Should you put your child on a diet?

Source: Web exclusive, March 2011

"What’s for dinner?" It’s a simple question. But as the number of overweight children in Canada increases, many parents are scratching their heads about how to answer it wisely. 

Concerns are justified about what kids are eating. In the past 25 years, the number of overweight and obese children in Canada has nearly tripled. Currently, around 26 percent of children within the ages of two to 17 are considered overweight or obese.

Clearly, a child carrying excess weight is a problem. But is the solution to put a child on a diet?

Absolutely not, say experts.

"At no point should a parent ever look at a child and say, we need to put you on a diet," says Tom Warshawski, a pediatrician and chair of the Childhood Obesity Foundation.

Diets rarely work for adults, he says, and they are entirely inappropriate for kids, who are still growing and therefore need to consume a varied diet that’s rich in vitamins and minerals, and that contains sufficient amounts of protein, iron, carbohydrates, fruits and vegetables, and certain fats.

Put any child’overweight or not’on a calorie-restrictive diet and you do more harm than good, explains Tracey Bridger, a pediatric endocrinologist and the medical director of the Lifestyle Program at the Janeway Children’s Health and Rehabilitation Centre in St. John’s, Nfld. “There’s research out there that shows if you just focus on weight and say, ‘Oh, you just need to eat less,’ that children actually wind up heavier,” says Bridger.

Why diets for kids don’t work

One of the reasons why diets don’t work is physiological. Low-calorie diets tend to lower metabolism, so once children resume normal eating they often gain back the weight. The other reason may be psychological. By focusing on a child’s size, parents unwittingly foster a negative self-image that may send a sensitive child to food for comfort, says Bridger.

Bridger also cautions parents not to think about the issue only in terms of food. While there’s no disputing its role as a significant contributor to the childhood obesity picture, it’s not the only factor that affects weight.

"What influences our body size is a very complicated thing," says Bridger. "We know that this paradigm of ‘calories in, calories out; energy in, energy out’ is being debunked, that it’s really not as simple as that."

In fact, many researchers believe that obesity is the result of a number of factors, including genetics, environment, and socio-economic status.

Alternatives to putting your child on a diet

A restrictive diet is an emphatic no-no for a child for any reason, but there are significant changes parents can make that will have a positive impact on a child’s health over the long-term.

The most important thing parents can do for their child is to commit the entire family to a healthy way of eating. A child doesn’t live or eat in isolation, but is part of a family culture so any modifications needed to improve a child’s eating habits need to be done with the participation of the group, says Warshawski.

The meal plan must put a premium on health rather than weight loss, per se. It should be "high in fruits and vegetables, high in fibre, very low in white foods’white rice, white bread, white potatoes’and with reasonable portion sizes for meats and fats," says Warshawski, who advises parents to consult a dietitian or Canada’s Food Guide for more detailed information.

Eating healthfully doesn’t need to exclude the occasional treat, however. Cookies aren’t prohibited for life. It’s simply a matter of knowing when enough is enough and when portion sizes are out of whack.

Over time, changes to the family diet will normalize weight without making a child feel punished or singled out. More importantly, these modifications help to establish a pattern of eating that will serve them well into adolescence and adulthood.

Simple changes you can make today

‘ Stop buying sugary drinks and reduce your child’s chances of being overweight. Several studies link consumption of sugar-sweetened beverages with increased body weight among children and adolescents (same goes for adults, by the way). Pop, energy drinks, and even some juices add up in the course of a day and offer little to no discernible health value. Warshawski advises dramatically reducing, if not completely cutting out, all sugar-sweetened drinks.

‘ Make sure your child is getting enough sleep. Poor sleeping habits can actually make kids hungry. "There’s a pretty strong link between sleep deprivation and excess weight gain in children, youth and adults," explains Warshawski. A bad night’s sleep encourages overeating, as it increases production of a hormone (grehlin) that makes us feel hungry, while decreasing production of a hormone (leptin) that makes us feel full. Children should get around nine hours of sleep a night to set them up properly for the day ahead.

‘ Gradually reduce a child’s screen time. Research suggests that the more time children spend in front of the TV or computer, the greater the likelihood of their being overweight or obese. Over the past 30 years, the amount of screen time has dramatically increased among kids, and more and more children are watching TV at even younger ages. In the 1970s, the median age kids began watching TV was four years old. Today, kids are watching TV as early as five months old, despite warnings that screen time should be zero for children under two, and limited to one hour a day for kids two to five. Both Bridger and Warshawski advise setting firm time limits for TV watching and other screen-related activities. No more than an hour or two a day, says Warshawski.

‘ Encourage active playtime. Kids don’t need formal exercise to be considered active’they just need to move their bodies for at least 60 minutes a day, says Bridger. Playing with Lego in the living room, or going to the park after school to play on the swings is more than enough, says Warshawski. “[Activity] doesn’t have to be structured, kids just need to be moving and having fun doing so. Walk to the park and back and let them run around.”

‘ Don’t forget about emotional health. A healthy diet and fun-based physical activity is part of the prescription for a healthy childhood, but so are overall happiness and a developing sense of self-worth. "Never forget about all those other things that make us feel good and well," cautions Bridger. “That includes doing things that promote self-esteem. It could be things like helping your child discover what they’re good at and encouraging them to do it.”