Tag Archives: child nutrition

A different perspective: nutrition from a 9 year old.

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My guest blogger today is my daughter Michelle. As many other children, she has been on the receiving end of the well-meaning advice by her mother to eat her greens, then a conscientious change from white bread to wholegrain, cereal bars to school, “don’t eat that chicken skin” and many others in her 9 years. Over the last year we have managed to turn it 180 degrees and finally indulge her love of red meat, ribs, eggs and sausages. Along the way we have discovered that wheat, even in a tiny amount, triggers her eczema. This has been both a curse and a blessing. A curse because we realised that even a piece of battered salt and pepper squid can set off the dreaded red spots (funnily enough, even gluten-free products given to her by the well-meaning family members cause a breakout). A blessing because it gave Michelle extra motivation to avoid processed food.

I know I might have been a bit harsh on parents in one of my previous posts. Saying “no” to junk food has never come difficult to me. But I was little prepared for the onslaught of wheat-, sugar-, preservatives-, colours- and refined-carb industrial-strength garbage called ”kids food” and the incredible temptations faced by Michelle every day. I know that she feels different. And sometimes being different is a lonely place to be, especially coming up to your teenage years. I did not want to medicalise this into a “condition”: you can’t eat wheat because you are allergic. I wanted to teach her that all these kids around might not have her skin but shouldn’t be eating what they are eating anyway. In an attempt to show her that there are other children out there who believe in eating real food that doesn’t come in a box I introduced her to Paleo Parents website. Reading the stories of Cole, Finian and Wesley was eye-opening for Michelle. I recommended that she should write down her experiences and her thoughts and maybe it will make it easier for another child (or adult) to say “No, thanks” to the sugar-in-the-box cereal in the morning or a sugar-in-a wrap snack bar.

So without further ado, here is Michelle:

Before I changed my diet I believed the government which was encouraging the point that wholegrain is best. Now I know otherwise and so does my family.

Nowadays when I go to school I notice a lot more about what my fellow students eat. Everywhere there are children stuffing themselves with chips, cookies, cake and donuts. The healthy options for lunch are a sandwich, a wrap, a bagel or some sort of batter. All my friends ask why I don’t eat like them and they offer some of their food to me because they think I’m missing out. Other children who follow the same diet as I do know how hard it is to skip the temptations, even my parents do.

After I changed my diet I noticed that an average child’s daily meals consist of:

Breakfast: Toast, pancakes or cereal, sometimes sprinkled with malt or sugar

Morning Tea: Packet of chips, brownie, donuts or any other sugar treat with one serving of fruit

Lunch: A sandwich, wrap or bagel/bun with sometimes a chicken schnitzel, low-fat yoghurt, serving of fruit or veg and some more chocolate and lollies

Afternoon tea: cake, biscuits and fruit

Dinner: Pasta, pizza, chicken nuggets, garlic bread with soup

Desserts: Waffles, ice-cream, chocolate and milk

As you can see every meal has at least one serving of wheat or sugar in it. Every day I go to school I yearn to say to my friends: “You shouldn’t eat that, it’s unhealthy”. But I know I can’t do that because nobody will believe me. It is difficult for a child like me to explain the matter that big.

I like the way I eat now because I don’t get “sugar crashes” anymore. I don’t get tired and have naps after school like I used to. I find that when I used to have wheat I was always hungry. Eating cereal for breakfast made me starving before recess, and then lunch. Now eggs and sausage make me full for hours. I also like that I get to try things I would never have tried before which I never thought I’d like.  I even tried chicken hearts once. The other day I tried baby octopus and it is now my #2 dish after osso bucco. I bring prosciutto to school and dare my friends to try it. If I had never changed my diet I would not be enjoying such great food.

We took some photos for you of my average day diet. Hope you like it.

Here is my breakfast.

And my lunch box.

And my dinner.

I also love to have a few squares of 85% cocoa chocolate for dessert.

I hope this helps some children and their parents to make better food choices.

Being active comes naturally if you are well nourished

I do too. Please feel free to share your journey across the muddy water of nutrition, conventional advice and real food in comments. Michelle and I would love to hear yours or your children’s story.

