HOW DO I KNOW IF MY CHILD IS OVERWEIGHT?

DISCLAIMER: Speak to a healthcare professional to ensure that the guidelines mentioned below are applicable to your child and if applicable, to assist with further management.

The topic of childhood obesity is very sensitive. No child should ever be judged by the size of their body as every child is beautiful in their own way. The problem at hand is that the childhood obesity statistics in South African are increasing at an alarming rate. One out of four girls and one out of five boys between the age of two and fourteen years old are overweight or obese1. Identifying overweight and obese children at an early stage and early intervention can have a profound impact on preventing long term health consequences.

WHAT MEASUREMENTS CAN YOU DO?

There are many methods that can be used. Keep in mind that there are numerous variables that must be considered with each method. For the purposes of this article we will look at children from the age of five to nineteen years old. 

The first measurement is Body Mass Index (BMI) for age. Your child’s growth chart found in their road to health booklet or growth book is an excellent indicator for red flags. Remember that these charts are gender specific and age specific so make sure these measurements are plotted on the correct chart. To do this you will need to:

• Step 1: Use a scale to measure your child’s weight. If you find it difficult to get your child to stand on the scale long enough then carry your child and stand on the scale. You can then measure your own weight and subtract this from the weight of you and your child to get your child’s weight.
• Step 2: Use a height chart to measure your child’s height. 
• Step 3: Take the value of their weight in kilograms and divide this by their height in metres squared (if they are 0.6m tall squared means 0.6 multiplied by 0.6) to calculate their BMI.
• Step 4: Plot their BMI value on the gender specific chart according to their age.
• Step 5: Interpret the result. If your child’s BMI is above the +1SD line it is indication that they are overweight. If your child’s BMI is above the +3SD line it is an indication that they are obese.

Depending on the age of your child, their BMI for age can be combined with other measurements done by a healthcare professional in order to classify your child as overweight or obese. These include:

• Waist circumference by measuring the circumference at their natural waist, between the lowest rib and the top of their hip bone.
• Body fat percentage which is done using skinfold calipers or doing a bioelectrical impedance test using a special scale. 

WHAT TO DO IF YOUR CHILD IS OVERWEIGHT

The guide below includes a few key ways to manage help manage your child:

• Visit your general practitioner

Your general practitioner will run a few routine tests. This will assist in identifying if there are any contributing factors to explain your child’s weight gain as well as identify any possible nutritional deficiencies.

• Make dietary changes

Google does not always have the answers and information can sometimes be misleading. There is also more to it than cutting out sugary drinks and watching portion sizes. So, once you have the results from your general practitioner visit a registered dietician with your child. A dietician will analyse the test results and assist you with your child’s eating by providing you with a personalized nutrition plan tailored to meet your child’s nutritional needs and consider your child’s likes, dislikes and day-to-day routine. Remember that the suggested changes should be applicable to the whole family and the child should not be singled out when it comes to meal times. The whole family should make the necessary changes and follow a healthy, balanced diet. Children also look up to their parents as role models so your support in terms of the food provided and setting an example when it comes to healthy eating is of utmost importance.

• Limit screen time and encourage physical activity

Does your child sit glued to some sort of screen for hours on end? This largely limits the time that your child spends engaging in physical activity. In addition to this, studies reveal that children who watch high levels of TV are less likely to ‘engage actively in other intellectually stimulating activities, to have mostly ‘A’ or ‘B’ grades and to do well on math achievement tests2 ‘. Watching excessive amounts of TV at a young age (one to three years old) is associated with a decreased attention span later in life as well as sleep problems. Studies show that adolescents who watch three or more hours of TV per day have a higher risk of sleep problems in their early twenties2. Research also shows that the less sleep children have, the greater their risk for obesity3. 

Whether it’s a phone, tablet, gaming device or TV, limit your child’s screen time. Encourage them to participate in after school sports. Plan weekend outings that involve the whole family enjoying some sort of physical activity such as going for a run together or playing a sport. In addition to the health benefits, it’s a great time for the family to bond. 

Childhood obesity has a huge impact on the quality of life of the affected individual. The best thing you can do for your child and their future is to set a good example for them, encourage them to follow a healthy balanced diet and lifestyle from the early years of childhood and seek professional help if they are at risk or obese.

REFERENCES

1. http://www.health.gov.za/index.php/gf-tb-program/323-world-obesity-day-2016Text
2. https://www.childtrends.org/indicators/watching-television 

https://www.nhs.uk/live-well/healthy-weight/overweight-children-advice-for-parents/

Author: Sonal Ratan RD (SA)