other family members. You mentioned that she consumes a lot of junk and juices. As the name suggests, junk has no place in a child's or adult's meal plan. So mom, you need to overhaul the meals at home.

Healthier choices

Replace junk, which I assume are the snack foods, with healthier choices such as fruits, small healthy sandwiches, crackers, etc. A snack should be a smaller version of a wholesome meal. Children have smaller stomach capacities than adults, but they do have healthy appetites and a great need for energy to support their growth. They should be provided with many small, healthy meals throughout the day.

For example, an adult with a larger stomach capacity can eat less often, but children have an even greater need but cannot consume all the food at once, so their daily requirements should be divided into as many small meals as it will take for them to consume their nutritional requirements. So, you see, a snack is not extra but part of the total requirement and it cannot be junk.

Example of afive-year-old meal plan

Breakfast: Cereal porridge (oats, cornmeal or wheat) with milk or soy

Snack: Orange halves or segments

Lunch: Pumpkin soup with meat and dumplings

Snack: Crackers with peanut butter four ounces of juice after completion of crackers

Dinner: Stewed peas and rice

Snack: Carrot-beet drink with milk or soy.

Child-friendly activities

Children should be allowed to guide their food intake in volumes. If foods are not high in sugars and fats, and taken from all the food groups in adequate proportions, children usually stop eating when they are full and you should see a reduction in the rate of fat increase.

Ensure daily play of an accumulated total of about two hours from a variety of fun, child-friendly activities. Remember all changes should be family centred. Seek help from your paediatrician and dietitian for an individual consultation.

Rosalee M. Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@gleanerjm.com.