 

 

 

What the @#$! do I feed my child?

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A blackboard used by Albert Einstein in a 1931 lecture in Oxford. Source: Creative Commons

I find maths and science quite soothing. There is something beautiful about straight numbers and clear cut conclusions. You must have already picked up on my love of graphs and diagrams. They got me through med school.

However, once you finish a beautifully straightforward equation or reach a perfectly logical conclusion using an algorithm you hit a little snag. How do you translate all these numbers to real life?

In the last few weeks I have read somewhere around 30+ journal articles on child metabolism alone. The numbers are simple, the graphs are straightforward but as we very well know the applications to child nutrition can be vastly different. For all the parents out there the only biochemical pathway they are likely to be interested in is the one between the fridge and the pantry.

Here is a short summary of my last few slightly dry posts on child metabolism (on conventional advice, BMR, malnutrition and catch up growth) and MY conclusions.

1. Children grow. Therefore children are not in “energy balance” in simple terms. The energy cost of growth is high including both the energy density plus quality nutrients to ensure lean body mass increase.

2. Energy quantity (calories) is important but ultimately you cannot build muscle and bone with broccoli or worse, orange cordial. The quality of nutrients needs to be concentrated to provide more bang for your buck: high nutrient density in a small volume fit for a small stomach.

3. Children regulate their energy needs with their appetite. No calorie calculators required. When the nutrient quality has been addressed the appetite will take care of the rest. If they are hungry they will eat.

4.  Babies, infants and children have less reserves to cope with malnutrition. Even a minor infection may potentially result in muscle loss.

5. Point 4 makes it obvious that it’s not a good idea to put children (=growing bodies) on calorie restricted diets for weight loss.

6. A decrease in activity is a pretty good marker for malnutrition especially for small children. This should give some worried-well parents some confidence, especially where breastfed babies are concerned. If you baby is happy and active it is likely that they are getting enough energy.

7. When children recover from even a minor infection their energy requirements are 4-5 times what they were before. They are going to be very hungry. Feed them. A lot.

8.The period of catch up growth during recovery puts children in a slightly vulnerable metabolic state. They seem more likely to develop insulin resistance (in skeletal muscle), sensitivity to glucose and store abdominal fat.

9. Point 8 makes you think that the post-recovery window is crucial for providing good nutrition for longer term gains. Maybe it is not a good time to provide sweet treats or let children laze around. My thoughts go towards fatty chewable chunks of meat and providing plenty of opportunities for spontaneous activity.

10. My personal way of identifying junk food: if a child is willing to have it after a steak dinner it’s junk. Nobody makes room for more meat or pumpkin when they are stuffed. But there is always stomach space to be found when lollies, cakes, milkshakes and ice-cream are on offer.

The diet recommended by our health authorities always confuses me. I assume (perhaps naively) that they read the same studies and they study the same physiology books. I’m stumped at how they arrive at their conclusions. Today Cancer Council NSW, backed by the Obesity Policy Coalition and the Parent’s Jury, announced the latest villains in the child obesity epidemic: Toucan Sam

and the Paddle Pop lion:

The research by Cancer Council NSW and the University of Sydney found  that 74% of supermarket products adorned with bright cartoon packaging are not up to our healthy nutritional standards. The specific complaints were high-sugar, high-salt and high fat. Apparently the adorable visages of cartoon characters and chiseled jaws of our sporting heroes are just too much for the little kiddies (and their parents) to resist.

“Although stopping short of calling for plain packaging (???) Cancer Council nutritionist Kathy Chapman said regulations around the marketing of foods to children were urgently needed.”

Deep breath. I am not defending sugary cereals. (Not entirely sure how the high-fat monster has slipped into the discussion since the foods in question are mostly low in fat to the point of deficiency. But that’s another matter). In fact, I’m happy to wear a t-shirt: “Friends don’t let friends eat cereal”.  I am more concerned about the whiff of a new scare campaign and propaganda. Plus, when it comes to my own child, I’m the one with a wallet, sorry kiddo.

