Helping our kids live healthy lifestyles

In Jamaica, the trend of increasing obesity rates has been observed to be of epidemic proportions.

With the main cause of “natural deaths” in Jamaica being diabetes, heart disease, hypertension, stroke and cancer, in some studies obesity has been found to increase your risk by 80 times!

Recent studies have revealed that our childhood obesity rates have doubled in recent years.

As of now, half of all Jamaican adults are considered either overweight or obese.

Our nutritional profile has shifted from a diet mainly consisting of whole grains and whole fruits to one that mainly consists of sugary drinks and ultra-processed foods.

The availability and low cost of such foods have contributed to this trend, while our lifestyles have become more centered around electronics, thus our activity level has decreased dramatically.

Helping our kids live healthy lifestyles

As a result of these trends, our children are at an increased risk of developing what were typically thought of as adult diseases, such as: diabetes mellitus (sugar), hypertension (high blood pressure), lipidemia (high cholesterol) and even early onset heart disease.

We, as paediatricians, are now faced with diagnosing and treating children and adolescents for these “adult” illnesses much earlier than expected.

It is critical to understand that if your child or adolescent is overweight or obese now, their risk of being overweight and obese as an adult is quite high, thus increasing their risk of these adult diseases (sugar, pressure, cholesterol, early onset heart disease, heart attack).

Being overweight is also associated with a higher risk of asthma, snoring, sleep apnea and some cancers.

Your child's risk

“Body Mass Index” (BMI) is a calculation between your child’s height and weight.

By plotting this number on a growth curve, it is possible for your doctor to 'predict' with pretty good accuracy who is at risk of being overweight or obese.

• BMI’s that fall between the 85th and 98th percentile are considered “overweight”
• BMI’s above 98th percentile are considered “obese”.

It is helpful now to know your child’s risk and how critical it is to make changes. However, I strongly recommend that all children and families make healthier food choices and exercise more regularly TOGETHER to decrease these risk factors associated with the most common chronic diseases as stated above.

Working as a family

Changing our lifestyles is best done as a whole family; we as parents must be able to model good behaviors.

Singling one child out as “fat” and restricting only their diet is unfair and may make the child feel that they're being punished and in turn create an unhealthy relationship with food.

There is no perfect way of eating for anyone, however, it is important to recognize some of the “pitfalls” of consuming too many calories and the culprit is almost always too much sugar and too many processed foods.

Here are some tips on healthy food choices and lifestyles:

1. Encourage healthy eating and exercise instead of trying to restrict your child’s calories as this can be dangerous. Unless your doctor has advised differently, I am generally not expecting 'weight loss' per se; however, just by changing your child’s diet, you may see the rate of weight gain decrease, which will ultimately decrease the BMI (and its associated risk factors) over time.
2. Limit the consumption of sugary drinks to no more than 4-6oz a day.
   1. Sodas, teas, and juices contain an enormous amount of unnecessary sugar
   2. All-natural, no sugar-added juices or freshly-blended juices should also be limited as the sugar content is concentrated by processing the fruit. For example, 4-6oz of freshly-juiced oranges will generally require the juicing of 4-6 whole oranges. So, it's better to just eat the oranges instead as it’s unlikely your child will consume 4-6 oranges, right?
3. Limit the number of times you eat out as this usually means consumption of fast food, fried food or food that is generally processed and unhealthy.
4. Encourage no screen time while eating. Try and sit down as a family and talk to each other without the TV, tablets or smart phones on. While distracted with these gadgets, your child is less likely to pick up on stomachs cues that they're full.
5. Decreasing screen time in general encourages our children to move more. Studies have shown that kids who spend a lot of time on the screen generally get very little to no exercise, thus increasing the risk of being overweight or obese.
6. Be creative as a family such as taking walks or runs, swimming, playing football or basketball. You do not have to join a gym; just moving/dancing at home provides exercise and encourages healthy lifestyles.
7. Avoid using terms such as “fat” or “weighty”. These have very negative connotations and may bring shame. There is no benefit gained through using these tactics and they often backfire.
8. Consume at least 5 fruits/vegetables daily. Using fruits/vegetables for snacks instead of chips or biscuits will end up with less calorie consumption. Fruits and vegetables that are in season tend to be less expensive, so being mindful around your choices helps to keep within a budget.
9. Drink plenty of water and if your child drinks milk, offer them 1% or skim milk only without any sweeteners or flavored syrups.
10. Replace the white foods (white bread, pasta, rice, crackers, Irish) with brown foods (such as whole wheat bread and pasta, brown rice, sweet potato) as most white foods are ‘simple carbohydrates’, meaning that they convert to sugar in the body quicker, thus leaving you hungry more quickly after eating. When it comes to choosing bread, be sure to look at the label and be sure that it contains 100% whole wheat as enriched wheat is a simple carbohydrate.
11. Provide adequate protein in your child’s diet such as lean meats, fish, eggs or peas/beans and choose “good fats”, such as avocado (pear), olive oil and nuts. Fatty fishes like mackerel, sardine, salmon, or trout also contain “good fats”.
12. Limit the amount of “unhealthy fats” such as butter or margarine, deep fried foods (fried chicken, fries, burgers, nuggets, patty, and chips.) Biscuits, cookies, muffins and cakes also contain a high number of unhealthy fats. These foods may be limited to special occasions only.
13. And lastly, but possibly most importantly... STOP ALL FOOD WARS!!!! As parents, we will never win this struggle! This division of power is a very effective tool in establishing boundaries:
14. • You get to choose what, where and when your child eats and allow them to choose whether to eat.
    • Children eat when they are hungry and stop when they are full.
    • When we quarrel about their choices, offer alternatives or “force” them to eat, an unhealthy relationship around food may develop.
    • If your child chooses not to eat what you offer, that's okay. A developmentally-appropriate child will not starve themselves; however, if you give in by offering them the unhealthy foods they desire, you may never get them to change their eating habits
    • Remind yourself that you are the parent and your child does not get to dictate what foods you offer.

Step-by-step approach

Nobody’s diet/lifestyle is perfect, but by learning about the risks of poor food choices and sedentary lifestyles, we can aim to make changes now that will strongly impact our health later.

Try and take a step-by-step approach as changing eating habits and lifestyles does not happen overnight.

Check in with your doctor regularly to help track progress and give you tips.

And remember, being overweight or obese is nothing to be ashamed of but it is something to be taken seriously as your child’s future health heavily depends on it.