A calorie restricted diet is never the answer to undoing excessive weight gain in children. The risk of stunting a child’s growth in height or causing micronutrient deficiencies is much too high. Either of these negative consequences will have a long term negative impact.
That said, the reduction of empty calories is the best way to achieve a healthier weight in children and adults alike. Highly processed foods and sugar containing foods and beverages are high in energy but empty of any nutritive value. A nutrient gap is created between this high energy consumption and low nutrient intake. Children who are overweight or obese often suffer with hidden malnutrition. These children do not appear to be undernourished but due to a poor dietary intake, they suffer from micronutrient deficiencies such as iron, vitamin A or zinc.
The first step towards improving a child’s dietary intake and food related behaviour is to make an honest and critical assessment of the child’s diet and physical activity level as well as an honest and critical assessment of the family diet and physical activity level. Are there major differences? If so, why?
An energy deficit will assist with weight loss but this deficit is best created with increased physical activity rather than a radical reduction in food intake. Initiating family physical activity time is recommended together with encouraging participation in school sports.
Enhancing the nutritive value of the diet should be the next step in helping a child to reduce their weight. Starting with deprivation or calorie counting immediately puts healthy eating in a negative light. Start by adding healthy foods rather than suddenly eliminating non-nutritious foods.
In essence, the diet should become less beige and more colourful, with the increased consumption of brightly coloured vegetables and fruits. When looking at the healthy plate model, think about the proportion of vegetables and fruit to starchy foods to proteins with respect to the full day’s food consumption. If all the food eaten by the child over the course of the day were placed on a giant plate, would vegetables and fruits dominate?
If not, this is a key focus area when it comes to reducing weight in an overweight child. An increased intake of vegetables and fruits comes with an increased intake of fibre as well as micronutrients and water. This fibre acts as a natural appetite controller while stabilizing blood glucose levels. Fibre also looks after the health of the digestive system which interacts directly with the brain.
Eating as a family, with parents modelling the enjoyment of a variety of vegetables, is critical to promoting the intake of a variety of vegetables, prepared in a diverse range of methods. Encourage the child to taste the new vegetables but do not force them to eat it.
Once a good routine is established and vegetables and fruits have become a more consistent part of the diet, you may notice that the consumption of less nutritious snacks and beverages has automatically reduced. Now is the time to increase the focus on reducing highly processed meals, snacks, ingredients and sugar laden beverages.
Look back at the initial assessment of the child’s diet taking note of the regularity with which the child consumes crisps, sugar containing beverages, crumbed food products, processed protein foods, fast food meals, flavoured dairy products, sweets and chocolates.
Making simple swaps will cut the empty calories without compromising nutrient intake.
|Crumbed chicken products
Sugar coated dried fruit
Donuts / Pastries
Take away burgers
Flavoured milk or yoghurt
A bar of chocolate
Packet of jelly sweets
|Chicken strips (breasts marinated in lemon juice)
Homemade meatballs (with lentils)
Homemade popcorn (3 cups as a snack)
Homemade oven baked potato wedges (skin on)
Wholewheat crackers with peanut butter
Carrots sticks with hummus
Home made burgers
Plain milk or yoghurt, low fat (1 ½ serves per day)
Water or diluted fruit juice
2 squares of chocolate
5 jelly sweets / a marshmallow
Slowly reducing the intake of energy dense but nutrient empty foods will help the child to make the necessary lifestyle transition to maintain a healthy weight as he / she grows through adolescence into adulthood.
The most important thing to note is that this needs to be a family effort and that no changes should be expected of the child that the parents themselves are not willing to do.