The second issue is that we rely on these guys for their interpretation of science to tell us which foods are healthy and which are not. I hope we all agree that Froot-Loops are not exactly health food. Nobody buys those because they think that the multiple colours are indicative of the high antioxidant and phytonutrient content. On the other hand Kathy Chapman “welcomes cricketers fronting Weet-Bix” presumably because she thinks that this brand of bland cardboard-like blocks of processed wheat is a healthy alternative. Never mind that most children cover it with malt, sugar, fruit and honey just to make it palatable.

And because the University of Sydney (the home of GI) is involved in this story I’ll throw in a GI reference:

Froot-Loops 69
Weet-Bix 69

Ha.

P.S. I have a very special guest post coming up for you next time. The guest is currently in the middle of the creative process and I am not sure how long before we see the final result. But I know it is going to be something.

Energy vampires and other matters

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In my last post I talked about the inconsistencies and often the sheer stupidity of some of the nutritional advice we hear on a daily basis. One of the readers made a comment ”I don’t understand the point she is trying to make”. Well, actually I’m not trying to send a big message here. My blog is where I write about what I see, comment on it (yes, sarcasm is my way of coping with some of the rubbish) and leave you to make up your own mind. Occasionally I throw a bit of science so you can see where I’m coming from. I do not spend hours doing an exhaustive literature search in Medline (I don’t have that luxury) but I’ve accumulated my fair share of information in the last 8 years of studying science and medicine and especially in the last year of learning about nutrition in particular.  If you see a study that supports some of the things here feel free to send it my way. Ditto if you feel it directly contradicts it.

Anyway let’s get into it. Today we are talking about metabolism in children. This post will be an overview of the basics and probably quite dry and boring. I’ll try to throw in some graphs and cute baby pictures for those who like that kind of thing.

It's been a few years but she still licks her bowl

I love the topic of child nutrition for several reasons. First, I have one of those little people at home so I’m naturally interested in what to feed her. Second, I believe that what you put in your body in infancy and childhood (and possibly even before, in the womb) is going to directly affect your health and size in the future. Third (and favourite), when you talk about child and particularly baby nutrition you take away the so-called “gluttonous sloth” theory of obesity and disease.  It’s ludicrous to accuse a 1 year old of a lack of willpower and laziness, so we are left with the bare bones of nutrition. And more than ever how that little body self-regulates its own nutritional status.

Metabolism (n) – the chemical processes occurring within a living cell of organism that are necessary for maintenance of life.

The Free Dictionary by Farlex

In other words, metabolism is the way your body processes the nutrients you receive with food. It’s tempting to look at food as pure energy but as we know calorie is not just a calorie. Food provides both the energy and the building blocks: 2 components required by each cell to perform its own unique function. In an adult this means you need to take in enough nutrition to provide energy for metabolic processes necessary for pure survival  and also the materials for the continuous repair, regeneration, special circumstances (illness, pregnancy, muscle growth).

In children, one more component is added to the picture = growth. The food they eat has to supply enough energy for basic metabolic processes and activity, building blocks for daily repair and regeneration AND additional intake to allow for growth.

Intake = Basal Metabolic Rate + Activity + Growth

Growth does not just come from extra energy but from extra nutrients required to create/synthesise new tissues. This has a few implications which I want to discuss in more detail later.

What is physical growth? Seems a silly question as this is a phenomenon most of us are very familiar with. We also have an intuitive understanding that different tissues grow at different rates, which accounts for a changed body composition. The body shape transition from a chubby baby to a stocky toddler to a lean pre-teen to the sex-specific changes in adolescence and finally into adulthood is multi-dimensional with unique composition corresponding to each stage.

An average newborn with a weight of 3.0kg (6.6 bs) increases her own weight by over 300% to around 10kgs (22lbs) by the end of her first year. Her brain weight goes from 450-500g to over 1000g in the same period of time, a weight remarkably close to 1400g in an average adult.

If you look at babies’ body composition their perceived chubbiness turns out largely illusionary. The body fat measurements of a newborn average a very svelte 12-15%. The remainder is allocated a name of FFM = fat free mass which consists of organs, muscles, skeletal structure and extracellular fluid. In the table below you can see how body composition changes in the first 18 months: muscle mass and fat mass increase, extracellular fluid decreases. Organ weight increases in proportion to body weight in the first year of life therefore the relative percentage of brain, liver, heart and kidney remain similar.

Adapted from Holliday,1986. ECF = Extracellular Fluid

Basal Metabolic Rate (BMR) in babies is determined mainly by the metabolically active tissues of the brain, liver, kidneys and muscles. The brain activity of a newborn is estimated at a whopping 80% of her BMR, dropping to about 60% through the first year as activity increases and muscle becomes more metabolically relevant.  In addition to organs and muscles there is new evidence that some of the fat mass in babies and children is in form of BAT = brown adipose tissue which is more metabolically active and itself participates in energy expenditure. (Adults have some BAT too but in much smaller quantities).

Distribution of brain, liver and muscle metabolic rates as percentage of total BMR at different body weights (Holliday 1986)

So what have we learned so far?

The energy intake in babies and children has to account for their high relative BMR, allow for activity and also provide the energy for the process of synthesis of new tissues PLUS the energy that is deposited in new tissues.  Once again:

Intake = Basal Metabolic Rate + Activity + Growth *

*For science geeks, I have left out the Diet Induced Thermogenesis for the sake of simplicity and uncertain contribution to energy balance in children

It’s official. Babies and children are energy vampires. This might sound very daunting for the food providers, the parents.  How do you know how much to feed a child to ensure all these processes perform without a hitch? At the same time the growth of most infants follows a fairly predictable pattern. Whether they are breastfed on demand or formula fed by the hour, whether they are weaned onto rice cereal or meat, save for small variations in fat mass their FFM (fat free mass) will be very similar.

Lucky for us, parents, we do not have to hunt around for scientific papers estimating energy expenditure, calculate our child’s activity and measure out every spoonful. Under normal circumstances, babies seem to do quite well without science.

That is when everything goes well. What if it doesn’t? For the first time in human history we are way more concerned with OVERnutrition rather than UNDERnutrition. But it is probably too simplistic to completely separate these two. Next post I will look at malnutrition and the fascinating subject of catch-up growth and what it can teach us about childhood obesity.

More reading:

Veldhuis JD et al 2005 Endocrine control of body composition in infancy, childhood and puberty. Endocrine Reviews 26(1): 114-146

Activity, energy expenditure and energy requirements of infants and children, Proceedings of an IDECG workshop held in Campbridge, USA, 1989

Holliday 1986 Body composition and energy needs during growth. In: Human growth: a comprehensive treatise, 2nd ed. Plenum press, NY 1986

Playing hostage to your child

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I was trying to find a picture of a child gnawing on a bone. But apparently it doesn't send the right message

We have all seen TV footage which normally accompanies the “childhood obesity epidemic” stories. Strangely headless muffin-topped children’s bodies in oversized t-shirts, digging into a packet of chips or clutching an ice-cream, filmed walking out of a fast-food joint with their obese parents. You’ve all seen it, right? This picture is remarkably divisive: some of us come pouring out with indignant accusations (“child abuse”, etc), some shrug off the criticism recognising themselves or friends. Dismissing the unlikely scenario that the parents of the 25% of overweight and obese children in Australia really don’t give a toss about their offspring (let’s work on the assumption that most people love their kids) what do we do?

Whether you are a parent or plan to become one some day you might feel legitimately concerned about how to keep your child out of similar news footage.

You might want to do what any responsible parent would do to find information: google it. A cursory search for “healthy eating for children” has yielded a staggering 19 500 000 results. So far so good: almost 20 million ways to avoid being a weight statistic. Encouraging to see so many experts.

But you don’t have to be a doctor, a nutritionist, an organic biochemist or a passionate Paleo convert to know a thing or two about kids. First, they are small. They have small stomachs, small mouths, small hands and small appetites compared to an adult. Second, they are not just “little grown ups”. They have unique needs for growth and development.

Put these two assertions together: high needs/small appetite. That makes me think that we need something nutritionally dense in a small package. Let’s see what the Healthy Kids Association (a very official looking site) says on the subject.

The Dietary Guidelines for Children and Adolescents in Australia (DGCA) recommends that for best health children should “enjoy a wide variety of nutritious foods”.

Why such concern about variety? Sounds like we are calculating that if we cast the net wide enough, sufficient nutrients will hopefully get inside those little bodies.  Every parent knows that extra food volume equals extra drama at the dinner table. If you put 5 different types of veggies on little Johnny’s plate hoping that one of them fulfills the vitamin C quota you might be setting yourself up for failure. It doesn’t look like we are aiming for the bull’s eye: that small package of condensed nutrition. “Eat a balanced diet” is a nutritional equivalent of sitting on the fence. Let’s find something more specific.

According to the official HealthyKids website (I’m sensing a certain lack of originality here) courtesy NSW Government there are 5 ways for your children to be healthy.

1. Get active each day

Sounds great, albeit oddly contrasted with the mantra of the 19th century: “children should be seen and not heard”.  All those quiet well behaved children back then clearly had a weight problem.

2. Choose water as a drink

In the world where soft drinks (sodas) are the daily norm this statement does not sound bizarre anymore.

3. Eat more fruit and veggies

I’m all for fruit and veggies. But what does “more” mean? More than what? Is the total amount of fruit and veggies per day uncapped? And if I could make an objective assessment that my child does not have “enough” you’d think that I would also work out that she needs “more”.

4. Turn off the TV or computer and get active

I thought we have already covered that one. What if you have a Wii-Fit? Does it count as active? Because I think it requires having the TV on? (we don’t own a Wii-Fit, or Nintendo or X-box  so I’m not sure how it all works). Is doing wii-boxing better than doing none? What about those schools that use Wii instead of sport?

5.  Eat fewer snacks and select healthier alternatives

Spot on. What are the healthier alternatives?

Here is a list from the snack page:

Fruit muffins or slices, baked using monounsaturated or polyunsaturated oils and margarine instead of butter
Fresh, frozen, canned (in natural or unsweetened juice) or dried fruit
Raisin or fruit toast
Toasted English muffins, preferably wholemeal or wholegrain
Reduced fat custard with fruit
Rice crackers or corn cakes
Plain popcorn (unbuttered and without sugar coating)
Muesli and fruit bars – look for the healthier choices or those with the Heart Foundation Tick.
Scones or pikelets (plain, fruit or savoury)
Plain breakfast cereals, such as wheat breakfast biscuits, topped with sliced banana with a drizzle of honey
Snack-sized tub of reduced fat yoghurt (plain or fruit flavoured)
Cubes, slices, shapes or wedges of reduced fat cheese with wholegrain crackers or  crispbread
Potatoes, topped with reduced fat cheese and baked in the microwave or oven.
Corn on the cob
A boiled egg (wow, and I almost lost hope at this point)

Question: since when have desserts become acceptable snack items?

So how much have we learned so far about child nutrition from popular media and health policy providers? Not much. Still clear as mud. More googling unearths the mention of the Food Pyramid, or MyPlate for my American friends. The development of this extremely intricate logo and the accompanying website has so far cost the American Government over $2 million. According to my calculations a nasty fake-meat patty on a “plastic bread” bun topped with flavor-free lettuce and tomato and served with banana milkshake is totally MyPlate-compliant. I can’t wait for an Aussie version. MyPie, anyone?

If you are still unclear on what to pack in school lunch boxes there are also the recommendations on the number of servings. Some recommend 1/2 serve of meat or fish a day, some go for 2-3. I’ve now spent a few hours browsing popular healthy kids sites and I’m still not closer to an answer.

Out of the confusion rises one common pattern. Every child-related website/book/magazine is full of it. It’s that child nutrition is soooooo difficult. Anybody under 18 is represented as a hardcore junk food addict and they will hold your household hostage until you give them that pizza. Here is a few titles and phrases.

Feeding your children is a challenging experience

Tips for fussy eaters

Persevere, keep trying

Ingredients in disguise

Do not ban foods – they will only want them more (Is that how we feel about giving children alcohol as well?)

Constant struggle

How to hide more vegetables in a pie

Snacking challenges in the shops (C’mon, is it really that hard to survive a 2 hr shopping trip without a top-up?)

On the other hand the advice of introducing solids to babies generally includes phrases like “delicate palate”, “bland foods preferred”, “many flavors are too strong”.

How does a baby with a pure clean delicate palate turn into a toddler incapable of staying sane in a confectionary aisle? Shouldn’t a 50 year old have more addiction issues with 50 years worth of bad habits? Let’s not even mention the fact that most toddlers do not own a wallet let alone the ability to navigate a self-serve checkout. Oops, I just mentioned it.

It shouldn’t be this hard. What nutrients are essential for growth? I’m sorry but bagels and peanut butter are not essential.  However after hours of perusing popular health websites a normal and slightly befuddled parent would come to believe that perhaps they are.

They are low-carb, I swear!

Maybe we should stop assuming that our kids cannot survive without muffins, waffles and milkshakes. Stop making “acceptable” healthy substitutes whether it is low-fat/low-carb/Paleo/vegan/gluten free just to avoid a tantrum. Remember Shakespeare? A pancake under any other name…

I know we are parents but do we have to be so damn patronising? Give your children some credit. They might surprise you.

This rant was inspired by my recent research into child nutrition. Next post I promise to bring you some science on this fascinating topic. Trivia question of the day: what is the average percentage of body fat in a newborn?

Gluttonous babies and other nonsense

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Children the way they are supposed to look

One of the highlights of my obstetrics rotation was a tutorial with a lactation consultant. I remember the conversation turning to the link between infant formula and future obesity. A medical student, a very intelligent and industrious girl, who will make a fantastic doctor one day, said: “The reason why infant formula causes future obesity is because a baby feels compelled to finish the bottle which is presented to him or her”. Too many calories and the habit to overeat makes Jack a fat boy. I don’t think this was one of her brightest moments. No judgement, we all have our bad days ( I did miss 4 cannulas today).

Funnily enough, I have heard similar sentiments quite a lot recently. We are all familiar with a “gluttonous sloth” theory of obesity. The cries of our public health authorities to eat EVEN LESS and move EVEN MORE are starting to sound a tad desperate. Considering that we are doing what they are asking us to do (for the analysis of the Australian Measure Up campaign please read here)… I have to admit though, I’ve never imagined that infants and children will cop the same admonishing finger.

The notion of caloric control is subtly penetrating the hitherto untouched area of infant nutrition. If Mummy is encouraged to weigh up her skinless chicken breast portion and count it into her daily caloric regimen, then why not her little baby?

Obviously, anybody who has had any contact with babies and children would know that they are unaware of our adult rules. Trying to stick a piece of meat into the mouth of a struggling toddler is something everybody needs to experience just for the fun of it. Amazingly enough, babies and small children cry and ask for food when they are hungry. Even more amazing is the fact that they will stubbornly squeeze their lips shut and shake their heads when they are full.

Newsflash: Infants say “No” to food when they are not hungry.

That is until their metabolisms are screwed up by foods like infant formula, sweets, fruit juices, biscuits and breads. The innate sense of satiety remains in children even if the bulk of their diet is made up of Coke, chips and lollies. “Do you want another grass-fed lamb chop?” Nope, full belly is displayed for visual confirmation.  ”Do you want some toast with vegemite (for non-Aussies, yes, our children really do love this black sticky yeasty spread)?” More often than not, you’ll get a yes.

As I’m about to publish this, I get the latest post from J.Stanton on satiation vs satiety. Looks like toddlers understand this concept much better than some adults.

So where do the problems start? Let’s say you have gone through the initial hurdles and now breastfeeding on demand, ensuring your baby develops a healthy gut, strong immune system and a smart brain (this bit may or may not come useful later). You may have already started some solids, introducing one food at a time, however the occasional spoonful which actually gets inside is unlikely to add much to overall caloric status.

Since you cannot measure how much breastmilk your baby is having, the secondary indicators of any baby thriving are weight gain, output (what goes in must come out) and energy levels. Here is where hit a second hurdle. To assess growth we use growth charts. How are growth charts designed? By collecting data on height, weight and head circumference from healthy babies, plotting them on a graph and allocating centiles (= equivalent to a bell curve distribution).

Did you know that the majority of growth charts used until recently were collected using the data from artificially fed babies, known to be heavier. Breastfed babies follow a different growth curve: they gain weight faster than the formula-fed in the first 2-3 months and slower afterwards. Breastfed infants remain lighter even AFTER introducing solids.

Both 1977 NCHS and the CDC 2000 growth charts were collected using the data from mostly artificially fed babies. They show higher infant weight and length compared to an average breastfed baby (no difference in head circumference – a surrogate marker for brain development). So a breastfeeding mum goes to her doctor or a nurse for a baby check. While sitting in the waiting room she looks at other babies and compares her own bub’s lean frame to the plump cheeks and fat rolls. The length and weight measurements are taken and shock! horror! the baby is below the 50th centile! The anxious mother then endures a well-meaning interrogation: has your baby been sick recently? is she spending enough time on the breast? are you feeding her when she is hungry or do you ignore the crying? do you smoke, drink alcohol or inject heroin? The anxiety levels are rising… Do I have enough milk? Maybe my breast are too small/too large/somehow inadequate… Aaaargh!

Here is a breastfed growth pattern (red data points) superimposed onto the CDC 2000 growth chart.

Pretty telling. How often do mothers start supplementing with formula, start solids early or add fruit juice when they think their baby is smaller than “should be”?

 In 2006 the WHO has developed new growth charts based on breastfed babies, effectively declaring their growth pattern as the norm, not an anomaly. You need to check which chart your doctor uses.

Another problem with relying on numbers is that it dumbs people down. When you treat people like sheep, they tend to see themselves as sheep. They trust the authorities to tell them what is right and what is wrong and forget to trust themselves. In a normal world preschools wouldn’t have to contact parents to tell them that their kid is overweight. The society seems to have divided into those who recite with relish the latest child obesity statistics and those who are in denial about the size of their little La-a (pronounced [La"dash"a], no kidding, I met one in a kid’s hospital).

So what if you were on a receiving end of that school nurse phone call? You are duly humiliated. Nobody has to accuse you of being a bad parent, most parents will jump to that conclusion themselves. And then they will go looking for answers.

Does my child eat too much? How do I say “No” to the little monster asking for sweets? What are the good healthy snack options?

And here are some healthy snack ideas from the Australian government-run website HealthyKids:

Low fat muffins
Raisin toast topped with banana or strawberries
Bread with tasty fillings such as baked beans
Home-made pizza using pita bread or muffins
Toasted sandwiches
Rice cakes topped with peanut butter or vegemite

Here is an example of a healthy kid-friendly breakfast from the same website.

Don’t forget that the fat which was helping develop a healthy nervous system turns into a heart killer on their second birthday. So low-fat dairy products please.

Of course, the “sloth” side of the coin gets just as much attention. Thankfully nobody has yet accused babies of being lazy. But older kids have been put on notice.

A helpful calorie calculator for children 2 and over has this definition of a Moderately Active (a grade between Sedentary and Active) child: “lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.” 

If you ever meet a toddler who WALKS please let me know. In my experience, little tykes are missing the in-between stage between conscientious block building and running with abandon. Next time I see a calmly walking toddler, I’ll be sure to tell the lucky mum that she needs to increase the activity level to the equivalent (whatever that means) of  over 3 miles a day. Maybe the child can start doing steady laps around the playground while the other kids are engaging in some healthy active play.

Just a few days ago, the chief medical officer of England announced that children under 5 require 3 hours of exercise daily. I imagine baby step classes. How about baby heart rate monitors to measure their caloric expenditure? Disturbing.

I’m not disputing the fact that kids need to be more active (and I’m not talking about Wii Fit). But we have now increased the adult activity recommendations to 1 hour a day most days. Telling adults to exercise doesn’t seem to be working.

Let’s not transfer our own insecurities to our kids. The ridiculous nature of the calorie-in-calorie-out theory looks absurd when applied to children.